1. Dental Therapy The New Zealand Scene
Dr Lyndie Foster Page
BSc BDS MPH
Dental Public Health Specialist
Taranaki District Health Board
New Zealand

3. New Zealand 4 million people 1.5 million in Auckland
Māori people are the tangata whenua (indigenous people)
15 percent of the NZ population
24% of 0-14 are Maori

5. History
NZ government noted the appalling state of soldiers teeth in WWI
Survey showed 90% of NZ’s children required dental care
Introduced trained women into primary schools to educate children and families on healthy living and nutrition and provide treatment
World first
1921 SDS began with “dental nurses” entering the workforce 2 years later
Teachers spent more time on dealing with children in pain than teaching

6. School Dental Nurses

7. Presently HPCA Act 2004 Therapists registered
Workforce shortage nationally
Employed in public sector
Facilities not meet standards to practice
modern day dentistry
Increase in wages and professional status
Review of child and adolescent oral health

8. 1990–2004 Prevalence of Decay Percentage Decay Free

9. 1990-2004 Severity of Decay Decayed, Missing, and Filled Teeth

10. Access Outcomes
5-year-olds nationally 95-99% seen annually till year 8 of school
Early enrolment
Projects running to improve preschool access to Maori and low-SES families
Data analysed at ethnicity/SES/fluoride exposure level
2003 Public Health Advisory Committee report showed that the SDS reduces oral health inequalities but they return in the early 20s
Reduced acute sequelae from early enrolment, early detection, prevention and intervention when needed
Data between the 5-year-olds and 12-year-olds showed reduced ethnic and socioeconomic gradients, illustrating the effectiveness of school based services in improving children’s oral health and reducing oral health inequalities

11. Dental Therapy Training
Two training institutes in NZ
AUT University
Bachelor of Health Sciences in Oral Health 2002
Bachelor of Health Sciences in Oral Health 2006 (hygiene/therapy) intake numbers doubled
Plan to introduce Adult Scope into degree in future
University of Otago
Diploma in Dental Therapy
Bachelor of Health Sciences (Dental Therapy) 2002
Bachelor of Oral Health 2007 (hygiene/therapy)

12. Safety Therapists were not registered until 2004
PDO (dentist) was responsible for standard of care prior to this date
No cases against PDO’s and only one case of a therapist’s standard of care has been investigated but not pursued
Complaints occur with any health professionals
DCNZ national competencies for therapist to ensure ongoing high standards of care
Currently therapists

13. NZ Dental Therapy Scopes of practice DCNZ
Subset of the practice of dentistry
Commensurate with a dental therapist’s approved education, training and competence
Provide oral health assessment, treatment, management and prevention services for children and adolescents up to age 18
Disease prevention and oral health promotion and maintenance are core activities
Dental therapists and dentists have a consultative working relationship which is documented in an agreement

14. My Role Clinical governance and support
Continuing professional development
Clinic visits
Health promotion/prevention
Dental advisor for DHB
Ministry of Health steering group for improving oral health for children
Hospital Clinician
20 therapist 3 adult scope

15. Future in NZ Joint dental therapy and hygiene degree
Adult scope of practice
Working in private/public
More Maori/Polynesian and male therapists
Team working environment
More involved in public health policy

17. Thank you