Public awareness and social acceptability of dental therapists

Abstract: Objectives: To investigate public awareness and the social acceptability of the use of dental therapists in dental care. Method: A telephone survey of a representative quota sample of 500 adults (>18 years of age) in South Yorkshire, England. Results: Fifteen per cent of participants were aware of dental therapists as a professional group, of whom only three people correctly identified their ‘permitted duties’. Those without problems of access to care were more likely to report awareness (P < 0.05). Fifty‐seven per cent were willing to receive simple restorative treatment from a therapist, with acceptability predicted by being younger [OR 1.016 (95% CI: 1.015–1.017)] and having a perceived need for treatment [OR 1.301 (1.053–1.607)]. Fewer were willing to allow a therapist to restore a child’s tooth (47%, P < 0.001, test for paired proportions) with acceptability predicted by being younger [OR 1.016 (1.015–1.017)] and being an irregular attender at the dentist [OR 1.309 (1.138–1.697)]. Forty per cent of participants expected to pay less for treatment provided by therapists with the acceptability of equal costs predicted by having access to care [OR 1.346 (1.017–1.781)]. Conclusion: These findings have implications for the use of dental therapists. They question patients’ and the public’s ability to provide informed consent for the treatment provided by them and identify a need for education of the public on the training and competence of therapists and the rationale for employing skill‐mix in dentistry.     

An analysis of complaints against Victorian dental care providers 2000-2004

BACKGROUND: There are little data available on the number and type of complaints made against dental care providers in Australia, despite anecdotal reports of an increasing trend in health-related complaints and litigation. METHODS: Data were obtained from the Dental Practice Board of Victoria on complaints received between July 2000 and December 2004. RESULTS: There were 651 complaints against all dental care providers in the study period, which equates to a rate of 4.1 complaints per 100 dental care providers per year. Dentists were responsible for 490 of the complaints, with 66 complaints against dental prosthetists and 43 complaints against dental specialists. There were very few complaints against dental therapists and students, and no complaints against dental hygienists, with 47 complaints against unregistered people or institutions. CONCLUSIONS: This study found that there was a relatively low rate of complaints made against dental care providers in Victoria, with most occurring against dentists in private practice in Melbourne. Less that 10 per cent of complaints resulted in an adverse finding against the dental care provider.     

Developing and deploying a new member of the dental team: a pediatric oral health therapist

There are inadequate numbers of dentists able and willing to treat America's children, specifically children from low income and minority populations. This has led to the well-publicized disparities in oral health among children. In the early part of the 20th century New Zealand faced a significant problem with oral disease among its children and introduced a School Dental Service, staffed by allied dental professionals with two years' training in caring for the teeth of children, "school dental nurses." A significant number of countries have adopted the model. This article reviews the history of attempts to develop such an approach in the United States. It advocates for the development and deployment of pediatric oral health therapists as a means of addressing the disparities problem that exists in America with such individuals being trained in children's dentistry in a two-year academic program. The article asserts that adding a pediatric oral health therapist to the dental team is one way in which the profession of dentistry can fulfill its moral obligation to care for the oral health of America's children and ensure that all children are treated justly. Recently, the American Association of Public Health Dentistry promulgated a strategic plan that endorsed such an approach.     

Chronicling the dental therapist movement in the United States

There have been three attempts to introduce dental therapists (DTs) to the US dental workforce. This account will review early failed attempts to develop DTs, the recent successful Alaska initiative, the Minnesota legislature's authorization of DTs, state dental associations' deliberations on therapists in the workforce, and the efforts of national advocacy groups, foundations, and state legislatures to promote workforce innovation. It concludes with a discussion of the opposition to therapists from elements of organized dentistry.     

Job satisfaction among dental therapists in South Africa

Objectives: This article forms part of a larger research project on the dental therapy profession in South Africa. The objective of this study was to determine the level of job satisfaction among dental therapists trained at one South African university. Methods: This study was conducted using the qualitative research approach, where purposive and convenience sampling was used to select interviewees. They were asked a single question: “Do you think that dental therapists in South Africa are satisfied within their present careers?” The narrative data was interpreted using thematic analysis, and the data was validated by using the markers of trustworthiness. Results: All stakeholders believed that dental therapists trained at this university were not satisfied in the private and public sectors. In the private sector, they expressed frustration with their limited scope of practice. In the public service, lack of posts, poorly functioning dental facilities, and inadequate remuneration caused high levels of dissatisfaction. Many dental therapists chose this profession as a stepping stone to dentistry. Conclusions: The roles and scope of practice of all members of the oral health team needs to be redefined within the context of the primary health care approach. Universities need to recruit students appropriately to fulfill their role within this team. Dental services in the public sector need to be upgraded to meet the oral health needs of the country.     

Radiographic interpretation and treatment decisions among dental therapists and dentists in Western Australia

All dentists and dental therapists employed in the Community Dental Services in Western Australia were invited to participate in a questionnaire study to find out about their use of radiographs and opinions and knowledge about the diagnosis of approximal caries. Replies were received from 45 dentists (95.1%) and 207 dental therapists (84.0%). Most dentists would not restore a lesion before it appeared on radiograph to have reached the dentine, while therapists were more likely to consider a restoration for a lesion just in enamel. Sixty percent of all respondents thought that a cavity was present when the radiographic lesion was confined to enamel. Fifty-seven percent of dentists thought that an average lesion took at least 12 months to progress from outer enamel to dentine, while a majority of dental therapists thought this would take less than 12 months. Radiographs were not frequently taken by the participants. Operators' opinions about cavity formation were the most important predictor of choice of treatment. In general, these participant's responses were similar to those provided by Norwegian and Dutch respondents in similar surveys conducted 5-6 yr ago, but the present participants worked in an optimally fluoridated area and might therefore have been expected to have adopted more cautious criteria for restorative treatment. Differences between dentists and dental therapists were generally not great. The results suggest that calibration of the operators in the service would offer benefits.     

Complaints about dental practitioners: an analysis of 6 years of complaints about dentists,dental prosthetists,oral health therapists,dental therapists and dental hygienists in Australia

Background

Previous research has found dental practitioners at elevated risk of complaint compared with other health professions. This study aimed to describe the frequency, nature and risk factors for complaints involving dental practitioners.

Methods

We assembled a national dataset of complaints about registered health practitioners in Australia between January 2011 and December 2016. We classified complaints into 23 issues across three domains: health, performance and conduct. We compared rates of complaints about dental practitioners and other health practitioners. We used negative binomial regression analysis to identify factors associated with complaints.

Results

Dental practitioners made up 3.5% of health practitioners, yet accounted for approximately 10% of complaints. Dental practitioners had the highest rate of complaints among fourteen health professions (42.7 per 1000 practitioners per year) with higher rates among dentists and dental prosthetists than allied dental practitioners. Male practitioners were at a higher risk of complaints. Most complaints about dentists related to treatments and procedures (59%). Around 4% of dentists received more than one complaint, accounting for 49% of complaints about dentists. In 60% of closed cases no regulatory action was required. Around 13% of complaints resulted in restrictive actions, such as conditions on practice.

Conclusion

Improved understanding of patterns may assist regulatory boards and professional associations to ensure competent practice and protect patient safety.