The role of the dental therapist in New Zealand's public health system
Tane, Helen Rose
This study examines aspects of how dental therapy began and developed, since it was introduced as one of the first public health occupations in New Zealand, in 1921. Dental therapy began as dental nursing, and was introduced by visionary dentists in order to treat widespread dental disease within the New Zealand population. The occupation gained international recognition. Dental nurses performed their tasks under the direct supervision and direction of a public health dentist and the occupation was restricted to females and child-patients. Investigating issues that have influenced the development of dental therapy is critical in today's climate. Background research in the thesis reveals an interplay of issues relating to gender, professional development and measures of how successful the occupation has been in relation to oral health need. The latter is particularly questionable for our indigenous people in New Zealand. How has the role of the dental therapist in New Zealand been utilised? Has the delivery of care been based on sound knowledge and dental need? Has the role progressed in order to provide effective and appropriate care within a publicly funded system? These issues are important issues, particularly when New Zealand's dental therapy profession becomes one of the many health professions that will be affected by the new Health Practitioners Competence Assurance Act when it is implented over the following year. In order to improve oral health for the population, it is vital that the dental therapist is appropriately and effectively utilised. How oral health workers perceive the past role and future role in achieving oral health gain is investigated in this study by using interviews and postal surveys, and the results are discussed. The findings show that the dental therapist has not always been utilised and developed using sound epidemiological evidence. Elements of professional protection by the dental profession coupled with depleted health funding rather than dental need have appeared as driving factors. Furthermore, the dental therapy profession has remained in a sub-ordinate role to the dental profession. The findings of this study show that a large number of the current dental therapy workforce do not feel that they are ready to provide dental care autonomously. Information in the thesis argues that past legislation and subordination to the dental profession has largely affected the development of dental therapy, and whether this has always assisted in improving oral health for the New Zealand population is questioned in this work. With a depleted number in the workforce, the role has become focussed on a reparative form of care, not one that promotes and improves oral health. This is not acceptable in a publicly funded system. Implementing changes to the dental therapy role must be undertaken, but undertaken with caution and based on progressive health-promoting ideology.
Degree Name: Master of Public Health
Degree Discipline: Dunedin School of Medicine
Publisher: University of Otago
Keywords: dental assistants; dental hygienists; public health; Maori; dental care
Research Type: Thesis