From School-Based to Community-Based Oral Health Services for Children – Recent Changes in the Provision of Oral Health Services within the Southern District Health Board

Abstract

Introduction: Introduced in 2006, ‘Good Oral Health, For All, For Life’ is New Zealand’s current oral health policy; this outlined the future direction of public dental service delivery in New Zealand. In this document, the reorientation of public dental services was forecast. This research examines the reorientation of public dental services: the change from the School Dental Service to the Community Oral Health Service in the Southern District Health Board region of New Zealand. Three perspectives were sought to gather evidence on the reorientation: stakeholders, dental therapists and parents/legal guardians of children attending the public dental service provided an account of their experiences of the reorientation.

Methods: Six stakeholders, eight dental therapists, and eight parents/legal guardians participated in semi-structured interviews. These interviews were audio-recorded and conducted via face-to-face and telephone interviews. The Donabedian Framework for quality assurance in health services was used to frame the semi-structured interview schedule, and to organise and analyse the information collected. The recorded interviews were transcribed and analysed using qualitative thematic analysis.

Results: The reorientation process gave rise to unique experiences of change. Stakeholders implemented oral health policy and managed change. Dental Therapists coped with change and kept the public dental services functioning for the child patients and their families. The Parent/Legal guardian participants were unaware of changes to the public dental service, and were satisfied with services from dental therapists.

Conclusion: The reorientation of the School Dental Service to the Community Oral Health Service impacted each group of participants differently. Stakeholders managed change, dental therapists coped with change and the parent/legal guardian participants did not notice a change until they arrived at their child’s scheduled dental appointment and noticed a new dental facility, or a different location from the last visit they had. The three perspectives of a time of change display the complexities of implementing oral health policy in a public dental service.

Key words: reorienting oral health services, public dental services, and public oral health policy implementation.