Dental therapist

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A dental therapist is a trained dental professional that is able to perform therapeutic procedures in primary dentition and adult dentition. [1] They are able to perform procedures such as: local anaesthesia, restorations, hygiene maintenance (cleans), extractions and the taking of radiographs.[1] Local dental regulations determine the duties therapists are able to perform. [1] Typically, therapists under the prescription of a dentist are licensed to examine children's teeth, administer restricted techniques of local anesthesia, take radiographs, provide sealants, scaling and cleaning in children.[2] Also restoring primary teeth and vital pulp treatments such as pulpotomies.[3][4][5] [6]

Local dental regulations are constantly changing to include extended duties and exemptions for dental therapists. Each country has their own regulations and guidelines.[citation needed]

Training[edit]

Dental Therapist Training in Australia[edit]

Dental therapists are no longer trained in Australia, and instead Oral Health Therapists are being trained. An oral health therapist is trained as both a dental therapist and a hygienist with a focus on health promotion and disease prevention. [7]

Oral health therapy training occurs at university and therefore completion of secondary schooling to a high standard is mandatory, including certain pre-requisite subjects that differ between states/territories and between the universities that offer the courses themselves. This specific information can be found by following this link … http://www.jobguide.thegoodguides.com.au/occupation/Oral-Health-Therapist [8]

The training differs in each course but the golden rule is that once graduated an oral health therapist can only perform what they have been formally trained in. [7] [8]

Dental Therapist Training in New Zealand[edit]

Development of the Dental Therapists began in New Zealand, they were initially trained as “Dental Nurses” providing preventative and simple restorative care to children aged up to 12 years old. Dental Therapists in New Zealand were employed to treat children at a school dental service including treatment of pre-schoolers. [9]

Dental Therapist Training in United Kingdom[edit]

Dental therapists in the UK are majorly employed into the community dental profession and perform a limited range of treatment. Some of the procedures carried out by UK dental therapists include examinations, taking radiographs, simple fillings, implementing preventative strategies (fluoride application, fissure sealants, oral hygiene instruction) and dental health education [10]

Dental Therapist Training in Alaska[edit]

Dental therapists were first employed in Alaska in 2005 , mostly focused on providing treatment in rural communities. [9]

Dental Therapist Training in the United States[edit]

The united states are increasing employment and training opportunities for dental therapists in order to reduce to the level of need and to increase access to care for Americans. [9]

Responsibilities of a Dental Therapist[edit]

Under the supervision of a dentist, in a private or public setting, a Dental therapist is allowed to examine, prevent and treat oral diseases in pre-school, primary and secondary school children .[11] The following tasks are regularly performed by Dental Therapists.

  • Educate patients, parents, schools and communities about the progression of dental disease, how to prevent dental disease and how to maintain good oral health.
  • Treat patients via giving comprehensive oral examination, dietary advice, help to modify any risk factors for dental disease, give oral hygiene instruction to patient and parent/guardian, remove and fill Dental caries. Extract deciduous (baby) teeth under local anaesthetic, perform Pulpotomy treatment on indicated deciduous teeth, take radiographs of the patient’s teeth, provide Dental sealant protection when necessary, administer fluoride therapy and provide a professional clean.[12]
  • Refer and Communicate - Dental Therapists are able to refer to a dentist when a problem becomes complex, they working with schools, including canteens in recommending healthy options for students and staff. They can give oral hygiene instruction to classes and can communicate with other health care providers ie. Immunisation clinics and maternal health care nurses.[13]

Role within the dental team[edit]

The dental profession involves the study, diagnosis, prevention and treatment of diseases, disorders and conditions involving the oral cavity and surrounding structures.[citation needed]

The dental therapists role in the dental team is the provisions of oral health assessment, treatment, management and prevention for children, adolescents and adults, which is dependent on their training.[citation needed] Dental therapists practice in a team situation alongside a practicing dentist and have a tradition of being part of the dental team primarily to provide dental care to children through school dental services[citation needed] For around forty years in Australia, dental therapists have been practicing alongside dentists providing diagnostic, preventive, restorative and health promotion services to children and adolescents.[14]

Common procedures performed by dental therapists include examination, radiology, local anaesthesia, preparation and restoration of carious lesions, pulpal therapies, extraction of deciduous teeth and preventive therapies such as fissure sealants and fluoride application. [14] Oral health education and promotion also plays a large part in the dental therapists role. [14]

History[edit]

In 1913, the then President of the New Zealand Dental Association, Dr Norman K Cox proposed a system of school clinics operated by the state and staffed by 'oral hygienists' to address the dental needs of children between the ages of 6 and 14 years. At the time the idea was considered too unorthodox but in 1920, at a special meeting of the New Zealand Dental Association, 16 members voted for the adoption of school dental nurses with 7 opposed to the proposal. School dental nurses were to provide diagnostic and restorative services to children '...in a rigidly structured set of methods and procedures which spare her the anxiety of making choices'. [15]

In Great Britan, during the first world war, 'dental dressers' were used to carry out examinations and treatment for children in parts of England. Their role however, was eliminated by the Dentist Act of 1921 because of hostility to the role on the part of the dentist profession. They were later re-introduced, on the strength of the New Zealand scheme, as dental therapists when the high dental needs of children were 'rediscovered' in the 1960's, carrying out similar services but under the prescription of a dentist who carried out the examination and care plan.

School dental services based on dental therapists were also established in other countries including Canada, South Africa, the Netherlands (temporarily), Fiji, Hong Kong, Malaysia and the Philippines and in 2000, 28 countries around the world utilised dental therapists.

By country[edit]

In the UK a dental therapist working from a prescribed treatment plan can treat children and adults, with direct restorations, periodontal and oral hygiene treatment and extraction of deciduous teeth. They can also place pre-formed stainless steel crowns on deciduous teeth. They can apply medicaments listed by the General Dental Council and administer local anaesthetic by infiltration, intrapapillary, intraligamentary and inferior block techniques. Dental therapists can work independently and outwith the supervision of a dentist. Training is usually by dual diploma in dental hygiene and dental therapy but a few dental schools offer full degree training in combined hygiene/therapy. Therapists trained in the UK can work in the NHS and privately or work in the hospital and community service.[citation needed]

In the United States certain states (Alaska and Minnesota) allow dental therapists to practice basic dental procedures under the supervision of a dentist. Also the duties that dental therapists allowed to practice in Alaska are very different than those in Minnesota. Alaskan dental therapists are taught in Washington state and Bethel Alaska. They can only practice on tribal rural areas. An October 2010 evaluation of the Alaska dental therapists found that they provide safe, effective and competent care.[citation needed]

In Canada dental therapists may practice basic dental surgical procedures only in certain communities and only under the supervision of a dentist.[citation needed]

In Australia and New Zealand, therapists mainly work for state government (public clinics) and school dental programs, treating children's teeth but are increasingly becoming employed in the private sector. In Australia, the scope of practice varied in each state and was set by a statewide board. However, all state boards have joined a nationwide Dental Board of Australia. Due to this, the new scope of practice for therapists in Australia has been set so that a therapist may practice any procedure in which they have been formally trained in and are competent in.[citation needed]

In Sri Lanka a dental therapy program was developed by New Zealand trained dental therapists as a result of the Colombo Plan. Dental therapists are allowed to work in school based clinics and maintain the dental hygiene in young Sri Lankans.[citation needed]

See also[edit]

References[edit]

  1. ^ a b c http://adohta.net.au/doc.php?doc_id=91&op=Download&file_id=file1.
  2. ^ http://www.dentalboard.gov.au/documents/default.aspx?record=WD13%2F10571&dbid=AP&chksum=iHFEYJZz1Z66SUAczlYq2Q%3D%3D.
  3. ^ http://www.surgeongeneral.gov/library/oralhealth/index.html (accessed August 25, 2010)
  4. ^ Nash DA, Nagel RJ, “A Brief History and Current Status of a Dental Therapy Initiative in the United States,” J Dent Ed 69(8):857-859, 2005.
  5. ^ http://www.law.duke.edu/shell/cite.pl?24+Alaska+L.+Rev.+105 (accessed August 25, 2010)
  6. ^ Bolin KA, “Assessment of Treatment Provided by Dental Health Aide Therapists in Alaska - A Pilot Study,” J Am Dent Assoc 139(11):1530-1535,2008.
  7. ^ a b Australian Dental Association. "Education and Training". Australian Dental Association. 
  8. ^ a b Aust Govt Dept Education. "Job Guide - OHT Australia". Australian Govt Dept Education. 
  9. ^ a b c Nash DA, Friedman, J. W., Kardos, T. B., Kardos, L. R., Schwarz, E., Satur, J., Berg, D. G., Nasruddin, J., Mumghamba, E. G., Davenport, S. E., and Kentucky, N. R. Dental therapists: a global perspective. International Dental Journal. 2008;58:61-70.
  10. ^ Gibbons, D. E., Corrigan, M. and Newton, J. T. (2000). The working practices and job satisfaction of dental therapists: findings of a national survey. British Dental Journal, 189(88), 435-438.
  11. ^ http://www.ada.org.au/dentalprofessionals/therapist.aspx
  12. ^ https://www.adansw.com.au/Careers/Dental-Therapist.aspx
  13. ^ https://www.adansw.com.au/Careers/Dental-Therapist.aspx
  14. ^ a b c Satur, Julie; Gussy, Mark; Marino, Rodrigo; Martini, Tamsin, (2009), "Patterns of Dental Therapists Scope of Practice and Employment in Victoria, Australia", Journal of Dental Education, 3(73), pg. 416-425.
  15. ^ Satur, Julie (2009), "The development of the dental therapy profession", Cited from http://adohta.net.au/contents_uploads/file/Dental_Therapy_History.pdf 15/12/2013

External links[edit]