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Attitudes of New Zealand Dentists, Dental Specialists and Dental Attitudes of New Zealand IN BRIEF • Provides an understanding of why New Zealand dentists/specialists may or may RESEARCH dentists, dental specialists not wish to employ Oral Health (OH) (dental hygiene/dental therapy) graduates and how this compares to the UK. • Increases awareness of the scopes of and dental students towards practice for New Zealand OH graduates and their legal requirements to practise. • Informs dental workforce planning in employing dual-trained New Zealand. Oral Health graduates S. Moffat1 and D. Coates2 Aims To determine the attitudes of New Zealand dentists and dental specialists towards employing dual-trained Oral Health (dental therapy/dental hygiene) graduates, their knowledge of the scopes of practice and practising requirements for Oral Health (OH) graduates, and the barriers to employment of these graduates. Materials and methods A postal questionnaire was sent to 600 dentists randomly selected from the Dental Council of New Zealand register, as well as all dental specialists on the register. All fifth-year dental students in 2008 were also surveyed.Results The response rates for the questionnaires were 66.8% for dentists, 64.5% for dental specialists (specialists) and 72.9% for dental students. Knowledge of the scopes of practice and practising requirements for OH graduates was limited in some areas. Fifty-nine percent of private dental practitioners (PDP dentists) and 53% of specialists would consider employing an OH graduate. The main reason given for not employing an OH graduate was insufficient physical space in the practice.Conclusion New Zealand dentists and dental specialists were receptive to employing OH graduates. Knowledge of the OH scopes of practice and practising requirements is likely to improve as more OH students graduate and start work. The OH graduates have the potential to make a valuable contribution to the dental team. INTRODUCTION in separate courses. In 1999, dental ther- dental therapists in the New Zealand SDS. New Zealand has been educating den- apy education moved from a polytechnic New Zealand hygienists have usually tal therapists (formerly known as dental course to the University of Otago. Dental worked part-time and in more than one nurses) since 1921. Dental therapists were hygiene education followed, moving from practice. With dual-trained graduates also traditionally employed in the public sec- the Otago Polytechnic to the University of being able to work in dental therapy, this tor, primarily in the School Dental Service Otago in 2001. The University of Otago may reduce the availability of hygienists (SDS). Since the Health Practitioners initially offered separate two-year diploma for private practice. Competence Assurance Act (2003), den- courses for hygiene and therapy; however, tal therapists can now also legally work it then introduced a three-year degree AIMS in private practice. Dental hygiene prac- programme for each in 2002. In 2002, the This study aims to: (1) determine whether tice has a shorter history in New Zealand. Auckland University of Technology (AUT) New Zealand registered dentists and spe- Although the New Zealand Army had also initiated a three-year dental therapy cialists would employ a dual-trained OH trained dental hygienists since 1974, it was degree, and then established a three- graduate and how they would utilise not until 1994 that a dental hygiene course year dual-degree in Oral Health (OH) in this employee; (2) explore the barriers to was established to train dental hygienists 2006. The University of Otago introduced employing a dual-trained graduate; and outside the Army. In New Zealand, the its dual-degree OH programme in 2007. (3) investigate dentists’, specialists’ and majority of dental hygienists work with OH students now graduate with both the fifth-year (final year) dental students’ dentists in private practice.1,2 dental therapy and dental hygiene scopes knowledge of the dual-trained practi- Until 2006, New Zealand dental thera- of practice and register with the Dental tioner’s practice and the associated legal pists and dental hygienists were educated Council of New Zealand (DCNZ) as a dental requirements. therapist and/or a dental hygienist.1,2 Although OH graduates are now enter- MATERIALS AND METHODS 1*Head of Dental Therapy, 2Assistant Research Fellow, ing the dental workforce in New Zealand, Ethics approval was obtained from the Department of Oral Sciences, Faculty of Dentistry, Uni- versity of Otago, P.O. Box 647, Dunedin, New Zealand the implications for the workforce remain University of Otago ethics committee. The *Correspondence to: Ms Susan Moffat unclear. There has been concern that now sample comprised 600 dentists, randomly Email: [email protected]; Tel: +64 3 479 7047 dental therapists are able to work in pri- selected from the DCNZ register, and all 220 Online article number E16 vate practice, and with the OH graduates registered dental specialists. All 70 fifth-year Refereed Paper - accepted 21 July 2011 DOI: 10.1038/sj.bdj.2011.870 also being able to work as hygienists, this dental students at the University of Otago ©British Dental Journal 2011; 211: E16 may exacerbate an ongoing shortage of in 2008 were also surveyed. Questionnaires BRITISH DENTAL JOURNAL 1 © 2011 Macmillan Publishers Limited. All rights reserved. RESEARCH were mailed to the dentists and specialists; the students received theirs in their Dental Table 1 Characteristics of PDP dentists and specialists School mail boxes. Respondents were entered PDP dentists Specialists Characteristic into a random prize draw. Information was n (%) n (%) sought on the general characteristics of Sex respondents and their practices, their knowl- Female 101 (30.4) 32 (23.5) edge of the dental hygiene/dental therapy scopes of practice and legal requirements for Male 231 (69.6) 104 (76.5) practice, and whether they would employ a Age dual-trained OH graduate. Responses were Up to 40 yrs 126 (38.0) 29 (21.3) analysed using the Statistical Package for the Social Sciences (SPSS, version 17 41‑54 yrs 142 (42.8) 63 (46.3) Chicago Il, USA). Associations between cat- 55 yrs or above 64 (19.3) 44 (32.4) egorical variables were tested for statistical Practice type significance using the Chi-square test with the alpha level set at 0.05 and 0.01. Other 0 (0.0) 53 (39.0) Private practice 332 (100.0) 83 (61.0) RESULTS Number of dentists in practice The response rates were 66.8% for dentists, 64.5% for specialists and 72.9% for dental 1 69 (20.8) 36 (28.6) students. Of the 390 dentists, 58 identified 2‑3 186 (56.0) 54 (42.9) that they worked within one or more of the 4+ 77 (23.2) 36 (28.6) following: teaching institution (11); public health dentist within the SDS (5); hospi- Number of hygienists in practice tal dental department (29); Māori health 0 185 (55.7) 84 (65.1) provider (3); or other (15). Subsequent 1+ 147 (44.3) 45 (34.9) analyses for the dentists are restricted to the remaining 332 private dental practi- Number of therapists in practice tioners (PDP dentists). The characteristics 0 316 (95.2) 97 (75.2) of the PDP dentists and specialists are pre- 1+ 16 (4.8) 32 (24.8) sented in Table 1. Most PDP dentists and specialists were male, in the 41‑54 year TOTAL 332 (100.0) 136 (100.0) age group, and worked in practices of two For specialists, the number of dentists in practice has 10 missing values, while the number of hygienists and number of therapists in practice have 7 missing values each. to three dentists. They were more likely to work in practices that employed den- tal hygienists than dental therapists. The 70 majority of dental students were female 60 (66.7%) and aged 23 years or less (64.7%). If respondents answered 80% or more 50 80% or more questions of the questions correctly on the scopes of on scopes of practice practice in which dual-trained OH gradu- 40 correctly answered ates can register, they were considered to 5 or more statements on practising requirements ercentage 30 have a good knowledge of these scopes P correctly answered of practice (Fig. 1). Only 44.2% of PDP 20 dentists answered 80% or more of these questions correctly, while 50.8% of spe- 10 cialists answered the questions correctly. Specialists were more likely to answer 0 correctly if their practice had an adoles- PDP Dentists Specialists All dentists 5th year surveyed dental students cent contract, employed dental hygienists, or if they were in a practice with four or Fig. 1 Knowledge of scopes of practice and the legal requirements to practise for registered Bachelor of Oral Health graduates more dentists (p <0.05). Dental students answered less well, with only 36.0% being able to answer 80% or more questions accident compensation, construct and fit Participants were also given statements correctly. Questions most often answered mouthguards, do pin-retained amalgam on the DCNZ registration requirements for incorrectly by all groups included whether restorations, remove sutures, or carry out practising as a dental therapist or dental OH graduates could register patients for a pulpectomy for a primary tooth (Fig. 2). hygienist in New Zealand. Identifying 2 BRITISH DENTAL JOURNAL © 2011 Macmillan Publishers Limited. All rights reserved. RESEARCH five out of eight statements as correct PDP dentists Specialists 5th year dental students indicated that respondents had a good 100 knowledge of these requirements (Fig. 1). 90 60.1% of all PDP dentists and specialists 80 surveyed (n = 526) were able to identify 70 five or more statements correctly. The 60 statements most likely to be identified as 50 correct were ‘registered dental hygienists 40 ercentage correct treat patients in a team situation with P 30 clinical guidance provided by a registered 20 dentist’ (81.3% correctly scored as true) 10 0 and ‘registered dental therapists practise s independently regardless of the age of the ciduous) tooth* patient’ (78.5% correctly scored as false).
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