A review of the global literature on dental therapists.

OBJECTIVE: Access to adequate oral health care is deficient in many parts of the world. Many countries are now using dental therapists to increase access, particularly for children. To inform the discussion on dental therapists in the workforce, particularly in the United States, the W.K. Kellogg Foundation funded a review of the global literature to identify as many documents as possible related to the practice of dental therapists since the establishment of the School Dental Service in New Zealand in 1921. METHODS: Consultants in each of the countries considered to have a substantive literature on dental therapists were asked to participate in the research; seventeen in total. In addition to identifying and reviewing published articles, a focus of the research was on identifying 'gray' documents. Standard databases were searched for key words associated with dental therapists. In addition, searches were conducted of the governmental and dental association websites of all countries known to have dental therapists in their oral health workforce. RESULTS: Fifty-four countries, both developing and developed, were identified where dental therapists are members of the workforce. Eleven hundred documents were identified from 26 of these countries, with over 2/3 of them cited in the published monograph. Reliable evidence from the related literature and verbal communication confirmed the utilization of dental therapists in an additional 28 countries. Thirty-three of the countries were members of the Commonwealth of Nations, suggesting a mechanism of spread from New Zealand. Variable lengths of training/education existed for dental therapists with the tradition being 2 years postsecondary. In a few countries, the training of therapists and hygienists is now being combined in a three academic year program. Historically, dental therapists have been employed by government agencies caring for children, typically in school-based programs. Initiatives in some countries allow limited care for adults by dental therapists with additional training. CONCLUSIONS: The evidence indicates that dental therapists provide effective, quality, and safe care for children in an economical manner and are generally accepted both by the public and where their use is established, by the dental profession.

Dental therapists and dental hygienists educated for the New Zealand environment.

New Zealand has a long history of dental care provided by school dental nurses, now known as dental therapists. The nature of their training courses, although delivered in different centers, had remained relatively constant until 1999 when educational responsibility was transferred to the universities. Dental hygienists were not trained in New Zealand until 1994, with the exception of the New Zealand Army hygienists. Since 2001, the education of both dental therapists and dental hygienists has been the responsibility of the universities. Significant and progressive changes in educational delivery have occurred since then, which have culminated in three-year degree qualifications for dual-trained oral health professionals. Factors influencing this change included increased professionalism associated with the new legislative requirements for registration, workforce shortages, and enhanced educational and clinical practice requirements. The Bachelor of Oral Health degree at the University of Otago has an added emphasis on social sciences and incorporates aspects of learning relating to New Zealand's cultural heritage. We explore in this article the rationale for the introduction of a Bachelor of Oral Health in New Zealand and how it is designed to equip graduates as professionals in oral health.

Dental therapists: a global perspective.

In 1921, New Zealand began training school dental nurses, subsequently deploying them throughout the country in school-based clinics providing basic dental care for children. The concept of training dental nurses, later to be designated dental therapists, was adopted by other countries as a means of improving access to care, particularly for children. This paper profiles six countries that utilise dental therapists, with a description of the training that therapists receive in these countries, and the context in which they practice. Based on available demographic information, it also updates the number of dental therapists practising globally, as well as the countries in which they practice. In several countries, dental therapy is now being integrated with dental hygiene in training and practice to create a new type of professional complementary to a dentist. Increasingly, dental therapists are permitted to treat adults as well as children. The paper also describes the status of a current initiative to introduce dental therapy to the United States. It concludes by suggesting that dental therapists can become valued members of the dental team throughout the world, helping to improve access to care and reducing existing disparities in oral health.