Professionalism by proxy: a case for the formal regulation of dental assistants in Australia.

Dental assistants are the most numerous member of the dental team in Australia, responsible for many clinical and non-clinical duties. Despite this, dental assistants are not registered and regulated in the same manner as their clinical colleagues within the dental profession. In this article, the authors argue that this is an unacceptable situation within the Australian dental context. In the examination of events within the profession both within Australia and overseas, it becomes apparent that this is an untenable position with regards to promoting the safety of the public. The current stance towards dental assistants is often perpetuated by a dental profession whose motives would not seem to be free from issues of professional dominance. Dental assistants may also be an essential division of the dental profession in providing culturally competent, economically viable and sustainable oral healthcare to those communities that are traditionally difficult to access.

The Making of a Health Profession: A South African Case Study.

The judgment by the Supreme Court of Appeal of South Africa in South African Dental Association v Minister of Health [2015] ZASCA 163 concerns a seemingly technical question about the statutory professional recognition of dental assistants, and therefore provides an opportunity for a legal-historical analysis of how a health/medical profession is "made". The primary locus of this article is South Africa. However, the value of the analysis is not confined to jurisdictional boundaries, as the reader is invited to reconsider how and when a vocation or occupation becomes a profession. The underlying question of professionalisation, incidental to the Supreme Court of Appeal's reasoning, informs and guides an important debate with relevance not only for the parties before the Court, but also for the contemporary notion of professional practice. It is argued that the power of professionalisation deserves to be demystified in order to make legal sense and to affect legitimacy and trust in the eyes of the public at large.

Extending dental nurses' duties: a national survey investigating skill-mix in Scotland's child oral health improvement programme (Childsmile).

BACKGROUND: Childsmile is Scotland's national child oral health improvement programme. To support the delivery of prevention in general dental practice in keeping with clinical guidelines, Childsmile sought accreditation for extended duty training for dental nurses to deliver clinical preventive care. This approach has allowed extended duty dental nurses (EDDNs) to take on roles traditionally undertaken by general dental practitioners (GDPs). While skill-mix approaches have been found to work well in general medicine, they have not been formally evaluated in dentistry. Understanding the factors which influence nurses' ability to fully deliver their extended roles is necessary to ensure nurses' potential is reached and that children receive preventive care in line with clinical guidance in a cost-effective way. This paper investigates the supplementation of GDPs' roles by EDDNs, in general dental practice across Scotland. METHODS: A cross-sectional postal survey aiming to reach all EDDNs practising in general dental practice in Scotland was undertaken. The survey measured nurses': role satisfaction, perceived utility of training, frequency, and potential behavioural mediators of, preventive delivery. Frequencies, correlations and multi-variable linear regression were used to analyse the data. RESULTS: Seventy-three percent of practices responded with 174 eligible nurses returning questionnaires. Respondents reported a very high level of role satisfaction and the majority found their training helpful in preparing them for their extended role. While a high level of preventive delivery was reported, fluoride vanish (FV) was delivered less frequently than dietary advice (DA), or oral hygiene advice (OHA). Delivering FV more frequently was associated with higher role satisfaction (p < 0.001). Those nurses who had been practising longer reported delivering FV less frequently than those more recently qualified (p < 0.001). Perceived difficulty of delivering preventive care (skills) and motivation to do so were most strongly associated with frequency of delivery (p < 0.001 for delivery of FV, DA and OHA). CONCLUSIONS: This study has provided insight into EDDNs' experiences and demonstrates that with appropriate training and support, EDDNs can supplement GDPs' roles in general dental practice in Scotland. However, some barriers to delivery were identified with delivery of FV showing scope for improvement.

Attitudes of New Zealand dentists, dental specialists and dental students towards employing dual-trained Oral Health graduates.

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.