Exploring professionalization among Brazilian oral health technicians.

Professional dental auxiliaries emerged in the early 20th century in the United States of America and quickly spread to Europe and other regions of the world. In Brazil, however, oral health technicians (OHTs), who occupy a similar role as dental hygienists, had a long journey before the occupation achieved legal recognition: Brazilian Law 11.889, which regulates this occupation in the country, was only enacted in 2008. The aim of this paper is to review the literature on the professionalization of OHTs, highlighting the triggering, limiting and conflicting aspects that exerted an influence on the historical progress of these professionals in Brazil. We have tested Abbott's and Larson's theory on professionalization, against the history of OHTs. A number of different dental corporative interests exerted an influence over professionalization, especially in discussions regarding the permissible activities of these professionals in the oral cavity of patients. With primary health care advances in Brazil, the importance of these professionals has once again come to the forefront. This seems to be a key point in the consolidation of OHTs in the area of human resources for health in Brazil.

Dental therapy in the United Kingdom: part 1. Developments in therapists' training and role.

The number of students entering training for dental therapy has been increasing rapidly over the last few years. In practice, the scope of their work has increased, both in terms of permitted duties and their range of clinical settings. The possibilities for dental practitioners to work with therapists is therefore increasing, so it is important for them to be clear about therapists' potential capacity to provide added value to the dental team. This paper, which is the first of four covering aspects of dental therapy in the UK, traces the history of dental therapy together with the development of therapists' training opportunities and emerging competencies, up to the present. The subsequent three papers will describe aspects of a survey of dental therapists undertaken in late 2006.

O técnico de higiene bucal: trajetória e tendências de profissionalização com vista ao maior acesso aos serviços de saúde bucal / Dental hygiene technician: history and trends of professionalism with a view to increasing access to oral health services

Este trabalho buscou identificar, ao longo do tempo, os tipos de auxiliares em odontologia que influenciaram a construção de perfis para a regulamentação da profissão do Técnico em Higiene Dental no Brasil. Para tanto, embasou-se em levantamento de bibliografia nacional e estrangeira; em análise dos textos fundamentais da década de 60 e 70, para captura do espírito de cada época e das influências da mesma sobre o monopólio do exercício da odontologia, e em entrevistas com especialistas que vivenciaram o período em recorte. A partir da compreensão histórica dos tipos básicos e da observação de alterações ou inovações apontadas na divisão social do trabalho em odontologia, objetivou-se examinar os quatro perfis do THD desenhados no Brasil e propostos pelos Plano de Reorganização da Atenção Básica; Consolidação das Normas do Conselho Federal de Odontologia; Classificação Brasileira das Ocupações e Projeto de Lei 00003/2007, este último em trâmite no Senado para sua definitiva aprovação. Os perfis foram observados sob a luz das potenciais possibilidades de contribuição do THD na assistência restauradora, na prevenção às doenças e na promoção de saúde bucal, que, de acordo com experimentos clássicos sobre aumento de produtividade, justificariam ou não sua utilização no âmbito da assistência, em especial, na estratégia de Saúde da Família respondendo as necessidades sociais. Concluiu-se que todos os perfis exigem reparos, e que o desenho do perfil apresentado pelo PL 00003/2007 não se adequa ao objetivo de conferir a este profissional atribuições potencializadoras de ganhos econômicos para o sistema assistencial, além de limitar o profissional em suas funções assistenciais e preventivas.

This work aimed to identify basic types of dental auxiliaries that influenced the “Dental Hygiene Technician” (THD) in Brazil throughout the history. In order to achieve this, it searched national and international literature, analyzed documents of outstanding importancefrom the 60’s and 70’s to capture the feelings and influences of each period. Besides, interviews were done with experts who lived in each period. From a historical understanding of those basic types of dental auxiliaries this work examined “Dental Hygiene Technician”profiles in Brazil, as proposed by the “Plano de Reorganização da Atenção Básica”; “Consolidação das Normas” of the Federal Council of Dentistry; Brazilian Classification of Occupations and Law Project No 00003/2007. The last is still in the Senate for final approval. The profiles were observed to investigate possible contribution of the THD on clinical services, and prevention and promotion of oral health, which would or would not justify their useaccording to classic experiments regarding productivity, It was concluded that all profiles need changes, and the profile showed in PL 00003/2007 does not fit the objective to give thisprofessional tasks economic gains for the care system, in addition to limit the professional in their functions and preventive care.

The supply of dental manpower in the United States.

This description of the supply of dental services in the United States addresses the number, kind, distribution, and training of dentists and dental auxiliaries, and the organizational factors that affect the production of dental services. Beginning with a brief historical review, the paper gives a general overview of the different types of dental personnel including the dentist, dental hygienist, dental assistant, and laboratory technician. The discussion of these categories of providers includes consideration of manpower planning as it has evolved over the past two decades, National manpower legislation is mentioned first as a reaction to the projected dentist shortage and then in response to the issues of geographic maldistribution and the effects of specialization. The second section of the paper discusses the dynamics of the dental care market. The distribution of the supply of services is identified and related to patterns of utilization and productivity. These factors are considered to be part of the set of dynamic relationships that help explain the current manpower problems of geographic and specialty maldistribution. A concluding section superficially discusses policy implications regarding the potential for increasing supply by: (1) increasing the number of dentists, (2) increasing the numbers and functions of auxiliaries, (3) increasing practice efficiency through group practice, and (4) reducing the restrictions that result from current state dental practice acts.