DENTEX: The emergence of dental therapists in the United States.

Dental therapists were introduced into Alaska in 2005 to meet the basic oral health needs of Alaska Native communities. Deployed in 54 countries, dental therapists are well distributed throughout their respective societies. In Alaska, they provide effective, quality, and safe care for children in an economical manner and are generally accepted both by the public and by the dental profession. Dental therapists are increasingly employed in other states. Historical parallels exist between the physician assistant movement and dental therapists in the United States.

California's Clinical Dental Team: Evolving Together With an Eye to the Future.

California dentists enjoy some of the most well-trained clinical teams in the country. In these changing times, reflecting on our collective history may help inform collaboration and innovation that will serve us well as we create new ways to care for our patients and thrive in our professional lives.

Job satisfaction and perceived future roles of Malaysian dental therapists: findings from a national survey.

OBJECTIVE: To assess Malaysian dental therapists' perceptions of their job satisfaction and future roles. METHODS: A nationwide postal survey involving all Malaysian dental therapists who met the inclusion criteria (n = 1726). RESULTS: The response rate was 76.8%. All respondents were females; mean age 35.4 years (SD = 8.4). Majority were married (85.5%) and more than one-half had a working experience of <10 years (56.1%). Majority worked in community dental service (94.3%) and in urban areas (61.7%). Overall, they were highly satisfied with most aspects of their career. However, they were least satisfied with administrative workload (58.1%), career advancement opportunities (51.9%) and remuneration package; specifically income (45.2%), allowances (45.2%) and non-commensurate between pay and performance (44.0%). Majority perceived their role as very important in routine clinical tasks such as examination and diagnosis, preventive treatment, extraction of deciduous teeth and oral health promotion. However, fewer than one-half consider complex treatment such as placement of preformed crowns on deciduous teeth (37.1%) and extraction of permanent teeth (37.2%) as very important tasks. CONCLUSION: Majority expressed high career satisfaction with most aspects of their employment but expressed low satisfaction in remuneration, lack of career advancement opportunities and administrative tasks. We conclude that most Malaysian dental therapists have positive perceptions of their current roles but do not favour wider expansion of their roles. These findings imply that there was a need to develop a more attractive career pathway for therapists to ensure sustainability of effective primary oral healthcare delivery system for Malaysia's children.

The past and future evolution of the dental workforce team.

This article looks at changes in the number and mix of providers in the dental workforce over the past sixty years. First, enrollment trends in dental education programs are investigated. These educational programs feed directly into the dental workforce. Then, the changes in the dental workforce are examined. The focus of this investigation is the composition of the dental workforce and how the components of the workforce have changed over time. The forces that are responsible for these changes in the workforce are explored next. Finally, the possibility for workforce changes in the future is considered.

Modelling workforce skill-mix: how can dental professionals meet the needs and demands of older people in England?

BACKGROUND: There is an urgent need to consider the skill-mix of the dental team to meet the oral health needs and demands of the population in general, and older people in particular. As people live longer and retain their teeth there will be a progressive change in both the volume and type of dental care required, and the demand for care. Operational research modelling provides the opportunity to examine and test future scenarios for National Health Service (NHS) care. AIM: The aim of this research was to explore the required skill-mix of the dental team to meet future need and demand of older people in England to 2028 utilising operational research methods and to examine a range of future scenarios. METHOD: A three-stage computer model was developed to consider demand for dental care, workforce supply and skill-mix. First, the demand model combined population demography and a marker of oral health with attendance and treatment rates based on NHS activity data. Monte Carlo simulation was used to give an indication of the uncertainty surrounding this projected demand. Second, projections on workforce supply and other assumptions relating to clinical hours, NHS commitment and workforce whole time equivalents (WTEs) were analysed to produce a range of estimates for the current and future workforce. Third, staff skill-mix competencies were examined and the data fed into an optimisation model. Linear programming was used to give the optimal workforce makeup and predictions for workforce requirements. Five future scenarios were run from 'no skill-mix' through to 'maximum skill-mix' in the dental team, and the outputs compared. RESULTS: The results indicate that by 2028 there will be an increase in demand for care among older people of over 80% to almost 8.8 million hours; however, Monte Carlo simulation suggests considerable uncertainty surrounding the demand model outputs with demand deviating from the average in terms of treatment hours by as much as 22%. Modelling a healthcare system with 'no skill-mix' resulted in the lowest volume of clinical staff equivalents (dentists: 8,668) providing care for older people, whereas maximum skill-mix involved more staff (clinical staff = 10,337, of whom 2,623 were dentists, 4,180 hygienist/therapists and 3,534 clinical dental technicians) if all care is provided at the relevant level of competence. CONCLUSION: The model suggests that with widening skill-mix, dental care professionals can play a major role in building dental care capacity for older people in future. The implications for health policy, professional bodies and dental teamworking are discussed.

Addressing children's oral health in the new millennium: trends in the dental workforce.

Oral Health in America: A Report of the Surgeon General (SGROH) and National Call to Action to Promote Oral Health outlined the need to increase the diversity, capacity, and flexibility of the dental workforce to reduce oral health disparities. This paper provides an update on dental workforce trends since the SGROH in the context of children's oral health needs. Major challenges remain to ensure a workforce that is adequate to address the needs of all children. The dentist-to-population ratio is declining while shortages of dentists continue in rural and underserved communities. The diversity of the dental workforce has only improved slightly, and the the diversity of the pediatric population has increased substantially. More pediatric dentists have been trained, and dental educational programs are preparing students for practice in underserved areas, but the impact of these efforts on underserved children is uncertain. Other workforce developments with the potential to improve children's oral health include enhanced training in children's oral health for general dentists, expanded scope of practice for allied dental health professionals, new dental practitioners including the dental health aid therapist, and increased engagement of pediatricians and other medical practitioners in children's oral health. The evidence for increasing caries experience in young children points to the need for continued efforts to bolster the oral health workforce. However, workforce strategies alone will not be sufficient to change this situation. Requisite policy changes, educational efforts, and strong partnerships with communities will be needed to effect substantive changes in children's oral health.

Challenges to future dental education.

The future of dental education in the UK is currently in a very dynamic phase; the GDC is changing its role and Europe is taking the lead. In addition there have been significant changes in the workforce and the role of the dentist. These changes will affect the future of the dental profession.

Allied dental personnel: will there be enough?

The escalating number and size of dental practices mean greater dependency on a ready supply of allied dental personnel. However, despite the increasing number of entry places in allied dental training programs, many places remain unfilled and large numbers of individuals do not complete the course of studies. A review of the changes in dental practice sizes and dental assistant, dental hygienist and dental laboratory technician programs raises concerns as to whether there will be enough allied dental personnel to meet the future needs of the profession. The need for increasing attention to this potential eventuality is stressed.

Will there be a shortage of dental auxiliaries in the future?

The number of graduates from dental hygiene programs continues to increase, but retention of dental hygienists in practices is a concern. The numbers of graduates from dental assisting and especially dental laboratory technology programs are decreasing. The impact on dental practice size and practice productivity is considered.

T.H.D. no mercado de trabalho: uma realidade? / Dental hygienist in the dentistry practice: a reality?

O Brasil é um país com diversos problemas sociais, em que o acesso aos serviços odontológicos é bastante restrito. Comprovadamente, a utilizaçäo de pessoal auxiliar aumenta a produtividade e a qualidade dos serviços. Assim sendo, os autores tiveram como objetivo analisar a situaçäo de mercado dos Técnicos em Higiene Dental formados desde 1993 pela FOP-UNICAMP, a fim de estabelecer um perfil social para esta categoria profissional. Foi enviado um questionário para 71 técnicos em higiene dental. para o sigilo dos dados dos participantes, näo era necessário identificaçäo. Conclui-se que: 1. Apesar da grande necessidade deste tipo de pessoal auxiliar (THD) no setor público, a maioria está empregada no setor privado, embora a média salarial do setor público seja melhor; 2. O tempo médio para se conseguir uma colocaçäo no mercado de trabalho foi de seis meses e a maioria tem uma jornada diária de oito horas; 3. A maioria das pessoas entrevistadas trabalham com especialistas nas áreas de Ortodontia e Periodontia; 4. Existe a necessidade da discussäo das normas que regulamentam o exercício profissional do THD, em funçäo de tópicos que abordam a necessidade da realizaçäo de diagnóstico

The changing role of dental auxiliaries: a literature review.

A review of the literature on dental auxiliaries and their utilization in the dental workforce is presented, and their future role is examined in the light of broader issues relating to changing disease patterns and service delivery. Legislative factors, productivity, quality assurance and the potential scope for dental auxiliaries in both the public sector and private practice setting are discussed. A strategy for adopting a team approach in the delivery of dental services is suggested, which would necessitate the dentist taking on the role of team leader and maintaining responsibility for overall treatment planning and quality assurance. Dental auxiliaries could provide basic preventive and restorative dental services, allowing dentists to concentrate on providing more complex high-technology treatment. Implications for the future training of dental auxiliaries are presented.