Training another workforce to provide adult dental care is not the answer to unmet needs – better subsidies are, argues the  New Zealand Dental Association.

The association was responding to the New Zealand Dental & Oral Health Therapists’ Association (NZDOTA) releasing results of a survey they commissioned which found that two-third of Kiwis had no objection to appropriately trained dental therapists providing dental care for all ages.

Arish Naresh, NZDOTA chair said the association commissioned Colmar Brunton to carry out an independent survey to see whether there was public support for it advocating for New Zealand therapists to be trained and allowed to offer adult care – beyond the current age restriction of 18.

Dr David Crum, chief executive of the Dental Association, said Ministry of Health New Zealand Health Survey 2016/17 showed around half of New Zealand’s adults visited a dentist in past 12 months.

“Over half of those who did not see a dentist listed their reason as ‘they saw no need to as they had no problem’, with others citing price as a barrier,” he said.

Crum said the reality was that over the past 20 years there had been a “huge reduction” in adult tooth loss and nearly a halving of the number of adult decayed teeth.  But he added it was fair to say that there was still high dental disease rates in adults with low incomes, with cost being the barrier for some, but the association was clear that dental therapists working with adults was not the answer.

“We don’t need to have the exorbitant expense of training and equipping another entire workforce, especially one that will move school dental therapists (or oral health therapists) from treating our kids to treating adults,” said Crum. “Kids don’t get to choose what their parents feed them or what attitudes they are taught regarding their daily oral hygiene. Adults do.”

“The real issue here is that we can’t afford to take away these therapists away from our children, the recent Child Poverty Action Group report showed many children are now not receiving dental care they require.”  He said many DHBs were already having trouble recruiting and retaining dental or oral health therapists resulting in “concerning” rates of children not being seen on time.

“There is increasing numbers of children (7000 a year) requiring treatment under general anesthetic (with associated risks and high costs) and significant levels of unmet dental treatment need in our child population,” said Crum.

He said therapists moving into adult care was not the answer for unmet adult need as there was already trained appropriately qualified dentists in every in community across New Zealand.

“What is needed are effective, consistent subsidies targeted at the neediest patients so they can access the level of dental diagnosis, surgery and care they need,” he said.

Dr Crum also said “shifting resources away from kids to adults would be detrimental overall”.

Naresh said there were system issues that needed to be addressed when it came to the DHB workforce; the arrival of the new dual scope meant oral health therapists were unable to use both scopes if employed by DHBs and were also able to earn a higher salary in the private than public sector. Naresh – who is Director of Allied Health and Technical services at Tairawhiti DHB, manages the DHB’s dental services and works part-time for a private dental practice offering dental care to adolescents – said in time he believes DHBs should move out of  public dental health services which could be provided by primary health organisations or iwi providers.

Currently the vast majority of the just under 1000 dental and oral therapists work for district health boards providing free school dental health services up to the age of 13. Therapists can work with adolescents up to the age of 18 but the vast majority of free dental health care for adolescents is offered by dentists in private practice.

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