The Health Practitioners Competence Assurance Act 2003 (the Act) describes a scope of practice as the health service that a practitioner registered in that scope of practice is permitted to perform, subject to any conditions for the time being imposed by the responsible authority.
The Council publishes a scope of practice as a Notice in the New Zealand Gazette under section 11 of the Act.
Scope of practice for dental therapy
The practice of dental therapy is the provision of oral health assessment, diagnosis, management, treatment and prevention of any disease, disorder or condition of the orofacial complex and associated structures in accordance with this scope of practice, and a dental therapist’s approved education, training, experience and competence. Dental therapy services are provided to children and adolescents up to age 18.
Disease prevention, oral health promotion and maintenance are core activities.
Dental therapists have a consultative working relationship with dentists or dental specialists1.
Dental therapy practice includes:
- obtaining medical histories and consulting with other health practitioners as appropriate
- examination of oral tissues, diagnosis of dental caries and recognition of abnormalities
- preparation of an oral care plan
- informed consent procedures
- administration of local anaesthetic using dentoalveolar infiltration, inferior dental nerve block and topical local anaesthetic techniques
- preparation of cavities and restoration of primary and permanent teeth using direct placement of appropriate dental materials
- extraction of primary teeth
- pulp capping in primary and permanent teeth
- preventive dentistry including cleaning, polishing and scaling (to remove deposits in association with gingivitis), fissure sealants, and fluoride applications
- oral health education and promotion
- taking of impressions for, constructing and fitting mouthguards2
- referral as necessary to the appropriate practitioner/agency
- performing pulpotomies on primary teeth
- taking and interpreting periapical and bitewing radiographs
- preparing teeth for and placing stainless steel crowns on primary teeth.
Practice in this context goes wider than clinical dental therapy practice to include teaching, research, and management, given that such roles influence clinical practice and public safety. Areas of dental therapy practice which were not included in a practitioner’s training should not be undertaken unless the practitioner has completed appropriate training and practises to the standards required by the Standards Framework for Oral Health Practitioners.
1 Further detail on the consultative working relationship between dental therapists and dentists or dental specialists is set out in the relevant Dental Council Practice Standard
2 Dental therapists who have not received training in this area as part of their undergraduate programme can undertake this activity only in accordance with the Dental Council’s Standards Framework for Oral Health Practitioners
Scope of practice for adult care in dental therapy practice
The practice of dental therapy on adults is the provision of oral health assessment, treatment, management and prevention services within the general dental therapy scope of practice for adult patients aged 18 years and older. Depending on the dental therapist’s qualifications this is provided in a team situation under direct clinical supervision3 or the clinical guidance4 of a practising dentist or dental specialist. Disease prevention, oral health promotion and maintenance are core activities.
Practice in this context goes wider than clinical dental therapy practice to include teaching, research, and management, given that such roles influence clinical practice and public safety. Areas of adult care in dental therapy practice which were not included in a practitioner’s training should not be undertaken unless the practitioner has completed appropriate training and practises to the standards required by the Standards Framework for Oral Health Practitioners.
3 Direct clinical supervision means the clinical supervision provided to a dental therapist by a practising dentist or dental specialist when the dentist is present on the premises at the time the dental therapy work is carried out
4 Clinical guidance means the professional support and assistance provided to a dental therapist by a practising dentist or dental specialist as part of the provision of overall integrated care to the adult patient group. Dental therapists and dentists/specialists normally work from the same premises providing a team approach. Clinical guidance may be provided at a distance but appropriate access must be available to ensure that the dentist or specialist is able to provide guidance and advice, when required and maintain general oversight of the clinical care outcomes of the adult patient group.
Prescribed qualifications for the dental therapy scope of practice.