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.
The scope of practice for oral health therapy came into effect on 1 November 2017.
Scope of practice for oral health therapy
The practice of oral health therapy is the provision of oral health assessment, diagnosis, management, treatment and preventive care for patients in accordance with this scope of practice and an oral health therapist’s approved education, training, experience and competence.
Oral health education, disease prevention and oral health promotion for individuals and communities are core activities, aimed at achieving and maintaining oral health as an integral part of general health.
Oral health therapists practise as part of the dental team and work collaboratively with other oral health practitioners and health practitioners to provide appropriate and comprehensive care to the benefit of patients’ overall health.
Oral health therapists and dentists have a consultative professional relationship. The relationship may be between an oral health therapist and one dentist or dental specialist or an oral health therapist and a number of dentists or dental specialists. The establishment and maintenance of the consultative professional relationship is required for the practice of oral health therapy.
Practitioners within the consultative professional relationship are jointly responsible and accountable for the standard of decisions and care delivered to patients based on professional advice sought and given. Practitioners may wish to jointly develop a document containing agreed processes to support the consultative professional relationship and ensure advice is readily available when needed, however this is not mandatory.
Oral health therapy practice includes:
- obtaining and assessing medical and oral health histories
- examining oral tissues and recognising abnormalities
- taking and interpreting intra and extra-oral radiographs
- taking intra and extra-oral photographs
- diagnosing dental caries for patients
- diagnosing periodontal disease
- preparing oral health care plans
- consulting with other health practitioners as appropriate
- referring as necessary to the appropriate practitioner/agency
- obtaining informed consent
- providing oral health education, information and counselling to patients
- applying and dispensing non-prescription preventive agents
- applying and dispensing prescription medicines and preventive agents
- applying and dispensing topical agents for the treatment of tooth surface sensitivity and tooth discolouration
- applying fissure sealants
- administering topical local anaesthetic
- administering local anaesthetic using dentoalveolar infiltration and inferior dental nerve block techniques
- removing hard and soft deposits from all tooth surfaces
- extracting primary teeth
- restorative activities:
- preparing cavities and restoring primary and permanent teeth using direct placement of dental materials
- performing pulpotomies on primary teeth
- preparing primary teeth for, and placing, stainless steel crowns
- recontouring and polishing restorations
- taking impressions, recording occlusal relationships, and making study models
- constructing and fitting mouthguards and bleaching trays
- performing postoperative procedures such as removal of sutures and placement and removal of periodontal dressings
- promoting the oral health of communities by:
- raising awareness of oral health and its effect on general health and well-being
- designing and implementing oral health promotion projects, and evaluating their effectiveness, in response to the oral health needs of specific communities
- assisting the dentist or dental specialist in implementing orthodontic treatment plans through performing the following orthodontic procedures:
- tracing cephalometric radiographs
- fabricating retainers, and undertaking other simple laboratory procedures of an orthodontic nature
- assisting the dentist or dental specialist in implementing orthodontic treatment plans, as directed by the dentist or dental specialist who is responsible for the patient’s clinical care outcomes and is on-site at the time, through performing the following orthodontic procedures:
- placing separators
- sizing and cementing metal bands including loose bands during treatment
- preparing teeth for bonding fixed attachments and fixed retainers
- indirect bonding of brackets as set up by the dentist or dental specialist
- placing archwires when necessary (as formed by the dentist or dental specialist) and replacing ligatures/closing self- ligating brackets
- trial fitting removable appliances - this does not include activation
- removing archwires after removing elastomeric or wire ligatures, or opening self- ligating brackets
- removing fixed orthodontic attachments and retainers
- removing adhesives after the removal of fixed attachments
- fitting passive removable retainers
- bonding preformed fixed retainers.
Practice in this context goes wider than clinical oral health therapy practice to include teaching, research, and management, given that such roles influence clinical practice and public safety. Areas of oral health 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.
Prescribed qualifications for the scope of practice for oral health therapy