The Role of the Oral Health Therapist in the Provision of Oral Health Care to Patients Across All Ages

This chapter will describe the role and evolution of the scope of clinical practice of dental hygienists, dental therapists and oral health therapists. These three groups of allied oral health professionals are playing an increasingly important role in the provision of oral health services and it is therefore important to understand how they are utilised as part of the dental team. Historically, the dental hygiene profession originated in the early 1900s in the US, followed by Norway, 1924; United Kingdom, 1943; Canada, 1947; Japan, 1948; and Australia, 1971 (Johnson, 2009). Dental hygienists predominantly provide health education, preventive, periodontal and orthodontic auxiliary services to people of all ages. Dental therapists were introduced in New Zealand in 1921 to provide basic preventive and restorative dental care for children in the School Dental Service. Currently more than 50 countries utilise dental therapists (Nash et al., 2008). In Australia and New Zealand, dental therapists have been responsible for examining, diagnosing, and developing plans for the oral health treatment they provide to children and adolescents, and referring patients with treatment needs beyond their scope of practice to dentists (Satur et al., 2009). Oral health therapists are a relatively new addition to the dental team. They have the combined education and training of both a dental therapist and a dental hygienist. Currently across Australia all oral health therapy education is provided through the tertiary education sector. An emerging oral health problem in many Western countries is access to dental services by disadvantaged groups, in particular public adult dental patients. Oral health disparities and socioeconomic disadvantage have led to a growing burden of disease amongst sections of the community who at the same time have difficulties accessing appropriate oral health services. There is currently debate in the United States and elsewhere about the need for an oral health practitioner with similar skills to a dental therapist to address the high levels of unmet restorative treatment needs and extend access to oral health care services for lower income groups. This is somewhat different to the situation in countries like Australia, where dental therapists have been long accepted as playing a role in the provision of oral health