Abstract
Abstract Background Timely referrals of appropriately screened cases are essential for the effective delivery of orthodontic treatment. Dental therapists are intimately involved with the orthodontic screening process in New Zealand, given that they are the primary oral health providers for child and adolescent patients. Objectives (1) To investigate New Zealand dental therapists’ orthodontic screening and referral practices; and, (2) to quantify the perceived need for supplementary orthodontic resources by New Zealand dental therapists. Methods An online questionnaire was distributed via email to 659 actively practising dental therapists in New Zealand. Participants answered questions related to their socio-demographic characteristics, orthodontic screening and referral practices, and further orthodontic education. Results All surveyed dental therapists viewed orthodontics as an important treatment priority. Most (64.6%, N = 148) agreed that the orthodontic screening process should be a joint undertaking between general dental practitioners and dental therapists. Most practitioners (63.3%, N = 145) had access to (and used) an orthodontic screening guideline. While almost all dental therapists (98.7%, N = 226) were confident in assessing cases that were suitable for orthodontic referral, 63.8% felt that they could gain from further education, and virtually all (99.6%, N = 228) believed that continuing professional development (CPD) courses in orthodontics would be beneficial. Over three-quarters were in favour of a standardised national guideline for orthodontic screening, while the remainder were either satisfied with their current guidelines (15.3%, N = 35) or believed that such guidelines were unnecessary (7.0%, N = 16). Several patterns were observed by therapist characteristics, particularly related to working sector (private or public) and length of professional experience. Conclusions There were differences in the orthodontic screening and referral practices of dental therapists in New Zealand. Dental therapists were receptive to the idea of standardised guidelines for orthodontic screening and there was a perceived need for CPD courses in orthodontics.
Highlights
The present survey found that dental therapists generally held a positive view of their role in the orthodontic referral chain, with most screening all of their patients
Perceived need for standardised guideline, N (%)
Caution should be exercised in generalising the findings of the current study to the entire New Zealand dental therapy workforce
Summary
Malocclusion is a highly prevalent dental condition in New Zealand children, as approximately one-third have been determined to be in need of treatment.[1,2] A malocclusion in the young is associated with a poorer oral health-related quality of life (OHRQOL), in the domains of emotional and social wellbeing.[3,4,5] Orthodontic treatment is efficacious in treating a malocclusion, it improves a Australasian Orthodontic Journal Volume 33 No 2 November 2017 patient’s OHRQOL.[6,7] Appropriate screening and referral of children and adolescents can significantly reduce the complexity of future treatment needs through interceptive treatment.[8]In New Zealand, dental therapists are the primary oral healthcare providers for those under the age of 18. Approximately one-quarter of patients who undergo orthodontic treatment in New Zealand are referred by a dental therapist.[10] At the same time, it is fundamental that dental therapists are well versed in this task in order to prevent inappropriate referrals. The latter can create unnecessary financial burden and long consultation waitlists, which are detrimental to the parties involved including the patient, orthodontist and the referring practitioner.[11] Overseas studies have demonstrated a high frequency of inappropriate orthodontic referrals which warrant the implementation of referral guidelines,[11,12] but there are no national standardised guidelines established in New Zealand. Dental therapists were receptive to the idea of standardised guidelines for orthodontic screening and there was a perceived need for CPD courses in orthodontics. (Aust Orthod J 2017; 33: 158-169)
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