The capacity of dental therapists to provide direct restorative care to adults

Abstract

In Victoria, dental therapists are restricted to treating patients under the age of 26 years. Removing this age restriction from dental therapists' scope of practice may assist significantly in addressing workforce shortages, particularly in rural Victoria. This study aims to assess the capacity of dental therapists to provide direct coronal restorations (dental fillings) to patients older than 25 years, on the prescription of a dentist. Its objectives include determining the success rate of restorations placed by dental therapists six months post placement; and patients' and dental therapists' satisfaction with the services provided. The project was carried out in 2007 at the Royal Dental Hospital of Melbourne. Seven dental therapists participated in the study, placed 356 restorations (115 patients) with the support of a dentist. These restorations were reviewed six-months post placement by dentists blinded as to which restorations were placed by the dental therapists. Patients' age ranged from 26 to 82 years (82% were >40 years). At six months post-treatment, 258 restorations (80 patients) were reviewed. At review, 94.6% of the restorations were successful. Patients and dental therapists were satisfied with the experience. The standard of restorations provided by dental therapists was considered to be at least similar to that expected of a newly graduated dentist. Broadening the dental therapists scope of practice would create opportunities to design more flexible 'oral health' clinical teams enabling dentists to provide more complex procedures for patients most in need. This is significant in the public sector and rural areas where workforce shortages are most acute.