Variations in Australian dental therapy practice by practitioner and workplace characteristics

Abstract

Introduction: Understanding dental therapy practice across clinical settings is useful for education and service planning. This study assessed if dental therapy service provision varied according to practitioner and workplace characteristics. Methods: Members of professional associations representing dental therapists (DT) and oral health therapists (OHT) were posted a self-complete survey collecting practitioner and workplace characteristics, together with clinical activity on a self-selected typical day of practice. Differences in service provision according to characteristics were assessed by comparing mean services per patient visit. Negative binomial regression models estimated adjusted ratios (R) of mean services per patient. Results: The response rate was 60.6%. Of practitioners registered as an OHT or a DT, 80.0% (n = 500) were employed in general clinical practice. Nearly one-third of OHT and nearly two-thirds of DT worked in public sector dental services. Patterns of service provision varied significantly according to practice sector and other characteristics. After adjusting for characteristics, relative to private sector, public sector practitioners had higher provision rates of fissure sealants (R = 3.79, 95% confidence interval [95% CI]: 2.84–5.06), restorations (R = 3.78, 95% CI: 2.94–4.86) and deciduous tooth extractions (R = 3.58, 95% CI: 2.60–4.93) per patient visit, and lower provision rates of oral health instruction (R = 0.86, 95% CI: 0.76–0.98), fluoride applications (R = 0.43, 95% CI: 0.33–0.56), scale and cleans (R = 0.39, 95% CI: 0.34–0.45) and periodontal services (R = 0.20, 95% CI: 0.14–0.28) per patient visit. Conclusion: Differences in service provision according to sector indicate that OHT and DT adapt to differing patient groups and models of care. Variations may also indicate that barriers to utilising the full scope of practice exist in some settings.