Shireen Smith, Dental Protection’s Oral Health Therapist, Hygienist and Therapist Adviser, discusses recent and proposed changes to registration standards and guidelines by the Dental Board of Australia 

Read this article to: 

• Understand how recent and proposed changes made by the Dental Board of Australia affect you 

Times are changing for dental hygienists, oral health therapists and dental therapists in Australia and, for this reason, it is best to be mindful of what has changed and what further changes are being proposed. 

It first started with the Dental Boards communique in February 2017 – an agreement was made to phase out the approval process of programs to extend scope of practice for dental hygienists, oral health therapists and dental therapists from 1 January 2017 until 31 December 2018. 

Then more recently, on 22 March 2018, the Dental Board released a proposal for public consultation in relation to:

• a revised scope of practice registration standard
• revised guidelines for scope of practice
• a new reflective practice tool for scope of practice.

At present you must only practise within a structured professional relationship with a dentist and must not practise as an independent practitioner.

The proposed changes to the current registration standard and guidelines that may affect you in the near future are as follows

Remove reference to programs to extend scope

The programs to extend scope (formerly known as add-on programs) cover a range of skills which allow dental practitioners to extend their education, training and competence in certain areas and within the division in which they are registered.

The Board made the decision because the historical need for these programs has faded, resulting in a decrease in the demand for them, with most of the topics now being incorporated in the programs of study already approved by the Board.

The programs to extend scope can still be delivered as continuing professional development (CPD) programs. However, all dental practitioners are reminded that CPD programs alone cannot be used to increase scope and may not provide a dental practitioner with the sufficient clinical experience to incorporate techniques and procedures into their practice.

Registered dental practitioners are responsible for self-assessing and selecting CPD programs that:

• relate to the definition of their practice as defined in the Board’s scope of practice guidelines
• broaden knowledge, expertise and competence” in accordance with the Board’s CPD registration standard and guidelines.

In addition, if you decide to expand your individual scope, you need to be mindful of:

• other regulatory requirements, including drugs and poisons legislation and radiation authorities
• whether your professional indemnity insurance covers any additional procedures or techniques
• always practising in accordance with the Board’s Code of Conduct.

For this reason, it is important that you keep a clear record of any program to extend scope or any CPD activity/course that you complete.

Clarify expectations around education, training and competence

The guidelines may be restructured and re-worded to improve readability and clarify current requirements around education, training and competence. In particular, reference to dental and oral health therapist and adult scope.

The new descriptions imply that dental therapists and oral health therapists may provide dental therapy treatment (for example, simple restorative treatment) to patients of all ages (as opposed to only patients under 18 or 26 years), provided that they complete an education program approved by the Board.

At present you must only practise within a structured professional relationship with a dentist and must not practise as an independent practitioner. It is only a proposal at this stage and you must meet the current registration standards.

Currently, at least three out of the eight Bachelor of Health (BOH) Board approved programs of study (La Trobe University, Newcastle University and Central Queensland University) teach dental therapy treatment on patients of all ages. Additionally, two programs to extend scope related to adult scope include The University of Adelaide and The University of Melbourne’s Graduate Certificate.

Remove the requirements of “independent practitioner”

Independent practitioner means a practitioner who may practise without a structured professional relationship.

The current registration requirements, which have been in place since 2010, state that oral health therapists, dental hygienists and dental therapists must only practise within a structured professional relationship and must not practise as independent practitioners.

Over the past years, the Board has seen the education programs for dental therapists, dental hygienists and oral health therapists continue to strengthen and mature and have indicated current training is sufficient to support these practitioners in working in team-based settings without supervision.

Remove the requirement of a structured professional relationship

The requirement of a structured professional relationship was included in the registration standard to provide a framework to support the team approach for dental care.

Dental practitioners have a responsibility to recognise and work within the limits of their competence and scope of practice, which may vary over time.

Dental practice is fundamentally team based and requires practitioners to work with other practitioners to provide patient care, which includes the appropriate delegation, referral and handover of patient care.

All dental practitioners must only perform those dental procedures for which they have been educated and trained, and in which they are competent, as per the registration standard and the guidelines.

Resources

Dental Board Australia Consultation paper - Scope of practice registration and guidelines for scope of practice (March 2018)

Communique - meeting of the Dental Board of Australia (February 2017)

More support

During these transitional periods, Dental Protection can be on hand to support and assist with colleague-to-colleague advice. However, your first point of call in relation to your individual scope of practice would be the university in which you obtained your qualifications for registration.

As part of your Dental Protection membership, you have access to free educational services such as such the sliding doors seminar series and workshops to help you and your team reduce dentolegal risks.