Scope of practice standard on hold

The Dental Board wants more time to consider changes to the Scope of Practice standard.
The Dental Board wants more time to consider changes to the Scope of Practice standard.

The Dental Board of Australia has asked for more time to consider the impact of any changes to the scope of practice standard. In the communiqué from its July meeting (released this week), the Board said it “remains committed to delivering well informed advice to the Australian Health Workforce Ministerial Council (Ministerial Council) on any proposed amendments to the Scope of practice registration standard to provide certainty to all divisions of dental practitioners on their scope of practice; and provide protection and certainty to the public in recognising the divisions of dental practitioners and their scope of practice.

“Due to the response to the public consultation, the National Board has advised the Ministerial Council that it would prefer more time to carefully consider the responses and any possible impact of the proposed standard to ensure that dental practitioners are able to continue to work safely and with certainty and within their scope of practice.

“The Scope of practice review committee, appointed by the National Board, will continue to provide advice to the National Board. The National Board will provide further updates after the submissions have been fully considered. The current Scope of practice registration standard remains in force.”

The ADA has previously made clear its opposition to any change in the scope of practice standard, saying “This is an arbitrary lowering of the bar for people receiving dental care without addressing the real problem – the lack of adequate funding for public dental services.”

The organisation has also said to its members that allied dental personnel are trained with a very limited skill set to work under the supervision of a dentist, and that “their training is in no way comparable to that of dentists.”

The Dental Hygienists Association of Australia was contacted for comment, but did not return calls or emails by the time we went to press.

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  1. As a registered dental practitioner – dental therapist – I have been disappointed and upset for months since the ADA attack on members of my profession commenced. Their comments are in conflict with the Dental Code of Conduct re working with other practitioners. Furthermore, if dentists want to be clinical leaders and leaders of the dental team, insulting your professional colleagues does not augur well for respectful relations. Fortunately, as we work with dentists in a respectful manner each working day, we realise that what the ADA says bears no resemblance to reality. Get real ADA!

  2. ‘The organisation has also said to its members that allied dental personnel are trained with a very limited skill set to work under the supervision of a dentist, and that “their training is in no way comparable to that of dentists’.
    Really? ‘No way comparable’? ‘Very limited skill set’?…a little extreme perhaps? I find these comment particularly insulting. I agree that the scope of practice needs to be carefully reviewed and as an OHT, have no desire to do RCT on a 11 or other such procedures that some dentists out there think we may end up performing. There’s been too many negative comments about auxiliaries on certain Facebook pages and other forums and it’s not healthy for our profession…OUR profession.

  3. The National Branch of the DHAA Inc. have not received any emails from Bite Magazine via the official website or directly to the National President on regarding a comment on Scope of Practice.

    The DHAA Inc. position is as follows:

    Members of the DHAA continue to provide oral health care utilising the highest level of professional knowledge, judgement and skill, working within scope of practice, and abide by the National Law.

    We serve all patients without discrimination, refrain from criticising the dental profession and function harmoniously with all health professions.

    The DHAA are supportive of Dental Hygienists, Oral Health Therapists and Dental Therapists and Dentists and their profession.

    Members of the DHAA have always provided a high safety standard treating patients in supervised environments and have maintained this level of safety providing preventive treatment in indirectly supervised environments, abiding by the National Law, since 2010.

    We have provided the public with the highest standard of quality preventive care for more than 40 years in Australia.

    The DHAA Inc. has an impeccable public safety record, treating patients in environments without a dentist present.

    Our members have the highest regard for public safety and work within our scope of practice (meaning we only perform procedures for which we have formal Dental Board Approved training).

    DHAA Inc. believes we need a paradigm shift to a preventive model of care, with dental hygienists providing outreach services in community settings in order to promote oral health and prevent costly and painful dental disease. We need to combat the existing ‘drill and fill’ mentality by utilising dental hygienists and oral health therapists in the primary prevention and treatment phase.

    The DHAA Inc. respects the time and careful consideration of the Dental Board of Australia in this review and will reserve any further public statement until the DBA release Scope of Practice Review.

    Furthermore the DHAA finds public criticism of any registered oral health professional unacceptable and unhelpful to the public in their understanding of preventive dental health care.

    All dental practitioners have a role in dental health and dentistry must evolve to meet the unmet needs of preventive health and our communities

    Hellen Checker
    National President DHAA Inc.

    • Hi Helen,

      Thank you for contributing to this important issue. Just for the record, as stated in the article, we did attempt to contact the DHAA before the article went to press – twice by phone, and once by email. I’ll get in touch off line to make sure we have the best way of communicating with you in the future.

      All the best
      Rob Johnson,
      Editor, Bite magazine

  4. The DHAA Inc. wish also to advise the Team at Bite Magazine that Magazine has on numerous occasions incorrectly referred to The Dental Hygienists’ Association of Australia Inc. in publication as
    DHHA (as tagged in this article and incorrectly as The Dental Hygienists Association of Australia even after DHAA Inc. had been in correspondence with the journalists of the articles

    The DHAA Inc. have contacted the editor in the past advising the correct name of our Association. Failed efforts to contact the Association may well be attributed to continued lack of effort or interest or decline of good journalism in the age of the electronic Media release.

    • Ouch! Whatever disagreements have happened between yourself and Bite magazine in the past, I think we agree this is an important issue and one worth covering, and we will always welcome comment from the DHAA Inc. on the issue.

  5. I am a registered Dental Practitioner – Oral Health Therapists and practice owner with equal partnership with 2 other dentists. I am appalled and upset with what I recently read in the ADAQ Bullentin stating that “….allied dental personnel are trained with a very limited skill set to work under the supervision of a dentist, and that their training is in no way comparable to that of a dentist.” In my experience I feel that many dentist and the ADA do not respect the fact that Dental hygienists, Dental therapist and Oral Health Therapists are registered dental practitioners in there own right. They just lump the 3 professions together. I feel the ADA and majority of dentists do not even have a clue what my profession does or the qualifications I achieved to become an Oral Health Therapist. I would like to enlighten the Ignorant. I graduated from Griffith University in 2006 with a Bachelor of Oral Health in Oral Health Therapy. I trained in the same classes and sat the same exams as students training to be dentists in those 3 years.
    My testamur reads
    Year 1 Semester 1. Chemistry 1,Health & Human Development, Principals of Physiology, Human Anatomy of Oral Health.
    Semester 2. Biological chemistry, Oral Biology, Intro Clinical Oral Health Practitioner, Physiological Science 1

    2nd Year Semester 1 Health Law &Ethics, Nutrition,Principals of Dental Care1, Pathology General.
    Semester 2 Pathology Oral, Microbiology for Oral Health, Research for Health Professionals, Principals of Denal Care 2, Physiological science 2

    3rd year. Semester 1 Public Oral Health, Comprehensive Oral Health Care 2, Community Research Placement 2,
    Semester 2 Australian Health Care, Community Research Placement 2, Comprehensive Oral Health Care 2

    In my opinion I feel it is fair to say that my degree and training is very much comparable. I would also argue that my profession and my scope of practice is in no way a danger to the community or that my scope of practice ” is lowering the bar ” in providing dental treatment to patients. I don’t understand is why our “team leaders” are so ignorant and threatened by our profession. I work in a team enviroment with my partners (dentist) in our practice and we mutually respect each other. I trained as an Oral Health Therapist because I did not want to do “high end” procedures ie crown and bridge Rct implants dentures etc. I feel that my profession deserves the respect and reconnition from our so called team leaders. And as a registered dental practitioner we also deserve our own provider number. It is so ridulous that as a dental practitioner I can practice dentistry but I can provide it. I feel the ADA should support us wholeheartedly and give us reconnition and respect for the service we provide to our valued patients just as we recognise and respect the dentist we work with. This whole situation reminds of what Dental Technicians went through in the late 1980’s and 1990’s. I just hope that common sense prevails

  6. The statements made here are factual, while the first three years of the bachelor of oral health therapy in Griffith were comparable to dental science the first two years of the program involved almost no clinical training and the third year for dental science limited clinical exposure.

    Although oral health therapists graduated in third year with a greater level of clinical exposure than third year dental science counterparts they did not have exactly the same subjects in our year, endodontics and prosthodontics were not covered or the second semester of dental materials.

    The final two years of dental science at griffith are the most important and intensive years of clinical exposure with a concurrent reduction in emphasis on theory.

    The statement that allied health practitioners training is “in no way comparable to that of dentists” is thus factual, any offence taken to this statement is borne by misinterpretation of the statement. Nowhere is it stated that allied dental practitioners are incompetent, or poorly trained, however their skill set is severely limited when compared to the level of training provided to dentists in their undergraduate training.

    These facts were the same when allied health practitioners commenced their training so it should not come as a surprise to allied practitioners their scope is limited as their skill set is limited by the level of training.

    In the best interests of public safety the diagnosis and treatment of adult patients should be carried out and/or supervised by a practitioner with sufficient skill level to diagnose oral pathology and assess options for restoration and rehabilitation.

    Treatment planning and diagnosis are not simple skills to master and these form the basis for referral to other dental practitioners. Training in speciality areas like endodontics, materials, pros, radiography, pathology, oral surgery etc… are important in providing accurate information for patients to decide on the best course of treatment within their budget.

    The statement the ADA and dentists are insulting OHT’s and allied dental providers is not true, defining ones role based on their level of training does not detract from their contribution to the community or state they are in anyway incompetent.

    Allied health professionals are important members of a dental team but they are not trained to provide the same level of care as dentists.

    Another point to consider is that oral health therapists currently can as pointed out own dental practices, as long as a dentist is employed, and can earn a relatively high salary compared to most other three year degree programmes.

    As noted in the programme established by Leonie Short: “Graduates usually work within a dental team environment as an employee, contractor, associate, partner or owner. Oral health therapists can earn high starting salaries of approximately $50 per hour in the private sector.”

    Arguments put forth by associate professor Short suggest the main benefit of these changes would be reduced cost of services to consumers, and that dental services should become as ubiquitous as “just cut’s” hair salons. submission – hardcopy – Leonie M Short.pdf of the Profession.pdf

    Dental care is not synonymous with massage services or hair cuts and the costs to run a dental practice and provide quality care are nowhere near the same.

    Oral health therapists should consider before embarking on this path or rhetoric the future of their own profession. Dentistry already is in the midst of an oversupply issue with almost double the number of undergraduate programs as before, and expansion of student numbers not to mention skilled migration. What do oral health therapists have to gain other than a pay cut by encouraging more practitioners to join their ranks?

  7. Dear Bite,

    I am very pleased to see a dental student following my publications and oral presentations very closely – very flattering indeed. However, I do not wish to be misquoted. My reference to ‘just cuts’ salons was in regard to looking at new markets and innovative ways to deliver oral health services to consumers. The dental example was a dental practice in an airport.

  8. If you want to practice like a dentist, go and study to be a dentist.

    A 3 year degree (with open entry) in no way is comparable to one who has studied for 5 – 8 years (with limited entry). The diagnostic skills which are a huge part of practising dentistry, are grossly undervalued to a casual observer.

  9. No, I have never wanted to be a dentist.

    No-one has ever said that an OHT and a dentist are the same – if one compares, them, they are very different.

  10. I don’t want to ‘practice like a dentist’…that’s why I chose my B App H (oral health) degree. I don’t think the points made above, are abou OHTst being equally recognised as dentists, it’s about getting some credit from the ADA.

  11. Hmmm it seem a lot of egos are being bruised looking at things from an emotional perspective and not from a diplomatic view of the facts.

    Its very stright forward, to me there is no argument:
    I am an OHT and formerly trained under National Law according to the ADC. We and others should be able to provide a service as we were ALL formally trained to do, no need for prescription dentistry. If you were cut back on your abilities, that you’ve been tried tested and “passed” on, you’d be fighting for what your entitled to.

    There are many great talented OHTs Therapists and Hygienists that the public need and deserve to have treat them. There is an epidemic of poor dental health in our country the more to help this the better “that should be the attitude” support each and elevate the public’s Oral Health.
    While I’m on my band wagon “where’s my provider number?”It seems a lot of health professionals who don’t do invasive practice have one, why can’t I???

    Some of the negative comments on this site are “outrageous” do your homework on each profession and the qualifications they’ve gained before you comment!!

  12. Dear Griffith Student,
    Your statements made above are unfounded. FYI when I did my Bachelor of Oral Health at Griffith we were trained extensively in the things you place under the heading of “in the interest of public safety”. To suggest that our Bacholers degree did not cover diagnosis, treatment planning, referral, radiology and pathology is insulting not only to my profession but also my lecturers, my university and the ADC who accredited our course. To also state that we are not trained to the same level of care is also insulting. We were trained to the same level of care it’s the scope of practice that is different. The level of care I provide to my patients is the same level of care that dentist I work with provide. Therefore to state that I was not trained to provide the same level of care as a dentist is ridiculous. Just because I don’t provide RCT’s, oral surgery, pros and other high end dental procedures does not make my profession substandard it just makes my profession different.
    Also FYI anyone can own a dental practice as long as you employ a dentist so I don’t understand what your point is?
    Your final point about what Oral Health Therapist have to gain? We have a lot to gain. Its more like what do you have to loose is the real issue here.

  13. I don’t want to practice as a dentist either. I love what I do.
    And FYI when I did my degree it wasn’t open entry. Actually I dont know of any dental bachelors degrees that are open entry.

  14. Thank you OHT
    you are obviously a very intelligent practitioner who understands exactly what the point and issues are about.

  15. Seems Griffith student has more sense than Prof Short. Obviously spelling is not a prerequisite for OHT but it seems OHT pang for reconnition when they can’t even recognise what it is they want!

    I might have missed something but my understanding is all auxiliary dental providers are trained and taught to practice under supervision.

    Sadly the DBA and AHPRA made a serious error in naming all professionals providing dental care dental practitioners. This was a protected title under all state dental acts before National Act for dentists. The price the public will now pay is for lesser trained dental providers wanting the same status and recognition as dentists. Seems the world goes in circles and I think it was in the 1890’s that Govt legislated the first dental acts in Australia to protect the public from the charlatans.

    History tells us other dental providers made claims of being able to provide dental prostheses cheaper and would resolve remote access issues. Funny how none practice in remote areas unless there is a dentist nearby and of course are not cheaper.

    As Ms Checker says “Members of the DHAA have always provided a high safety standard treating patients in supervised environments…”. The emphasis please on supervised — no argument.

    OHTs not only struggle with spelling but maths as well. Let’s see… 3yrs open entry Vs 5-8yrs graduate entry. Seem exactly the same to me!!Of course they are just as well trained!!

    At least the OHTs have one thing right – they aren’t dentists!

  16. Leonie here are some excerpts from your article unedited: of the Profession.pdf

    “i. Services that cater for patients on a drop-in basis: More and more clients are utilising services on a drop-in basis- Clients are not making appointments nor see any reason why they should make an appointment. These include : Just Cuts TM for haircuts, no-appointment waxing and beauty services, no-appointment restaurants, and walk-in doctor surgeries or GP clinics. So why don’t we offer this service for dental surgeries as well? Vancouver International Airport since 2001 (Lunt, 2001, p. 86-91). The dental practice offers a wide range of dental services for workers at the airport; however, its niche market is emergency dental treatment for travellers with a toothache or broken tooth. Oral health-care sessions are also provided to promote employee wellness for different employers at the airport. I can see the day when dental services are provided for patients on a drop-in basis in busy commercial centres like airports and shopping centres.” submission – hardcopy – Leonie M Short.pdf
    “If so, what is the detriment or loss suffered by consumers? The detriment or
    loss suffered by consumers is reduced access to dental services and/or at a reduced
    It would be a more competitive market if oral health professionals were able to offer
    a range of preventive and operative dental procedures at prices different to, or lower
    than, the ADA Schedule of Dental Services. A more competitive market could reduce
    prices and lower out-of-pocket dental expenses for consumers.”

    Cheryl, in no way did I state your profession is trained to a substandard level however it is true that the OHT program does not have as extensive clinical training in the areas mentioned.

    It is not an insult to state the level of clinical exposure and training in these areas is less than that of a dentist, this is true. Although training is undertaken in overlapping disciplines the clinical skills required to safely practice without supervision is only accredited in a dentists degree program.

    A fourth year student in dental science, with arguably more training in dental practice than OHT’s still requires supervision and cannot practice without supervision to protect the public against malpractice. Similarly a third year dental student requires the guidance and advice of supervisors to safely practice and prescribe treatment plans for their patients.

    Higher levels of care require a higher level of expertise to guide the referral process as 3rd year students do not have adequate knowledge to recommend RCT’s, extractions or prosthesis without the guidance of supervisors and their higher level peers. Thus safe treatment of the patient is achieved by supervision by trained professionals who have a broader knowledge and depth of clinical experience than undergraduate students.

    To argue an OHT graduate from a 3 year degree has sufficient knowledge to practice independently and provide the same level of care as a dentist is not true, and not in the interests of public safety as OHT’s are not trained to treatment plan at the same level as dentists are trained to.

    The issue of concern is not that OHT’s will expand their scope of practice to compare with that of dentists, it is that the level of clinical training provided to OHT’s is not the same as that of dentists thus treatment of the adult dentition and performing irreversible procedures should be done by or under the supervision of a dentist.

    The final point is OHT’s are earning a relatively high salary for a three year degree program, in a market with a rising number of unemployed/underemployed dentists. What do OHT’s stand to gain by promoting a reduction in dental care costs which provide this salary, and in promoting measures to increase the number of OHT’s in practice to augment the current dental health services supply.

    An oversupply of dentists and a concomitant increase in students studying OHT adds fuel to the fire so why would OHT’s want to stimulate the supply of allied practitioners in a market that is clearly saturated.

    Any government would encourage an increase in the supply of dentists and allied health professionals as it cuts costs and improves their budgets, at the expense of the providers and the public who are offered a reduced standard of care.

  17. Yes, Cheryll Dunn, I’m not aware of any open entry Oral Health Therapy degrees – not even the new RMIT Diploma in Dental Hygiene which is only open to Cert 4 dental assistants. Not sure what you mean, Michael.

    Hmm.. OHTs are trained to practice dentistry and diagnose oral disease but it’s not comparable to the training of a dentist? Well that’s going to confuse the ‘casual observer’!

    What is “in the interest of public safety” is the focus on prevention which is what ALL dental professions are supposed to be aiming for. OHTs are proud to provide the latest minimal intervention care to their patients to prevent complexities that call for referral.

    I also think its great we finally have our first group of Postgraduate oral health therapy students to graduate at the end of the year! They will have the formal training to provide preventive and restorative care for all adult ages, thus shortening public waiting lists and reducing emergency cases – traditionally why dental therapists were introduced in the first place.

  18. What about why we want the changes. The ADA make one good point, lack of funding for public dental services. So now I ask the ADA what their solution’s are?? Find a solution for that problem and another “the oversupplying workforce” issue could ease. In regard to needing to work under supervision of a dentist, even the dentist who I work for thinks this is unnecessary. Paramedics do not have the qualifications of a doctor yet are left unsupervised and in control of their patients administering drugs and performing life saving procedures that are within their scope of practice. Also by only allowing hygienists to treat patients rather than examine and diagnose first is frustrating for all involved, including the patient. If we can treat the diagnosed condition, shouldn’t we know enough about these conditions to be able to examine and diagnose them to begin with. In respect to caries detection and the whole picture, in a real in-chair situation with a patient I have picked up on further treatment required such as cavities and other concerns throughout my cleaning appointment, this is after the dentist’s initial examination and diagnosis. In order to do that I am examining the patient. So if I can re-examine and diagnose a cavity/other concern and refer back to the dentist in this given situation, why can’t this be achieved for patients who haven’t seen the dentist first?? Remember we can take x-rays too and have the skill and ability to recognise boundaries within our scope of practice to refer them onto the dentist if unsure. In addition to that I agree we need a provider number like 90% of all health professionals have. To be able to become a responsible practice owner in which your already partnered with a dentist or have one working for you, we should have fair access to payments made to the practice on our behalf. In other words the funds that are legally mine could go directly into my account if I had a provider number. Not to mention the other already known benefits. No bruised ego just wishful thinking that makes common sense. That factor (common sense) I hope, still exists and gets consideration..

  19. I have a student loan of $300,000. Half of my graduating class are unable to find a full-time job. Some have even been on Centrelink. Then there’s the indemnity insurance fees, CE fees, incoming accreditation. And as you know there is an oversupply of dentists, and now OHTs want to join in on the fun too. The fact is in the last few years I’ve fought tooth and nail to get into dental school – how hard have you fought Cheryl?

    I’ve been reading these posts on here. And it’s funny that OHTs are complaining about being “appalled”, “upset”, “dentists being emotional”, “save our profession”. Yet much of the negativity has been spouted by the OHTs because they feel they’re not getting their way. Childish. The fact is an OHT was never trained to treat an adult tooth. If I go to a hospital with a problem, I want to be diagnosed and treated by a doctor. He has the full scope of diagnostic skills available.

    Dentistry is gradually being de-skilled in this country. It’s the public that are going to suffer.

  20. Im an OHT in Melb & Im happy with my job. I do not understand why my profession wants more responsibilities because I find treating patients challenging enough the way it is now LOL

  21. Zac your should really reasearch the Facts. “The fact that an OHT was never trained to treat an adult tooth” really please. Ummmm yes we have. Do you think we stop diagnosing, treating and restoring dentition just because the 6 or 12 year old molars erupt. Really this is exactly the ignorance I am talking about.
    If you and your graduating class have a problem with employment then that is hardly an OHT problem. And guess what Zac we have student loans, indeminity insurance fees, CPD fees too.
    You question how hard I fought to get into dental school… Well Zac after working as a dental assistant for 22 years for some great mentors and dentist/specialists like Dr David Thompson and Dr George Yakimoff I applied to Griffith University for selection into their school of dentistry and oral health. Mind you to get a competive OP to be considered I had attended Uni part time in the previous 5 years studing an Arts degree( while working full time). Inbetween that Zac I gave birth to 2 children and went straight back to work…no handouts here. Having a disabled husband who couldn’t work I also had to work over 40 hours a week to provide for my family. So I was accepted into Griffith Dentanl school after extensive interviews, an exam and the competive OP 2 I had worked my ass off to beat 100’s of other candidates. So with 2 small children ( 2 and 4 )and a disabled husband I managed to continue working up to 28 hrs a week and study a full time dental degree with intensives during holidays and extended semesters.My I also say that while we were the first lot of students in the dental school we had no students above us to refer or consult with or compare notes. It was difficult to move between courses even if I wanted to as we need to have our course accredited with the ADC. With Associate Professor Short, Professor Hedley Colman, Dr Helen Bocock, both Drs Fosters and many other local dentist who mentored us we charted the uncharted waters successfully and had our courses accredited. I have also advised other students in entrance into Dental school both in OHT and Dental Science. So I think it would be fair Zac to say I worked pretty hard to get into Dental school.
    OHT’s are not to blame for the de skilling of dentistry as you so claim.

  22. Griffith student
    How is it true that an OHT program does not have the clinical in the areas mentioned.? I am assuming that you are referring to diagnosis treatment planning and restoration ?
    And just to enlighten you OHT work autonomously.

  23. Seems a waste if time training dentists. The OHTs can do it all and want it all!! really dumb if you ask me as they enjoy perhaps the highest rate of pay and are involved in true “team” dentistry. There is no “I” in team and every team needs a leader. That happens to be the dentist. OHTs are in for a hell of a time with oversupply and the original intent of auxiliaries being prevention orientated and treating school age ha fallen due to Govt cut backs. WA and SA have reasonable School dental services and the OHTs ought to be campaigning for every State and Federal Govt to be getting school age children treated. this is where real prevention comes into play. Instead the OHTs want to bite the hand that has got them into being. No wonder dentist students feel the way they are. Ms Dunn needs to take a firm grip because once patients realise they could see a fully trained dentist for the same fee as an OHT then I know who I would prefer to see.

    The attitude of the OHT says it all. Their arrogance not the dentist’s needs to be questioned.

  24. Bagging another profession is not very professional weather you agree if they are lesser qualified or not. Nor it is sending a positive message that we are grown up enough to “supervise” another professional. Asking for more time isn’t going to make any difference, if anything it will just expose more ugliness in this matter.
    P.S If you are criticising spelling and maths you had better check your punctuation. ; )

  25. I think changes should be made, I also think dentists should upskill and decrease in number to make room. However when it comes to full diagnosis and treatment planning; I do think this should be a dentist’s responsibility, at least for now. One must have a sound understanding of the disease process, risk factors and the multitude of treatment and management options including many referral options and their timing. The truth is that (as a gross generalisation) dentists have this training and understanding while other dental professionals do not. It not as simple as saying, “there are caries and perio disease, let me treat it because I am well trained to”. The options for treatment are so vast. Perhaps instead of a simple class II I want to place an inlay with a special connector for a removable prosthesis. So I think, the question is not that we want to draw a new line, in my opinion we should, but rather, where should that line be drawn? Diagnostic and treatment planning responsibility should be in the hands of dentists, but carrying out parts if that treatment plan should be open to those trained to perform the surgery, including therapists/OHT’s.

  26. To Cheryll,

    Firstly, your perseverance and life story is certainly admirable but your circumstances are not representative of the majority of OHTs. And you know that.

    Secondly, I believe it is the OHTs that are ignorant. How can you completely diagnose an adult tooth when you do not have the awareness or skill set to know ALL the procedures available. Diagnosis requires a little bit more than a “cookbook” and “recipe” approach you know. And then there’s the thought process that a dentist goes through when diagnosing, which funnily enough is not seen by OHT. Out of sight out of mind right?

    OHTs are NOT doctors. They never will be doctors. This is a reality check for their profession. They SHOULD NOT be performing medical procedures in adult’s mouths.

  27. Dear Zac
    I indulged you into how hard I had to work to get into dental school because you asked me that question. In no way is it reflective on how other OHT entered university but the point being there are standards to be meet in entering a OHT degree.
    Secondly, you are entitled to your believes just make sure before you belittle other health profession’s education that you have all the CORRECT facts.
    Also I too have a thought process when I treat a patient. And part of my diagnosis and treatment planning is weather or not to consult and refer on to the dentist, refer on to a Periodontitis or even on to the Orthodontist. See I can think without supervision, why because I was educated and trained to in a university just like others.
    And OHT’s are not Dr’s we never said we were. But neither is a Dentist a Dr. Here is a link to help you out with understanding the use of the Dr title.

  28. I can’t wait to start doing big fillings. Nan is going to be the first! She needs a root canal therapy on her 11 and big white fillings on all her teeth because they look old.

    Because I can do fillings, both silver and white, I should be ok. I don’t need to take a course or anything do I?

  29. As an Oral Heath Therapist working for the Government I would like to make the following points based on my experience and perspective:

    1. It is important to be aware that Oral Health graduates as dual qualified Therapist/Hygienists are primarily skilled and focused on oral health promotion, maintenance and preventative dentistry. For the treatment we do conduct we are fully trained to perform our scope and in most cases more trained and experienced to perform this work on children than dentists are. To highlight this point, many of the children I see are referred to me (unofficially of course) from private and public dentists who can’t perform treatment on children due to lack of experience in child patient management.

    2. I would suggest most people that become OHT’s do so as they would rather promote good oral health and prevent poor oral health more than they want to perform complex dental surgery, i.e. root canal, crowns etc. This is exactly in the same vein as a physiotherapist and an orthopaedic surgeon, or a Nurse Practitioner and a Doctor. Also, even the title; Oral Health Therapist/Practitioner Vs Dental Surgeon clearly indicates a difference in scope and practice.

    3. Under the eventual successful deployment of a therapist/dental surgeon’s model (it will happen it is just a matter of when), the majority of dental work required will be performed by Therapists. This is because the majority of dental work is and should be health promotion, maintenance and preventative dentistry. This will leave dental surgeons to do exactly what their name implies, dental surgery. This is currently the Government model for <18 YO patients and it highlights why Dentists are so concerned about this change as it means a reduction of workforce and heightening of complex work Dentists will perform day to day.

    4. Clearly the position taken by the ADA demonstrates that they are committed to the line of don't question the system and status quo and keep the post problem treatment based methodology instead of a preventative dentistry methodology.

    5. This optimisation and modernisation of the Dental industry is well overdue and I believe the current dental model will not be sustainable if OHT's don’t receive recognition and widespread adoption into the industry.

    6. Finally on a philosophical level, consider the following, should your first step when wanting to become healthy and lose weight be to go to a bariatric surgeon? Or is it to go to a personal trainer and dietician/nutritionist to try a preventative and more sustainable approach first?

    It is with this in mind that I suggest the ADA along with many dentists need to reset their mindset on the OHT profession and better understand the OHT role and how it will benefit patients.

  30. ‘And OHT’s are not Dr’s we never said we were. But neither is a Dentist a Dr. Here is a link to help you out with understanding the use of the Dr title.’

    Maybe if cheryll should learn to read before making such ignorant comments

    ‘unless a dental practitioner has a demonstrable right to use the title of ‘doctor’ (for example is a dentist, or specialist dentist or holds a Doctorate degree or PhD)’

  31. The rest of the sentence reads ” Only dental practitioners who are dentists or specialist dentist should use the title “doctor” in advertising and a dental practitioner who proposes to use the title “doctor” should make it clear that they are NOT registered as a medical practitioner or in a division of the dental practitioner register which they are not.
    In response to Zac’s claim on informing us that “OHTs are NOT doctors. They never will be doctors. This is a reality check for their profession. They SHOULD NOT be performing medical procedures in adult’s mouths”
    Reality Check Zac… we do not nor do we claim to perform MEDICAL procedures in Adult mouths. We preform what we are formally educated and trained to do which include procedures in Adult and children mouths.

  32. Hey OHT chic you should be fine
    I did implants, ortho and oral surgery first year out and I didn’t do any extra course
    maybe we should hook up

  33. I think the ridiculous “dr” argument can be dropped. It doesn’t add to this conversation.

    Actually OHT’s/therapists/hygienists do perform surgery on patients everyday and they do a great job of it. I totally agree with point 3 of OH Therapists post. It’s up to the dentists now to find a more skilled surgical and medical niche and allow the simpler procedures be performed by OHT’s etc.

    There should be less dentists which are more highly trained.

    I still maintain that in the majority of adult cases dentists (as we’re called now) will need to assess, diagnose and treatment plan the patients. All though this may even change with time.

  34. I’m now finding thus quite comical!!

    I willing to perform proceedures as I was formaly trained to do. I can’t see how it can’t be ok, youve been doing that. None of you dentists in this forum assessed me or are aware of my skill base or experience, you can’t judge nor am I taking your criticisms in board. I know the Dentist I currently work for, has faith in my skills as do the dentists that trained me at University. That’s what matters.

  35. The whole pretence behind this government “initiative” is based a poorly researched publication written by the health workforce Australia.

    The notion that this model of health care can address shortages in rural Australia of dental practitioners is a poorly constructed guise to reduce funding towards government sponsored dental funding & increase the supply of practitioners to bring down costs.

    There has never and never will be a case in which the independent practice of OHT’s in rural locations could be used to compensate for a lack of dentists practising rurally, just as there has never been a case to increase the number of dentists immigrating and studying to make up for a shortage of rural practitioners.

    Out of date data, poor research methodology (“Narrative” based), biased sampling and a lack of understanding of dental practice are the reasons behind the government pressing the DBA to take these actions.

    A review of the agenda behind this argument is presented here. Reform Agenda article Graham Middleton.pdf

    The big picture has nothing to do with professional recognition of OHT’s services or provision of rural health care or a “vision” to improve dental services. What it has done is divide allied practitioners and dentists who work side by side every day in teams so while everyone is fighting amongst themselves they can go quietly about devaluing the dental profession.

    A point to note is the powers that be have no idea about dentistry, they don’t realize that more dentists and OHT’s doing fillings at cheaper rates is not the answer to improving dental health, the answer is improving oral hygiene and general health.

    Moving the focus of OHT’s to restorative care rather than preventative is not in the best interests of the public, and will do nothing to reduce the incidence of dental disease in the general public.

    Fillings don’t last forever but good oral hygiene & public oral health measures can reduce or remover the need for costly fillings (and the repeat restorative cycle), oral prosthesis, and oral pathologies, pain/suffering altogether.

  36. Hi Kirsten.

    With all due respect can you please explain to me your comments from a previous posts?

    Quote Kirsten “We and others should be able to provide a service as we were ALL formally trained to do, no need for prescription dentistry. If you were cut back on your abilities, that you’ve been tried tested and “passed” on, you’d be fighting for what your entitled to.”

    Is the issue that your University trained you for an increase in scope and you now feel ripped off that this hasn’t been delivered on? Might be worth a class action lawsuit to regain some tuition fees? I would think it is preposterous of a University to be pushing this without adequate public or professional consultation.

    Quote Kirsten “There are many great talented OHTs Therapists and Hygienists that the public need and deserve to have treat them. There is an epidemic of poor dental health in our country the more to help this the better “that should be the attitude” support each and elevate the public’s Oral Health.”

    Seriously? The public needs and deserves? Maybe get your hand off it for a minute and understand that dentistry has come a long, long way over the last 100 years in elevating the public’s oral health without your input.

    Quote Kirsten “While I’m on my band wagon “where’s my provider number?”It seems a lot of health professionals who don’t do invasive practice have one, why can’t I???”

    Now you are talking sense. A provider number is what you are after? Take with it an increase in DBA rego fees, an increase in PI insurance, the option of joining prefered provider schemes, patient litigation and all the competition that comes with independeant practice.



  37. Hi Zak.
    You may need to read up on what an oht does!!! I as an oht in private practice that has an interest in early orthodontics my role is– hygiene therapies for adults and children, children’s dentistry needs including all their ADULT teeth excluding extractions, mouth guards, ortho appointments.
    My boss prefers me to see the kids and cleans and he does the adult restorative including rct and crown and bridge. We have a great relationship where we work independently of each other but support each other at the same time. I communicate and connect with patients well and sell ortho, crown and bridge etc to patients who need it and he provides support to me in return. We bounce off each other in our lunch breaks and neither of us trip over our egos on the way out at night. You and many others forget its a team approach to reach the best treatment for every individual and in many cases oht’s do a remarkable job with the kids and I know that’s where my passion is. You can choose to work through your career with or without the help of an oht, but from my experiences and the many patients that bring their kids to me from recommendations and referrals shows me the need for children focused dentistry in which I am busy providing. I’m feeling from the nasty posts that maybe dentists are just feeling threatened in general due to there over supply to the industry. Sorry that’s not our fault. I chose a career, studied and am practicing with great dentists and auxiliary staff around me and patients love our practice. Good luck to u hopefully u can get a more informed attitude and focus on your patients and paying back that $300,000 debt.

  38. Seems no one wants to look at the real workforce demand. Clearly the majority of private practice wants auxiliaries to perform mainly hygiene duties and Govt wants mainly therapy duties.

    The big issue is that they want to fluff around the comparability of the OHT curricula with dentists curricula. Simply comparing the subjects and not the levels to which they are taught – and publish them will resolve the difference between levels of training.

    Assoc Prof Short is relying on ignorance of the OHT curriculum to bolster her story, she needs to be disabused of this immediately.

    Universities see money in OHT courses hand have blown numbers sky high and well outside of workforce demand. As I read the play not only have we massive oversupply of dentists on our door step but even bigger oversupply of auxiliaries. Given the veracity of the comments by OHTs here why would you want to employ one. Seems they are all bragging about how good they are but as best as I can ascertain most of the OHTs are working and employed by dentists if in private practice and under supervision. Pia might bounce off her boss at lunch time and I won’t go there but am not sure her primary role is to “sell” ortho and crown and bridge, etc .

    Seems to me the dental profession is at the cross roads and if academics are teaching OHT’s scope of practice outside of what private practice wants then they will be resigned to being Govt employees or on centre-link payroll. I think universities and ADC have plenty to answer for not accurately defining scope of practice. To say they can practice what they are taught is nonsense if what they are taught is not well defined and uniform regardless of the uni attended. Dentists undergraduate training ventures into neuro-anatomy and we don’t want them going there in practice.

    The comparison of paramedics is crap. They do not perform life threatening surgical procedures but emergency care and in high end emergency are in contact with ED consultants. They are not doctors and unlike OHTs are not pretending to go beyond their role.

    Extending scope of practice for GP dentists is just as dumb. It already occurs but is called a Specialist.

    Govt’s often pang for cheaper is better and using lesser trained is better but the funny thing in this world it rarely works. Nurse practitioner’s were supposed to resolve remote medical access issues – funny that most work in ED or GP medicos rooms. Funny how now they want parity with GP medicos medicare rebate. Didn’t one of the “Super clinics” in Qld go bust based upon NP model? Prosthetists were going to do the same ie be cheaper and go remote. Funny not many are in remote and guess what – they want parity with dentists fees?

    If OHTs are not careful they could kill their own existence. I have heard Some unis did not have OHT intake this year. OHT and other auxiliary provider organisations need to be responsible in what they are driving – they could be on the verge of massive unemployment. They need dentists to employ them and dentists need them as employees. This game isn’t being played very cleverly and it is not about ego’s but providing appropriate dental care to the public. “Selling” treatment is not what the profession is about!!

  39. Hey dentist dude,

    Yep I thought no more courses were necessary. If you can do one filling, you can do any sort of filling. I can do silver, white, pink and orange.

    The other day a patient came to me with an abscessing 46. It seemed a bit loose. I wish I could have removed it for him. I can do everything else mind you!! No big deal, Im guessing it’s the same routine as removing Es… hmmm…

  40. It is extremely disappointing to see the volume of faceless bullying here.

    As an OHT working primarily in the public sector, I have experienced first hand the growth in dental decay in under 18s. I am committed to providing gold standard preventive and restorative work to all my patients within my scope of practice. I do so with a 2 on 1 therapist – nurse ratio and strict time constraints, often working outside work hours without pay to ensure all notes are completed accurately , given admin time is not allocated. This is the career i chose; I had a tertiary entrance/UMAT score that permitted me to do whichever course I desired to do.

    We are a very proud body of OHT professionals who desire foremost respect from the dental team.We do not want to take from the dentists their job, but be granted the ability to focus on our task of improving dental health outcomes well.

  41. “Dental therapists and OHTs have always been taught to treat adult teeth with restorations.”

    – this is a misleading statement as it does not address the fact that any treatment taught is under supervision, in a population under 18 years of age. Independent is a completely different ball-game to being supervised.

    “I have experienced first hand the growth in dental decay in under 18s. I am committed to providing gold standard preventive and restorative work to all my patients within my scope of practice.”

    – yes dental decay has grown. That is why we have an over-supply of dentists to tackle the problem in over 18s. Shouldn’t OHTs be focussing more on prevention in under 18s then?

    – yes within your scope of practice, which is under 18 years. So is it the fact that you’re not satisfied with your occupation at the moment that you want to treat adults?

    “Neither are dentists Drs its a courtesy title!”

    – it’s not just a courtesy title. Dentists are doctors of the mouth. We can prescribe medication, perform surgery (yes restoring a tooth is dental surgery), and have the ability to diagnose the mouth completely.

    “We are a very proud body of OHT professionals who desire foremost respect from the dental team.”

    – OHTs certainly have respect within the dental team. Emphasis on TEAM. Working as an individual outside of the dental team is the problem here…

    The day an OHT is permitted to independently practice on adults, will be a very worrying day for dental healthcare in Australia. It will de-value the dental degree so much and almost make it obselete unless you want to specialise.

  42. Hey OHT chic
    What awesome diagonsis and treatment planning fot the 46 glad you were taught you to think thru ur treament. Did you think it all up by yourself or did you need supervision?? I am glad you didnt remove it because with my skills I will root canal it and post core and crown it. if it falls out then I will place an implant.
    Not sure about removing e’s not good treating kids they move around too much and its really hard to work on a moving target. Besides I dont bother much with the little stuff not enough money it hey.

  43. Mazza

    1 You have no idea how long and how large my impact on OH in the dental profession is
    2 I’m happy in my OHT scope as I was formally trained, you need to read my statement again for a start
    3 provider number is to provide a service like any other practitioner
    4 my indemnity insurance and fees are the same as a dentist so no increase required.
    Thank you …….

  44. It’s disappointing to watch what could be an exciting opportunity for all Oral Health Practitioners to discuss in a mature and mutually respectful atmosphere a way in which we can work together in order to do what it is most of us are passionate about, and that is to provide a specialised health service to ALL Australians.
    I would like to see Dental Practitioners such as OHTs DHs and DTs issued with a provider number which enables them for billing purposes to be recognised by Medicare and health funds for the services we provide so that more people are able to access our services.
    I personally don’t feel that I want the responsibility of owning a practice, I’m not convinced at this stage that it is a good idea to practice without the support or guidance of an experienced Dentist, but I certainly don’t need to work to prescription from a dentist.
    It’s very easy to get hot under the collar about throw away remarks but most of us are above that.
    We should all do what we do best and collaborate our skills for the benefit of the public and stop putting our egos first.

  45. Hurt feelings and disappointment at not getting your own way isn’t in my mind the definition of bullying. A bit of back and forth is inevitable here as standing up for what you believe in and de-constructing a flawed argument is the essence of debate.

    If OHT’s want to be taken seriously in these comments they need to present a cogent argument which outlines a need in society for them to practice independently based on ACCURATE workforce data demonstrating a shortage of practitioners & to prove their contribution as independent practitioners would fill a gap not already provided by dentists or OHT’s employed by dentists.

    A decision to put an operator with a lower amount of training in a situation to perform irreversible surgical procedures involving removal & replacement or hard or soft tissue has to be carefully considered.

    The argument that massage therapists who don’t perform irreversible procedures have provider numbers so OHT’s should too does not make logical sense, the risk of irreversible damage is the whole reason supervision is necessary.

    Obviously a dentist isn’t looking over an OHT’s shoulder every 10 seconds if they are competent within their scope of practice, but if something goes wrong the dentist is there to intervene. Limiting their scope of practice provides further protection to adult patients as to the procedures they can and can’t conduct.

    The funny thing about the comments OHT’s are making here is they have a great relationship with their dentist, they have freedom within their working relation ship under a supervising dentist and respect, and many have noted they would not operate independently if changes occurred as they valued the presence of and experience of their supervising dentist.

    The provisions are in place to protect the public and serve their purpose in limiting the liability of OHT’s, providing security to patients if something goes wrong and as their is little evidence to suggest a change in policy would benefit anyone other than to stem OHT’s misplaced sense of injustice what reason is there to alter such a policy.

    Dentists don’t need to boost their ego to say they are more highly trained than OHT’s it is a fact, 3 years (or less) vs 5 years with intensive clinical training in the final 2 years Australia wide in all courses.

    It is not a malicious statement to say dentists are better trained to treatment plan and manage patients but it is incorrect to assume if one believes this they don’t value OHT’s & auxiliaries contribution to their practices.

    Being trained to perform a procedure and having an in depth knowledge about the consequences of that procedure and how it fits in with a treatment plan are two different things. If you want to read more on this issue please consult the following articles from the ADA.

    Scope of practice within workplace policies and new models of care 14 May 2013: The ADA wrote to the Dental Board of Australia stating that the scope of practice defines the construct of any workforce policies and so must define models of care and training. The ADA stated its support for existing DBA scope of practice standard remaining.

    “There seems to be an opportunistic push by some state based dental health services to utilise allied dental practitioners to provide a broad range of adult dental services on the assumption that cost savings will occur and that such actions will satisfy remote and very remote dental manpower issues. Both of these claims are unfounded and there is a distinct paucity of evidence anywhere in the world to support these claims.”

    Draft scope of practice registration standard and guidelines
    19 JUNE 2013

  46. Dear Griffith student,
    1. If You want to be taken seriously you should put your name to your comments.
    2. We already work without supervision so your arguments about how we can’t operate or function without your supervision is pointless and unsupported.
    3. We do irreversible procedures and we (not you) are responsible for the treatment we provide to our patients, that is why we are registered dental practitioners and pay indeminity insurance. Therefore respectfully we should have a provider number.
    4. The reasons we make reference to the dentists we work with is the mutural respect we experience with them. They are not threatened or closed minded. They consult and welcome our suggestions in diagnosis,treatment planning and treatment. We work as a team for a better outcome for our patients. We support one another and brain storm our ideas. There is no egos involved, and who has the higher education doesn’t get in the way of what is the best options for our patients. Economically that is why our practices are thriving.
    5. Using the words ” protecting the public” and “OHT’s” in the same sentence is making quite a dangerous statement on your behalf. If you are formally trained (in a university) to practice what was taught ( including post graduate study) it hardly makes you a danger to the public. I would be more concerned about a practitioner doing a weekend course then” trying it out ” on a patient.
    6. Your thoughts on Bullying (in your mind) amuse me.

  47. Just remember kids, OHTs can’t perform any duty unless they’ve been trained to do so….so, although I’ve treated many permanent teeth, doesn’t mean I can treat permanent teeth on anyone over 18 yrs of age.
    Griffith student, you seem to know a lot for a student.

  48. Dear Griffith Student,

    Please remember that no dentist can perform any duty unless they’ve been trained to do so and are competent – The Scope of Practice Registration Standard applies to us all…

  49. Dear DH&DT,

    Owning a practice does not mean working alone…. It does not make business sense to work alone as one cannot offer a full range of services for all patients. Many OHTs and DTs and DHs own practices -and they all work with denitsts.

  50. The Dentist and Periodontist with whom I work respect my competencies as a hygienist and therapist. We co-diagnose and co-treat. Any well educated and intelligent dentist understands the advantages of having a well trained, intelligent auxiliary on their team. Just as a surgeon is not a theater nurse, a dentist is not an OHT. They are two distinctive, highly skilled and interactive professions which rely on each other to provide the best treatment for the patient. Every operative has his / her limitations, regardless of formal training, which is why a combination of skill sets will enhance the provision of optimal care. Respect is the key to great partnerships between dentists, hygienists and therapists. As registered dental providers we are recognised with respect by governing bodies as equal in our intent to provide treatment to the best of our abilities. OHT’s will not fulfil the role of the dentist, but will offer communities access to dentistry through forward thinking practices, where teams are focused on comprehensive provision of care, the eradication of disease and kindness to humanity.

  51. Cheryll you’ve chosen to provide your name on a site which does not require you to use your actual name. If you require a comment to be taken seriously present legitimate evidence to support your cause not anecdotes of yours and others personal “experiences”.

    Policy decisions require research and analysis of facts not the off the cuff opinions presented by OHT’s here.

    If you want to understand more about this issue I would suggest researching it a little more and providing some solid evidence as to why these changes should occur.

    Who really takes half of these comments seriously: “I’m a good practitioner and I treat my patients with the respect they deserve, because I’m serving humanity and giving up my free time to write up patient notes, I do what I do because I care for patients unlike those dentists out there who want to do high end procedures like crowns and implants”, and so on.

    Anyone who takes this issue serious should consult other sources for accurate information, say for instance the articles I have linked to possibly?

    A random string of comments by the way does not equal legitimacy even if you add a name to it nor does flooding a board with pointless comments. The content determines the value of a post and stories of woe from OHT’s feeling undervalued do not cut it as a serious piece of information.

  52. This is the classic argument made by those who are underqualified to perform a service. Nobody doubts your ability as an individual and I’m sure you have plenty of examples of how you provided better treatment than the supervising dentist. But this isn’t about you and your examples are anecdotal. The reality is that on average OHT are not equipped with the training to perform these duties. Qualifications matter. They matter because the public deserves a standard of care. You wouldn’t like a system that allows under qualified pilots to fly a 747 Boeing? An under qualified surgeon to perform surgery on your wife.. On your husband?? Underqualified builder to build your house?? Engineer to build your bridge??

    You are kidding yourself. We need a standard to differentiate levels of skill and training to prevent harm to the public. There will always be examples of under qualified people who show a level skill that would be texhnically adequate, but we don’t decide the standards based on what the best OHT can do. We base it on what the average OHT can do. And the average OHT practitioner does not have sufficient training, skill, education, and proven aptitude to perform the duties proposed.

    What happens when the poorly trained OHT practitioners start getting sued for poorly performed treatment. Who is to blame when it is realised that the OHT practitioner is simply not qualified or trained well enough to be responsible for the mismanagement. Who is to blame then?. What will be the excuse… ‘We had to abandon a minimum standard of care because dentistry is unaffordable and there is a shortage in rural regions.? ‘ is that the excuse?

    To perform the duties of a dentist, candidates not only receive more training, but they are also picked from the top end of the pool to be accepted into the program. They must pass a more rigurous training program and show a higher aptitude than OHT. Fact. I’m sorry if that hurts you. Get over it. Know your place in the profession. If you don’t like it… Go be a dentist.

  53. Dear Griffith student
    I put my name to my comments because I am proud to do so and because I know what I am talking about.. I own a successful practice and know how it works. Your comments are the reason why we have already won. Ignorance is bliss .,,,,but in your case ignorance is why you and your mates can’t or will never get employed. And I am ashamed that the university that I went to now produces ignorant practitioners like you. By not putting your name to your comments makes you unaccountable for your actions. Surely as a highly educated, (who can think without supervision,) practitioner you are capable of ownership. Maybe not. As you say a random string of comments dose not equal legitimacy. Your a faceless contradiction. The boys club is finally closed you no longer have the monopoly on dentistry. you have lost control. Grow up and stop your whinging.

  54. Cheryll. Why dont you be honest with yourself. You need to go back to uni and study dentistry. Its written in every forceful sentence you blog, and in every heartfelt response you have made on this page. YOU want to be a dentist. Unfortunately you cant steam roll your way into the health profession. Nobody wants to ride with a pilot who has no qualifications. It must really annoy you to that you feel every bit capable as a dentist but nobody is willing to recognise your potential. But that is how society works. No degree = no qualifications. Now if the debate was whether we train OHT to perform simple restorative on adults this debate would be very different. BUT this is not the proposal put forward by the dental profession.

    I havent read this entire comment box. I just read the last message here by you and it ends with ‘stop your whinging’. Its childish and speaks volume about the kinds of dangerous attitudes that might enter the adult profession if the proposal is accepted. The boys club you refer to currently has a 50:50 female to male ratio. Your anger is misdirected. You should turn this resentment into something positive. You should look into a career in dentistry. Ring your university, enquire and make it happen. Good luck

  55. By joining this discussion recently I am very appalled to see such disrespect shown towards eachother’s profession.

    On the first day of studying at dental school a lecturer had gave a speech firstly to congratulate us for getting accepted in but secondly to teach us our very first vital lesson….it was on ATTITUDE. She had said attitude is everything and yes it was everything in getting you through dental school !

    Unfortunately you dent kiddos have quite a bit to learn about life….with an arrogant attitude like that you’ll be forever unemployed or lacking full time work and not to mention forever a lonely, single pringle.

    Maybe with this work drought it will teach you a lesson to be humble. As dentists are no longer associated with the tahoohaa of extreme money making, four figure salaries days especially if there’s no PTs to fill those books.

  56. Attitude several posts already cover your point of view, however skewed it may be.

    At what point did anyone see a dentist or dental student say anything resentful towards OHT’s? What I do see is some resentment towards dentists, which even though unfounded is nothing new. Maybe that is why dentists cop it on the chin rather than carry on about how they are unrecognised in their profession.

    OHT’s are quick to demonstrate how greedy dentists are but they make a a fair bit of money compared to the average 3 year degree holder. I don’t see working OHT’s lining up at soup kitchens.

    Although I have never seen a soup kitchen before that’s not the point it’s an based on what I see homeless people doing in the US and there is no analogous food source I can think of in Australia which compares to this provider of care to homeless people.

    If somebody asked me advice on a 3 year degree with a positive career outlook I would have told them to become an OHT, and if I had to do it all again I would definitely consider it over what I have already done.

    Now however the career prospects of OHT’s are looking worse as if you don’t own a practice like Cheryll, and there are many more programs and entrants looking forward to the promise of independent practice, the career outlook is changing. When lecturers like Leonie are promoting an increase in the number of OHT’s and allied practitioners what is the future of such a profession?

    “Health Workforce Study
    Leonie M. Short
    School of Dentistry and Oral Health
    Most commentators would agree that there is a shortage of oral health workers across Australia, particularly in regional, rural and remote areas.


    2 Education and Training:
    HECS funded places should be increased for the education and training of specialist dentists, dentists, dental therapists, dental hygienists, dental technicians and dental prosthetists.”

    Dentists are experiencing a change no doubt about it in terms of graduates under/unemployment however dentists are trained to do anything an OHT can do and more.

    The grim outlook you paint is shared by all dental professions, yet many OHT’s (not all OHT’s of course) here seem to be confident their profession will sustain itself without considering the competition they are up against.

    Nobody here resents OHT’s, there are no negative attitudes harboured to OHT’s in general, rather the comments made by SOME OHT’s have had an inflammatory affect on the comments that followed. These comments have been responded to to query their legitimacy, and every response has an individual flair, but the response has been pretty predictable.

    People can get caught up in the details fighting these little insignificant fights or you can see the big picture behind it all. The big picture has nothing to do with respect between professions.

    It has been noted by both sides of this fabricated argument that dentists work in mutually respectful teams with OHT’s, so what is this argument really about if not about reducing costs?

    I would ask all OHT’s out there to consider with your knowledge of the overheads involved in dentistry and the cost and sacrifice of training whether they truly believe dentists are greedy and overpaid.

    If so should they be examining themselves and their own salaries? I doubt there would be any full time OHT’s below the poverty line or earning much less than any of their counterparts from 3 year degree’s.

    Dentist & Ashley have added unique contributions to these comments, and nobody needs to join in and support their comments. Has anyone had to jump in and congratulate them on their keen sense of observation that for some reason nobody recognized? When you read a post it should not require a crowd of “here, here” statements in agreement as it stands on its own.

    Construct a post which is worthy of standing on its own that people will find meaning in and you will find supporters for your cause, until then readers will listen to the voice of reason.

  57. All I read here is a deep resentment towards dentists. There is an underlying inferior complex shown by some of the commenters.

    ‘Attitude’ speaks about the lack of respect here on this site and then laughably proceeds to comment ‘time to teach dentists a lesson’.

    The sad thing is that you are all screwed. Dentist and OHT. There is a massive oversupply of the entire profession. And you are all blind sighted by the bigger more relevant problem.

    Education has become a business in the last 5 years.

    At this point it doesn’t matter what your qualified to perform. None of you are going to perform anything full time. They are pumping out ridiculous numbers of dentists and OHTs which will leave you all unemployed. Dentists will have to reduce prices to match OHT salaries and OHTs will be jobless altogether when there are dentists available that can do what the OHT can do for the same price.

    Your ripping each others heads but the finger should be pointed at the associate professor who outright lies and insists that we have a shortage in the profession just to boost business in education.

    OHTs need to realise one thing. You won’t be performing much if dentists are not busy enough. You will see billboards that will say things like ‘guaranteed to see a dentist’ before you ever see OHTs taking work from dentists who are unemployed.

    So laugh hard as much as you want ‘attitude’. The entire profession will collapse in on itself before you ever come out ahead on the misfortune of others.

  58. Some great comments being made. When I commented earlier in regard to supervision, I was referring to direct supervision. I believe supervision could be met in an indirect manner in most cases. What happens if the dentist becomes sick and is unable to work? neither am I. Therefore all of the patients are rescheduled if possible, his patients and my patients for that day and following days if he is really sick. Leave in general is also dictated by the dentist because of the existing rule. This can be really frustrating for the patients when it comes to booking appointments. I never mentioned working independently on my own, I mentioned the dentist I work for. I expressed frustration at why a patient cannot be examined and treated by a hygienist first then passed onto the dentist. Even in the case of a new patient who presents upfront with complex needs, consultation could still be arranged with the dentist in most cases directly, at worst via a phone call or rebook the patient. In a busy practice this could provide more appointment options for the patients and less rescheduling on those unfortunate sick days. My main point with paramedics was they are not doctors, they are however in most cases the first point of contact with the patient. And while examining, stabilizing and transporting the patient to the hospital the ED consultants are not “onsite” in the back of the ambulance with them, they generally take over once the patient arrives at hospital. Owning a practice or entering a business arrangement is an individual choice, if you do not want that responsibility that is your choice. Wanting changes is an open debate for everyone.

  59. Just fuel for thought….

    i have never heard of students, upon the completion of 3rd year dental surgery, being given the opportunity to drop out with the title OHT.

  60. A lot of wasted time and energy on this forum, you OHT DON’T GET IT! There is no actual demand in the market for your services. Never was. Nobody wakes up and says. I WANT TO SEE AN OHT? What they want is a well trained, caring professional and the person that always comes to their mind is us dentists,.
    1. There are too many dentists anyway who are willing to work for the same or less. I can employ ADC specialists from overseas for less that some stuck up, overqualified young girl out of hygiene school.
    2. Dentistry is 50% diagnostic, 40% salesmanship, 10% clinical. OHT are very bad at the former 2.
    The course is run by feminists who think governments should create jobs and that they can regulate themselves into relevance. YOU MADE A BAD CAREER CHOICE! plain and simple, because you’ve always been an auxiliary element of the profession, never had your own FREEDOM and control.
    Tme to retrain girls!

  61. @ Rich Dentist Owner, Firstly, WOW, I thought people like you died out in the stone age! Obviously not, but let me enlighten you a little if I may. I own a practice and have been a Dentist for many years, I don’t claim to be rich but I have noticed that people who do typically are enlarging the truth. What I do claim is that in the 21st century, OHT’s when correctly utilised are profitable for a Dental practice and change an outdated business model to something in line with the century we live in. My question for you is, when you have a headache do you go to a brain surgeon? No? Why not? Because there is no need to pay for one when a panadol does the trick, it is not that you undervalue your health you are making a logical decision. Business is changing, so is the world, there is no efficiency in paying someone 50% more to do the same thing, you may argue dentists are better qualified which is true but not in the bulk of daily dentistry, that the industry requires. Up to you really if you accept this or deny it, your loss if you choose the latter. Finally, on your point about people not waking up and wanting an OHT, this is purely an education and time thing, in time they will, just like people now see online shopping as better often even though it is cheaper to deliver.

  62. Some, including some members of the ADA, do not understand the OHT profession. In my full time position as an OHT I treat 8 – 12 patients daily. I examine, take radiographs and OPGs, scale & clean, fissure seal, extract deciduous teeth, provide basic restorations and educate patients on dental disease and prevention. The dentist spends several minutes with each patient to confirm diagnosis and plan treatment which I explain and appoint. The dentist is then able to utilize his valuable time on all the additional aspects of dentistry I am not qualified and don’t have time to do – i.e Endodontic, Orthodontics, Prosthodontics and other complex restorative procedures. Yes, a dentist can do exactly what I do, and many do. However by employing an OHT @ $50/hr, dentists can increase the profitability of their practices by increasing the number of patients who seek care, and employ additional dentists to provide treatment outside the scope of the OHT. There is NOT an oversupply of dental professionals – there IS an indisputable, under-demand for our services. Just ask yourselves does EVERY person you know go to the dentist every 6 – 12 months? No? Why not – because they don’t believe they need to or they can not afford it. OHTs are trained specifically to address these issues – provide affordable care and educate people to seek regular dental care. I do – this is why patients I have do book “to see the hygienist”, and why for every patient who is in maintenance with an OHT, there are several more who are being treated by the dentist/s. This is exactly the intention of updating the scope of practice to allow the OHT to work without direct supervision, to provide access (financial and physical) to millions of Australians who currently do not have regular dental care. Next year, when the new government funded dental scheme begins, we have the opportunity to engage with people who are now able to afford a visit to the dentist – the task is to provide a service that will keep them in regular care and optimal dental health – if they spend 1 hour and some of their $1000 allowance on preventive services provided by an OHT, it will be the best money the government has ever spent!

  63. All I see is anecdotal examples of how ‘Michelle’ thinks her situation speaks for the entire OHT profession. That’s fine, you seem to think you are most capable of performing this service.

    Unfortunately what you are unable to comprehend is the notion that the EVERY person must be competent enough to perform this duty. That means every OHT provider straight out of school needs to have the training and aptitude to perform this procedure. Otherwise we have no standards.

    This is why we have minimum standards irrespective of how amazing YOU are.

    We don’t let people drive without a drivers licence… Irrespective of how amazing YOU are without one.

    Please stop telling us how amazing YOU are without a licence.

    A lack of regard for standards. It’s just dangerous.

  64. Hi
    As a former dental nurse I would just like noted that I have worked aside many brilliant dentists and oral health therapists. BUT over the past 19 yrs I have also worked along side some very questionable dentists as well. Seriously I have had to sit and watch silently as supposibly well trained dentists provide below average treatment to the unsuspecting public and not being unable to pass judgement. So some of these dentists need to stop with the banter on training because I’ve seen first hand time and time again bad dentistry. In the end everyone has there place in providing dental services and dentists need to relax you have had it too good for to long. If I have perio I want a periodontist if I need braces I want an orthodontist but noooo lots of dentist provide these services even though there are specialists that provide these services. Why? because u are trained too! is that your debate. Well, welcome to the oht’s debates. In the end it’s all relative isn’t it lol.

  65. ‘Dental nurse ‘ has no grasp if what she is talking about. So there maybe a few who have questionable practices as dentist. You think that this only occurs with dentists only? It occurs in every occupation available. By your logic maybe some medical nurses should act as doctors then hmm? Who needs degrees?
    We have standards in place to prevent malpractice as best as possible. You think that all ohts in australia are soo great as some of the ohts here make themselves up to be? There will always be a good batch and a bad batch in every professional field.

    In regards to your statement in regards to perio and ortho, no dentist who have just graduated will undertake orthodontics and advanced perio treatments. They either specialise or take extra training and courses which takes time and are extremely expensive. Research abit more before spouting such ignorant comments.

  66. Oh really ? Some dentists are bad so we should let the ohts do the job. Seriously? Maybe we should let medical nurses act as doctors as well, since some of them have so much experience in hospital they should know it all right ? Who needs degrees?
    Sure there will be some bad batch of graduates, but that occurs across every single profession out there. You think all ohts in australia are so great as some of the ohts here make themselves out to be? Sigh
    The standards are in place for a reason and a good reason at that. You can’t freeride to other professions without the necessary training. You want expanded scope go study argument.
    In regards to your idiotic statement regarding general dentist doing ortho and perio, no dentists who have just graduated perform orthodontic or advanced perio treaments. They either specialise or go through advanced courses and extra training which take a significant amount of time and are extremly expensive. Research abit before spouting such ignorant comments

  67. Dental nurse there is no debate about whether general dentists can or can’t perform periodontal treatment or orthodontic treatment and there may be good reason for people not seeing specialists.

    One of the dentists at Griffith practices in a small town where specialist services are limited and they have completed several CPD courses and further study to provide these services to the community which they would otherwise lack.

    The reason they are able to do this is they are provided with a level of training to asses whether they are able to undertake a treatment or whether they should refer it.

    I know specialists in practice who have told me their best referrals come from the worst dentists because they are the ones who will not touch difficult cases due to low skill levels in the speciality area. Although they are all trained with a general skill set each dentist has their own strengths and can perform certain procedures more predictably and efficiently.

    If as a general dentist you can treat cases within your skill level that some consider specialist level work that is not a reflection of an extension of your practice beyond your scope as we are provided with training in all areas however the hand skills of all dentists are not always the same.

    On periodontal treatment and ortho. General dentists are trained to perform most perio treatments but ortho’s are a little more guarded about who does what.

    For the most part I agree with Michelle, If I want to get a good scale and clean I would go to an OHT, and there is a role in providing OHI which may be neglected by dentists but for diagnosis and treatment planning, diagnosis of oral pathology i.e. oral cancer, you cannot substitute an exam by an OHT with that of a dentist.

    I’m not saying no dentist misses anything or that there aren’t bad dentists out there. Some dentists pass all their exams but do what they need to to get through & the same goes for OHT’s or any other degree, but accreditation and program structure is the only viable method of providing assurance that at the time the student was in university they demonstrated the competence and knowledge retention required to practice independantly.

    In terms of relative level of skill and training the training provided to OHT’s is of a lower duration and intensity with less focus on other specialities which puts them at a disadvantage when providing comprehensive treatment planning and diagnosis.

    In every profession you will find there are people who are passionate about what they do as many of the OHT’s are here, and are very good at their job, the same goes for dentists, dental assistants, dental technicians & prosthesists.

    One of our pros lab demonstrators & owners constantly reminds us you can build a practice on quality work that will survive when others around you are heavily discounting because the work you do will provide comfort and predictable results.

    All dental professionals should work together to provide the best treatment possible but who has the training to bring it all together? OHTs? Prosthesists? nope, the answer is dentists.

    You can call it an ego trip, and yes some dentists are less involved in the profession than they should be, but they have met the requirements to practice independantly and what they do from there is up to them.

  68. Every tertiary trained OHT is “licensed” and capable of performing the duties I described as the current scope of practice allows and CPD responsibilities are met. Hardly amazing, just fact. Everyone knows experience is invaluable and that individuals have varying talents. Most people, including myself, are fully able to comprehend that if you gain a recognized qualification, you have met the required standards, and are permitted to fully utilize this qualification. OHT courses are delivered, at least in part, by dentists. Some dentists have total disregard for the Dental Code of Conduct and should be ashamed of their derogatory comments on this site. Their slur on the OHT profession is also a slur against their fellow dentists, lectures, and some of the most respected professors of dentistry in Australia. It’s just dangerous. And so rude.

  69. It might really upset you to hear this as fact… But OHT students and graduates don’t have the proven aptitude.

    There is a clear reason we expect a certain level of education, intelligence and aptitude from high school candidates if they want to do dentistry. And these students are then put through rigorous training to complete a dental degree. There is no way in hell i will accept the premise that we should let any half baked cookie to start performing invasive surgery on the population. If I had it my way I’d disband this second rate profession we have erected called OHT and look elsewhere for solutions to meeting the financial burdens of dental care.

  70. Hi MIchelle with a big M, completely concur with your views about not letting our profession be overrun bay bunch of winging, childish half baked cookies

    Michelle with a small m, you seem to be like all you’re OHT colleagues sting your life on endless chatter and self reflection. Yu stuffed up with your career choice l Sorry! I on the other hand banked $40k in profit in the last fortnight,

  71. What a hoot! I came upon this discussion inadvertently and have just spent an hour reading each post. Vitriol abounds!
    As a well known, long standing opponent of the OHT concept, I feel vindicated. My preferred model was always a degree level course for hygienists and therapists in their own right. Each should be valued for their own areas of expertise and offered a three year course which provides a solid education in a dynamic, evidence based profession to a standard that ensures safe, unsupervised practice within a well defined scope.
    Sadly, I think BOH graduates are pawns in the political game of funding Universities – too many graduates are being trained for too few jobs.
    Regarding levels of training, BDS students at third year level have a much greater depth of knowledge than third year BOH students. Third year BDS students who’ve already completed BOH and then been accepted to BDS, will confirm that. I know because I teach them.
    I await my invitation to the Dean’s office…
    Just as an aside, these posts are full of appalling spelling and grammar errors – doesn’t anyone care about presentation these days?

  72. Are you serious? “If You want to be taken seriously you should put your name to your comments”? How does that have any bearing on this debate?

    I see someone losing this argument…..

  73. Having successfully completed the first two years of a five year dentistry course I concur with some of the above statements. I agree that although similar in many ways, the diagnosis and treatment planning of oral health therapy courses is not comparable to that of dentists. I do believe, however that the phrases chosen to convey this message have negative connotations and should have been chosen more wisely. Dentists depend on OHTs (check when to use apostrophes ‘Griffith Student’) to care for patients with minor periodontal issues and children.
    I am a firm believer that they are BETTER trained in these areas than any dentist other than paedodontists and periodontists.
    I would like to extend an apology to OHTs and ask that you excuse the poor wording by the ADA. I can understand the way you have interpreted it- I was offended and I was studying to be a dentist. On that note, it is appropriate to acknowledge the extended knowledge base of the dentists that have undertaken an additional two years of study compared with OHTs.
    Respect is critical and I know that all dentists could make a little more effort to appreciate OHTs and offer to assist them with an extended scope of practice rather than resent progress. At the same time, dentists deserve your respect and together you will provide better care.
    Most importantly- NEITHER of the two sides are innocent here.

  74. Lol yeah I study dentistry not engrish but fair point about apostrophes, I’m also bad at maths but I do know a little, not a lot about diagnosis and my own limitations.

    I don’t know what you do now or how much clinic time you had, but experience and training counts when it comes to diagnosis which is why we third years defer to our supervisors and higher year levels for more difficult problems.

    The dentist is there to notice problems in screening and routine practice and is also trained to refer and identify oral pathology where the OHT cannot. Cutting dentists out of the loop of diagnosis is like letting nurses take over identification of lower level diseases. How are they supposed to know whether the person has something more serious if they’ve only been taught to identify certain problems.

    I don’t see any problem with the phrasing used by the ADA or dentists opposition to the changes to scope of practice, they are expressing a legitimate concern for the welfare of patients who would be seen by a practitioner with less training in diagnosis and treatment planning than dentists, potentially missing dangerous lesions or other contributing factors.

    Perhaps if you had seen some of the team based treatment planning we do at our university you could see how different levels of training affect the quality of diagnosis and care provided to patients, If nobody is there to correct us and keep everyone on their toes who knows what havoc would ensue.

    I certainly would not want to be left solely in the care of a dental student with only 3 years training and no supervision, let alone an OHT to plan my treatment, identify referrals and check whether some lesions are dangerous. That is what we as dental students and dentists are talking about, not spelling mistakes or being mean in the way competence is phrased, at the end of the day it comes down to quality of care.

    All this talk about respect is secondary BS, we’re not colleagues here this is a forum so people can say whatever they want and we have no idea of the skill level of whoever posts so what is there to respect.

    I do respect the OHTs (no apostrophe) I know and would refer all my scale and cleans to them if I had heaps of patients as I know they do a good job, but with OHTs on this forum, how do I know who they are or what they do, and why should I care what their opinion is?

    Respect on the internet and respect in real life are two different things. For respect on forums you need to actually know what you are talking about or your argument will be ripped to shreds.

  75. These comments are clearly misguided, given the scope of competencies and accreditation by the Dental Board of Australia and the Australian Dental Council. If you look in the literature, many peer reviewed articles confirm these professions offer safe and quality care. The roles and responsibilities of the dental hygienist, dental therapist or oral health therapist should not be at the scope of dentist, and clearly this is not the argument (i.e. not about the training in all aspects of dentistry). The fact is, these dental practitioners are trained and competent in their own scope of practice, and able to detect and refer areas of dentistry that is beyond the scope of practice.

  76. Excuse me ‘Dentist dude’,

    Why on earth would you label a child a ‘target’? Perhaps all of your patients are viewed in this manner? You should take a good hard look at yourself and examine the reasons why you decided to enter a health care profession in the first place. Dentists like you only contribute to the continued mistrust amongst some members the general public – profiteering off of ignorance and vulnerability.

  77. I believe your understanding is wrong, and clearly you either don’t currently do clinical supervision to Bachelor of Oral Health students, or not an dental academic. Oral health students are supervised by dental therapists, dental hygienists and oral health therapists in a consultative relationship with dentists, and make autonomous decisions. That is, they refer patients to have more appropriate care that is outside their scope of practice. Why should there be a double standard for dentists, and for dental therapists, dental hygienists and oral health therapists, when they all should work in a team environment. The length of training and experience does not equate to safe and quality care. Rather it is the recognition of individual skills and competencies to offer care, and refer when appropriate.

  78. Just alerted to this debate through another site.

    Associate Professor Shorts comments on lowering the cost of preventative services and delivery systems seem questionable in at least two respects.

    Health Value is predicated on price and outcomes . Lowering the price alone may increase access potentially but may just as easily lower outcomes unless proper procedures and protocols are followed.

    Reduced fee “preventative services” are very common in my area and most commonly lower cost equates to less time for the service which equates to poorer outcome. This is irrespective of who delivers the service. Measurement monitoring recording treatment planning and communication leading to behavioural change are the key to good prevention. The mechanical part takes lots of practice but really almost anyone with good dexterity can be trained for that.

    Drop in dentistry goes against one of the most important principles of preventative care which is the establishment of a dental home. Innovation and improved access I’m all for but there is good evidence by Elderton in the UK and others that seeing different practitioners increases the amount of treatment but does not necessarily increase the outcome. Ie it promotes invasive treatment.

    This is why the establishment of dental teams and ongoing contact is so important. How that ongoing contact takes place is an area for innovation.

    I realise Associate Professor Shorts statements were possibly in a broader context., but on those points I would like to see the supporting evidence.

  79. The DBA is again consulting on the scope of practice of OHTs and DTs and submissions are due 14 may 2018. The DBA is recommending OHTs and DTs practice independently with no relationship required with a dentist, and that they are able to determine their own scope of practice by “self reflection” of their own ability and competence.

    The DHAA have been consulting OHTs and DHs and have already prepared a position statement. They are well prepared with submissions and are likely to use similar tactics that they have used in the past using value based statements that have no basis in fact.

    I have already heard statements from OHTs stating they feel they are justified to charge for a comprehensive exam on adult patients, and suggest they may be better at it as their patients have told them they are more thorough. This comes from the former president of the DHAA. There are OHTs out there who already feel they can perform comprehensive treatment planning and are charging 011s, but insist this is ok “within their scope of practice”.

    The ADA has yet to consult it’s members and has yet to release a statement, in the past consultation the combined efforts and submissions of hundreds of dentists helped prevent the disastrous proposal of independently practice and kept in place the focus on treatment in teams with the most qualified practitioner performing diagnosis. If you made a submission in the past please submit your opinion again, please recirculate this message to your colleagues, to your students and if you are still on your year level groups and message boards.

    Talk to your representatives in the Ada and put pressure on them to take some action on this issue. If the ADA and dentists fall victim to complacency we will have nobody to blame but ourselves if this proposal slips through unopposed, every voice counts so make sure you make yours heard!

    If you are a dental student this issue affects you more than anyone, you are graduating into an oversupplied market where commission is going down every year, young dentists are having to work multiple jobs part time with huge gaps on their books and at the same time are pressured to provide no gap treatment whiche health funds are making more untenable every day.


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