Dental Board proposes scope of practice changes

The Dental Board is recommending scope of practice changes, but the ADA doesn't like it.
The Dental Board is recommending scope of practice changes, but the ADA doesn’t like it.

Following on from Health Workforce Australia’s recommendations and pressure from the Ministerial Council, the Dental Board of Australia (DBA) has proposed to remove the supervision requirement for allied dental personnel (namely dental hygienists, oral health therapists and dental therapists – ADPs).

While some groups are happy with this recommendation, the ADA is not, saying in its latest newsletters that “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.”

In the newsletter, the ADA says that scope of practice (SoP) is the delineating factor between individual health professionals. It identifies the education and training and subsequent competencies required for registration and, by default, identifies the tasks and procedures that those professionals can perform as part of their particular practice.


The DBA is currently reviewing the SoP Registration Standard (the Standard) that all registered dental practitioners must abide by under the National Law. The current Standard was developed as part of the introduction of the national registration scheme. It sought to accommodate the range of conditions that existed under previous state and territory regulatory authorities. It was developed in concert with the community and the dental profession with protection of the public as its foundation.

The Association has said to its members that ADPs are trained with a very limited skill set to work under the supervision of a dentist, and  “Their training is in no way comparable to that of dentists.”

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  1. My concern, as with many other dental professionals and allied dental personnel, is first and formost the safety of the patient. Many feel pressured to perform tasks outside of their skill set for mainly financial reasons. Most ADP’s realise the gravity of the responsibility placed on them, but there will always be some who operate on the fringes of their skill set. Secondly, I fear there will be a disillusionment in the public eyes over the confusion created between dentists and ADP’s. Even now patients find it difficult to differentiate and become quite angry when they feel they have been mislead. I believe we will see an increase in the number of complaints to AHPRA.

  2. My concerns are for the patients and the operators. Public safety as well as pressure for ADP’s to perform tasks that are not in their skill set are going to lead to more complaints to AHPRA. Patients already feel confused, what is going to happen if there is no supervision and no defining borders?

  3. Prior to national registration, Tasmania allowed unsupervised dental hygiene visits. I worked in this situation as a locum for a month. The practice was “fronted” by a dental hygienist advertising a smile clinic and whitening proceedures. All patients were recommended to have an examination with their dentist every 6 months. 2-3 Dentists local to the patients location or work place were written as referrals. A dentist was verbally available (by a supervision agreement) to the hygienist if she had questions or concerns about a patient’s health or oral care.

    My observations – The patients came for whitening and often were recommended to see the dentist first for “filling replacements” advised prior to whitening, hence they had an unplanned dentist examination which is very desirable.

    – Dentists without the services of their own dental hygienist or who was unavailable due to leave, referred to this service for regular periodontal care.

    – The operators were very responsible and thorough regarding referral to other health professionals.

    – The responsibility of care was placed with the patient, empowering them. This appeared to reap a good result.

    I do not believe that dh or dt or oht are less professional in their scope of practice than dentists. However,I do believe that a scale of experience and training in specific areas is necessary for these professionals. eg minimum 2 years supervised experience prior to working unsupervised. Specific remote, rural or aged care qualifications.

  4. I would be interested to hear some more information and particular examples of ADP’s who Lan has mentioned;
    ‘Many feel pressured to perform tasks outside of their skill set for mainly financial reasons’
    Who is pressuring the ADP? The overseeing dentist or the patient? The receptionist? What are they being pressured into?
    If it is for financial reasons as stated, one would assume the practice owner (more than likely a dentist) is applying pressure to reach a target each day?

    I am very curious about this comment also,

    ‘Even now patients find it difficult to differentiate and become quite angry when they feel they have been mislead’

    How are these patients being misled? Who is misleading them?
    There must be something very wrong in the communication process within that environment if patients are feeling angry or misled after a visit to an ADP.
    Having worked in numerous dental practices over many years, these are most unusual statements?!


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