Pursuant to sections 11 and 12 of the Health Practitioners Competence Assurance Act 2003, this notice is issued by the Dental Council.
The following replaces the scope of practice and the prescribed qualifications for the "Scope of General Dental Hygiene Practice", "Scope for Administering Local Anaesthetic in Dental Hygiene Practice", "Scope for Undertaking Orthodontic Procedures in Dental Hygiene Practice", "Scope for Intraoral Radiography in Dental Hygiene and Orthodontic Auxiliary Practice" and "Scope for Extraoral Radiography in Dental Hygiene and Orthodontic Auxiliary Practice" in the previous notice published in the New Zealand Gazette, 4 March 2010, No. 25, page 592.
Dental Hygiene
Scope of Dental Hygiene Practice
The scope of practice for dental hygiene is set out in the documented "Detailed Scope of Practice for Dental Hygiene Practice" produced and published from time to time by the Dental Council.
Dental hygiene practice is a subset of the practice of dentistry, and is commensurate with a dental hygienist’s approved education, training and competence.
A dental hygienist’s major role is in the provision of oral health education and the prevention of oral disease to promote healthy oral behaviours. A dental hygienist’s primary task is in prevention and non-surgical treatment of periodontal diseases. A dental hygienist guides patients’ personal care to maintain sound oral tissues as an integral part of their general health.
Dental hygienists practise in a team situation with clinical guidance provided by a practising dentist or dental specialist1.
Detailed Scope of Practice for Dental Hygiene Practice
The Dental Council defines the practice of dentistry as the maintenance of health through the assessment, diagnosis, management, treatment and prevention of any disease, disorder or condition of the orofacial complex and associated structures.
Dental hygiene practice is a subset of the practice of dentistry, and is commensurate with a dental hygienist’s approved education, training and competence.
A dental hygienist’s major role is in the provision of oral health education and the prevention of oral disease to promote healthy oral behaviours. A dental hygienist’s primary task is in prevention and non-surgical treatment of periodontal diseases. A dental hygienist guides patients’ personal care to maintain sound oral tissues as an integral part of their general health. Dental hygienists practise in a team situation with clinical guidance provided by a practising dentist or dental specialist.
Dental hygiene practice includes teaching, research and management given that such roles influence clinical practice and public safety.
Dental hygiene practice involves:
- obtaining and reassessing medical and dental health histories
- examination of oral tissues and recognition of abnormalities
- assessing and provisionally diagnosing disease of periodontal tissues, and appropriate referral
- obtaining informed consent for dental hygiene care plans
- providing oral health education, information, promotion and counselling
- scaling, debridement and prophylaxis of supra and subgingival tooth surfaces
- applying prescription preventive agents under the direct clinical supervision of a dentist2
- applying and dispensing non-prescription preventive agents and fissure sealants
- applying and dispensing topical agents for the treatment of tooth surface sensitivity and tooth discolouration
- administering topical local anaesthetic
- taking impressions, recording occlusal relationships and making study models
- taking impressions, constructing and fitting mouthguards and bleaching trays
- taking intra and extra-oral photographs
- performing postoperative procedures such as removal of sutures and placement and removal of periodontal dressings
- recontouring and polishing of restorations
- administering of local anaesthetic using dentoalveolar infiltration and inferior dental nerve block techniques under the direct clinical supervision of a dentist or specialist
- assisting the dentist or orthodontist in implementing orthodontic treatment plans through performing such orthodontic procedures as: making study models including taking impressions and occlusal registration; taking clinical photographs for records; inserting, and removing some orthodontic appliances; pre-banding polishing of teeth; removing and placing arch wires as formed by the orthodontist; removing bonding composite and banding cement; removing O rings; de-bonding
and de-banding fixed appliances; replacing loose bands and providing oral health education and advice on the care and maintenance of orthodontic appliances. These are done under the clinical guidance and to a treatment plan prepared by the dentist or orthodontist responsible for the patient’s clinical care outcomes
- taking periapical and bitewing radiographs for the purpose of recognising disease of the periodontium3
- taking extra-oral radiographs.
Prescribed Qualifications
1. Bachelor of Oral Health, University of Otago; or
2. Bachelor of Health Science in Oral Health, Auckland University of Technology; and Dental Council approved course for Orthodontic Procedures; or
3. Certificate in Dental Hygiene issued by Otago Polytechnic and approved experience in the provision of oral health services within the scope of dental hygiene practice; and Dental Council approved courses for Administering Local Anaesthetic, Undertaking Orthodontic Procedures, Intra-oral Radiography and Extra-oral Radiography; or
4. New Zealand Defence Force training programme in Dental Hygiene and approved experience in the provision of oral health services within the scope of dental hygiene practice; and Dental Council approved courses for Administering Local Anaesthetic, Undertaking Orthodontic Procedures, Intra-oral Radiography and Extra-oral Radiography; or
5. Diploma in Dental Hygiene issued by a New Zealand educational institution; and Dental Council approved courses for Administering Local Anaesthetic, Undertaking Orthodontic Procedures, Intra-oral Radiography and Extra-oral Radiography; or
6. Diploma in Dental Hygiene, University of Otago (Orthodontic Procedures conferred from 2002) and Dental Council approved courses for Administering Local Anaesthetic and Extra-oral Radiography; or
7. Bachelor of Health Science (Endorsement in Dental Hygiene), University of Otago; or
8. an undergraduate dental hygiene degree or diploma from the Australian Dental Council or Dental Board of Australia accredited educational institution that included education in Administering Local Anaesthetic, Undertaking Orthodontic Procedures, Intra-oral Radiography and Extra-oral Radiography and registration in Australia4; or
9. an undergraduate dental hygiene degree or diploma, or undergraduate dental degree; and a pass in the Dental Council Dental Hygiene Registration Examination; or
10. an undergraduate dental hygiene degree or diploma or undergraduate dental degree and a pass in the USA National Board Dental Hygiene Examination or Canadian National Dental Hygiene Certification Examination and a pass in a USA or Canadian regional or state board dental hygiene clinical examination; and registration with a USA or Canadian dental authority; and Dental Council approved courses for Administering Local Anaesthetic, Undertaking Orthodontic Procedures, Intra-oral Radiography and Extra-oral Radiography; or
11. a Commission on Dental Accreditation (CDA) accredited undergraduate dental hygiene degree or diploma; a pass in the USA National Board Dental Hygiene Examination or Canadian National Dental Hygiene Certification Examination; and registration with a USA or Canadian dental authority; and Dental Council approved courses for Administering Local Anaesthetic, Undertaking Orthodontic Procedures, Intra-oral Radiography and Extra-oral Radiography; or
12. a General Dental Council (GDC) accredited undergraduate dental hygiene degree or diploma from the United Kingdom; and registration with the GDC; and Dental Council approved courses for Administering Local Anaesthetic, Undertaking Orthodontic Procedures, Intra-oral Radiography and Extra-oral Radiography; or
13. a Certificate or Diploma in Dental Hygiene conferred by the GDC; and registration with the GDC; and Dental Council approved courses for Administering Local Anaesthetic, Undertaking Orthodontic Procedures, Intra-oral Radiography and Extra-oral Radiography.
The following replaces the scope of practice and the prescribed qualifications for the "Scope of Orthodontic Auxiliary Practice" in the previous notice published in the New Zealand Gazette, 4 March 2010, No. 25, page 592.
Orthodontic Auxiliaries
Scope of Orthodontic Auxiliary Practice
The scope of practice for orthodontic auxiliaries is set out in the documented "Detailed Scope of Practice for Orthodontic Auxiliary Practice" produced and published from time to time by the Dental Council.
Orthodontic auxiliary practice is a subset of the practice of dentistry, and is commensurate with an orthodontic auxiliary’s approved training, experience and competence.
Orthodontic auxiliaries practise to a treatment plan prepared by a dentist or orthodontist for the patient concerned. Orthodontic auxiliaries practise under the direct supervision of a dentist or orthodontist who is present on the premises at which the work is carried out. The dentist or orthodontist is responsible for the patient’s overall clinical care outcomes5.
Orthodontic auxiliaries assist the dentist or orthodontist in implementing orthodontic treatment through performing such orthodontic procedures as taking impressions and making study models, inserting and removing some orthodontic appliances, preparing teeth for bonding, removing bonding composite and banding cement and providing oral health education and advice on the care and maintenance of orthodontic appliances.
Detailed Scope of Practice for Orthodontic Auxiliary Practice
Orthodontic Auxiliary practice involves:
- Taking clinical photographs for records
- Taking impressions. Obtaining a record of occlusal relationships
- Tracing cephalometric radiographs
- Placing separators
- Sizing of metal bands and their cementation including loose bands during treatment
- Supragingival polishing of teeth (as part of oral hygiene, before bonding and after removal of fixed attachments)
- Preparation of teeth for the bonding of fixed attachments and fixed retainers
- Indirect bonding of brackets as set up by the orthodontist
- Providing oral hygiene instruction and advice on the care and maintenance of orthodontic appliances
- Placing archwires as formed by the orthodontist when necessary and replacing ligatures/closing self ligating brackets
- Removing archwires after removing elastomeric or wire ligatures, or opening self ligating brackets
- Removing fixed orthodontic attachments and retainers
- Removing adhesives after the removal of fixed attachments using burs in slow speed handpieces where there is minimal potential for the removal of enamel
- Trial fitting of removable appliances. This does not include activation
- Fitting of passive removable retainers
- Bonding preformed fixed retainers
- Making study models, and fabricating retainers, and undertaking other simple laboratory procedures of an orthodontic nature
- Taking intra-oral and extra-oral radiographs.
Prescribed Qualifications
- Graduate Certificate of Orthodontic Assisting, Academy of Orthodontic Assisting; possession of a dental therapy, dental hygiene or dentistry qualification and approved experience in the provision of orthodontic auxiliary services under the direction and supervision of a dentist or dental specialist who can attest to competency6, and a Dental Council approved course for Intra-oral and Extra-oral radiography.
- New Zealand Association of Orthodontists, Orthodontic Auxiliary Training Programme: Certificate of Orthodontic Assisting7 , and a Dental Council approved course for Intra-oral and Extra-oral radiography.
The following replaces the scope of practice and the prescribed qualifications for the "Scope for General Dental Therapy Practice", "Scope for Pulpotomies in Dental Therapy Practice", "Scope for Stainless Steel Crowns in Dental
Therapy practice", "Scope for Radiography in Dental Therapy Practice" and "Scope for Diagnostic Radiography in Dental Therapy Practice" in the previous notice published in the New Zealand Gazette, 11 December 2008, No. 192, page 5099.
Dental Therapists
Scope of Dental Therapy Practice
The scope of practice for dental therapists is set out in the documented "Detailed Scope of Practice for Dental Therapy Practice" produced and published from time to time by the Dental Council.
Dental therapy practice is a subset of the practice of dentistry, and is commensurate with a dental therapist’s approved education, training and competence.
Dental therapists provide oral health assessment, treatment, management and prevention services for children and adolescents up to age 18. Disease prevention and oral health promotion and maintenance are core activities.
Dental therapists and dentists have a consultative working relationship, which is documented in an agreement between the parties.
Detailed Scope of Practice for Dental Therapy Practice
The Dental Council defines the practice of dentistry as the maintenance of health through the assessment, diagnosis, management, treatment and prevention of any disease, disorder or condition of the orofacial complex and associated structures.
Dental therapy practice is a subset of the practice of dentistry, and is commensurate with a dental therapist’s approved education, training and competence.
Dental therapists and dentists have a consultative working relationship, which is documented in an agreement between the parties.
In collaboration with dentists and other health care professionals, and in partnership with individuals, whanau and communities, dental therapists provide oral health assessment, treatment, management and prevention services for children
and adolescents up to age 18. Disease prevention and oral health promotion and maintenance are core activities.
Dental therapy practice involves:
- obtaining medical histories and consulting with other health practitioners as appropriate
- examination of oral tissues, diagnosis of dental caries and recognition of abnormalities
- preparation of an oral care plan
- informed consent procedures
- administration of local anaesthetic using dentoalveolar infiltration, inferior dental nerve block and topical local anaesthetic techniques
- preparation of cavities and restoration of primary and permanent teeth using direct placement of appropriate dental materials
- extraction of primary teeth
- pulp capping in primary and permanent teeth
- preventive dentistry including cleaning, polishing and scaling (to remove deposits in association with gingivitis), fissure sealants, and fluoride applications
- oral health education and promotion
- taking of impressions for, constructing and fitting mouthguards8
- referral as necessary to the appropriate practitioner/agency
- performing pulpotomies on primary teeth.
- taking and interpreting periapical and bitewing radiographs
- preparing teeth for, and placing stainless steel crowns on primary teeth.
Dental therapy practice includes teaching, research and management given that such roles influence clinical practice and public safety.
Prescribed Qualifications
1. Bachelor of Oral Health, University of Otago; or
2. Bachelor of Health Science in Oral Health, Auckland University of Technology; or
3. Certificate in Dental Therapy or Certificate in Dental Nursing (issued by the Department of Health or a New Zealand educational institution) and approved experience in the provision of dental therapy services within the scope of dental therapy practice (including interpreting periapical and bitewing radiographs under the direction and supervision of a dentist who can attest to competency) and evidence of successful completion of Dental Council approved courses for Pulpotomies and Stainless Steel Crowns and Radiography and Diagnostic Radiography (or an exemption certificate for radiography issued by the New Zealand Medical Radiation Technologists Board (MRTB) current as at 18 September 2004); or
4. Diploma in Dental Therapy (issued by a New Zealand educational institution) and approved experience in the provision of dental therapy services within the scope of dental therapy practice (including interpreting periapical and bitewing radiographs under the direction and supervision of a dentist who can attest to competency) and evidence of successful completion of Dental Council approved courses for Pulpotomies and Stainless Steel Crowns and Radiography and Diagnostic Radiography (excluding a Diploma in Dental Therapy issued by University of Otago or an exemption certificate for radiography issued by the New Zealand Medical Radiation Technologists Board (MRTB) current as at 18 September 2004); or
5. Bachelor of Health Science (Endorsement in Dental Therapy), University of Otago; or
6. Undergraduate dental therapy degree or diploma from the Australian Dental Council or Dental Board of Australia accredited educational programme that included education in Pulpotomies, Stainless Steel Crowns, Radiography and Diagnostic Radiography and registration in Australia; or
7. Undergraduate dental therapy degree or diploma, or an undergraduate dental degree; and a pass in the Dental Council Dental Therapy Registration Examination.
Key to Annotations
1Clinical guidance means the professional support and assistance provided to a dental hygienist by a practising dentist or dental specialist as part of the provision of overall integrated care to the patient group. Dental hygienists and dentists/specialists normally work from the same premises providing a team approach. Clinical guidance may be provided at a distance but appropriate access must be available to ensure that the dentist or specialist is able to provide guidance and advice, when required, and maintain general oversight of the clinical care outcomes of the patient group. Dental hygienists are responsible and accountable for their own clinical practice within their scope of practice but the dentist or dental specialist is responsible and accountable for the clinical guidance provided. Further detail on the working relationship between dental hygienists and dentists will be set out in the relevant Dental Council Code of Practice.
2Direct clinical supervision means the clinical supervision provided to a dental hygienist by a practising dentist or dental specialist when the dentist is present on the premises at the time the dental hygiene work is carried out.
3Section 15 of the Radiation Protection Act 1965 requires non-licensed persons who take x-rays to do so under the supervision or instructions of a person who holds a licence under that Act.
4With the introduction of the National Registration and Accreditation Scheme in 2010 all Australian State Licensing Boards were replaced by the Dental Board of Australia.
5Further detail on the working relationship between orthodontic auxiliaries and dentists/orthodontists will be set out in the relevant Dental Council Code of Practice.
6The Dental Council approved this prescribed qualification on 10 July 2006.
7The Dental Council approved this prescribed qualification on 15 February 2010.
8Dental therapists who have not received training in this area as part of their undergraduate programme can undertake this activity only in accordance with the Council’s policy on advanced areas of practice.