Patients, colleagues and the public

A dental technician will be able to:

1.1 Provide patient-centred care by putting the patient’s needs first, and protect and promote patient and whānau or family wellbeing.

1.2 Understand the concept of professionalism and how to develop and maintain an effective practitioner-patient relationship.

1.3 Act with dignity and respect towards others by being open and honest, courteous, empathetic, and supportive in interactions, and acknowledging and respecting Tikanga Māori.

1.4 Treat others fairly and without discrimination, respecting cultural values, personal disabilities, and individual differences.

1.5 Respect patients’ autonomy and their right to make their own oral health decisions, aligned with kāwanatanga, tino rangatiratanga and ōritetanga.

1.6 Respect patients’ right to complain and enable them to seek redress by facilitating the fair, simple, speedy, and efficient resolution of complaints.

1.7 Respect and protect the confidentiality of patient information at all times, including situations outside the healthcare setting.

1.8 Behave in a professional manner that maintains public trust and confidence in them personally, and the profession.

1.9 Act to protect the interests of patients and colleagues from any risk posed by their own personal issues, health, competence, or conduct; or those of a colleague.

1.10 Act to protect the interests of tamariki, mokopuna, rangatahi in cases of suspected neglect or abuse by disclosing information to a relevant authority or person.

Laws and regulation

A dental technician will be able to:

1.11 Practise in accordance with legal and regulatory requirements that affect oral health practice in Aotearoa New Zealand.

1.12 Understand the relevance of Te Tiriti o Waitangi. Specifically, the concepts in relation to hauora Māori and Māori oral health outcomes: tino rangatiratanga, equity, active protection, options, and partnerships.

1.13 Understand and comply with the professional standards and practice standards of the Dental Council’s standards framework, and adhere to the ethical principles, in their interactions with patients and their communities.

Professional development and ongoing competence

A dental technician will be able to:

1.14 Critically self-reflect on their practice and apply this to their ongoing professional development; including reflecting on their decision-making, actions, performance, and whether culturally safe care has been achieved.

1.15 Recognise the importance of ongoing learning and professional interaction as means of maintaining and enhancing professional knowledge and skills.

Communication

A dental technician will be able to:

2.1 Communicate respectfully, effectively and in a culturally appropriate way with and about patients, their parents, whānau or family, carers, representatives, kaiāwhina, and the public.

2.2 Listen to their patients, recognise communication barriers, and take into account specific communication needs and preferences. This includes Te Reo Māori me ona Tikanga, communication needs and preferences.

2.3 Communicate honestly, factually and without exaggeration in all forms of communication.

2.4 Provide patients with the information they need and request, and facilitate their understanding of the information and their options.

2.5 Communicate openly and respectfully with colleagues, other members of the oral health team, other health professionals, other hauora providers and social organisations.

Culturally competent

A dental technician will be able to:

3.1 Understand Te Tiriti o Waitangi and Treaty of Waitangi and the application of the principles to their practice.

3.2 Recognise and respect the cultural diversity of the Aotearoa New Zealand population.

3.3 Describe the Māori world view of hauora, tikanga and kawa and apply this knowledge to their practice.

3.4 Use knowledge of whanaungatanga and Te Tiriti o Waitangi as a basis of their practice to establish functional relationships with Māori patients.

3.5 Understand that a patient’s cultural beliefs, values and practices influence their perceptions of health, illness and disease; their health care practices; their interactions with health professionals and the health care system; and treatment preferences.

3.6 Recognise that the concept of culture extends beyond ethnicity and includes, but is not restricted to, age or generation; gender; sexual orientation; occupation and socioeconomic status; ethnic origin or migrant experience; religious or spiritual belief; and disability. Patients may identify with several hapū, iwi and/or cultural identity.

3.7 Reflect on their own culture (including their own biases, attitudes, assumptions, stereotypes, prejudices and characteristics) and its impact on clinical interactions and the care they provide, including delivery of culturally appropriate care.

3.8 Understand the inherent power imbalance that exists in the practitioner-patient relationship and commit to work in partnership with their patients and whānau to enable culturally competent care.

Culturally safe care

A dental technician will be able to:

3.1 Understand Te Tiriti o Waitangi and their application of the articles, as described in Wai 2575, when providing care.

3.2 Recognise and respect the cultural diversity of the Aotearoa New Zealand population.

3.3 Describe the Māori world view of hauora, tikanga and kawa and apply this knowledge to their practice.

3.4 Use knowledge of Te Kawa Whakaruruhau and Te Tiriti o Waitangi as a basis for their practice, to achieve whanaungatanga- based relationships.

3.5 Understand the following concepts in relation to hauora Māori and Māori oral health outcomes:

• tino rangatiratanga which provides for self-determination and mana Motuhake
• equity¹ which focusses on equitable health outcomes for Māori
• active protection to achieve equitable health outcomes
• options which focus on access to oral health care, and delivering the care in a culturally appropriate way that recognises hauora Māori models of care
• partner with Māori on delivery of oral health care to Māori to improve access, equity and oral health outcomes.

3.6 Understand that a patient’s cultural beliefs, values and practices influence their perceptions of health, illness and disease; their health care practices; their interactions with health professionals and the health care system; and treatment preferences.

3.7 Understand the impacts of racism, colonisation and power imbalance on Māori oral health, and the current state of inequitable access to care and hauora outcomes.

3.8 Provide culturally safe care - as determined by the patient, their whānau, hapū or community.

3.9 Recognise that the concept of culture extends beyond ethnicity and includes, but is not restricted to, age or generation; gender; sexual orientation; occupation and socioeconomic status; ethnic origin or migrant experience; religious or spiritual belief; and disability. Patients may identify with several hapū, iwi and/or cultural identity.

3.10 Reflect on their own culture (including their own biases, attitudes, assumptions, stereotypes, prejudices and characteristics) and its impact on clinical interactions and the care they provide.

3.11 Understand the inherent power imbalance that exists in the practitioner-patient relationship and commit to work in partnership with their patients and whānau to enable culturally safe care.

Critical thinking

A dental technician will be able to:

4.1 Apply contemporary scientific knowledge to dental technology practice appropriately.

4.2 Critically evaluate published clinical, scientific, Matāuranga Māori and health related research; and integrate this information, where appropriate, into their practice.

4.3 Understand and apply the principles of good rangahau and research practice. This includes, scientific method, critical evaluation and referenced tohungatanga of research, evidence or information.

4.4 Recognise and evaluate the impact of new techniques, materials, and technologies in dental technology practice.

4.5 Recognise and evaluate the impact of Matāuranga Māori and research on Māori oral health outcomes and equity, and how to use this information to improve hauora Māori and equity.

4.6 Critically reflect on their individual knowledge and skills throughout their professional career, to inform their ongoing professional development or identify their own limitations and how that may impact on their current practice.

Application of scientific and clinical knowledge

A dental technician will be able to apply the scientific and clinical knowledge base relating to:

5.1 Fundamental principles of chemistry, physics, and engineering as they relate to dental technology.

5.2 Anatomy and physiology of the head, neck, and oral cavity, relevant to dental technology.

5.3 Tooth development, tooth eruption and the occlusal development of the dentition in relationship to the development of the craniofacial complex.

5.4 The effect of tooth loss, and the impact of appliances, on the oral environment.

5.5 The core principles of infection prevention and control, including standard precautions, and reprocessing of reusable items, performance testing and validation when applicable (for example, when reusable items have been in contact with the oral environment). This includes consideration of tikanga Māori.

5.6 The science of dental materials used in the design and manufacture of prostheses and appliances. This includes:

• clinical, physical and biological properties
• how and why these may be modified by manipulation, environmental and chemical modifiers
• how these changes relate to the success or failure of the material
• safety and Te Taiao considerations.

Obtaining prescribing clinician and patient information

A dental technician will be able to effectively obtain:

6.1 Prescribing clinician and patient information relevant to the design, manufacture and delivery of prostheses and appliances, for example, name and address of the prescribing practitioner, name of the patient, a detailed prescription, etc.

When providing repair services direct to patients

6.2 Information related to a patient’s:

• presenting problem
• concerns, ideas, wishes and expectations.

When carrying out shade taking procedures

6.3 Information related to a patient’s:

• concerns, ideas, wishes and expectations
• current medical conditions, and allergies - to enable safe practice and effective management of medical emergencies.

Analysing the health practitioner’s prescription and patient information

A dental technician will be able to:

6.4 Analyse the health practitioner’s prescription and the patient information to design and manufacture suitable prostheses and appliances using appropriate materials; and make repairs.

Planning services

A dental technician will be able to:

6.5 Determine whether they have the knowledge, skills and competence to provide the services required, and refer appropriately when they do not.

When planning to provide repair services direct to patients:

6.6 Gain informed consent, appropriate for the individual, and ensure informed consent remains valid throughout.

6.7 Refer the patient to the appropriate oral health professional for an intra-oral examination to ensure that the repaired prosthesis or appliance is fit for purpose.

Providing services

A dental technician will be able to:

Design, manufacture, and repair

6.8 Design, manufacture, and repair fixed and removable oral and extraoral appliances and prostheses, so they are fully functional, effective, and aesthetically pleasing, including:

• Complete removable dentures and overdentures
• Removable partial dentures including precision attachments
• Fixed and removable orthodontic appliances
• Crowns and bridges including precision attachments on natural teeth and implants
• Implant overdentures and implant supported dentures
• Tissue and implant supported maxillofacial, ocular and auricular appliances and prostheses, and other appliances and prostheses involved in the overall prosthetic rehabilitation of patients
• Appliances for the treatment of temporomandibular, speech, sleep, and audio disorders
• Diagnostic and radiographic stents.

Dental materials, design and manufacturing techniques

6.9 Select dental materials and manufacturing techniques for use in the manufacture and repair of fixed and removable prostheses and appliances, appropriate for their application.

6.10 Ensure that the manufacturer’s guidelines are followed for materials and components used in the manufacturing of prostheses and appliances.

6.11 Use a range of recognised design and manufacturing techniques including contemporary digital technology.

Shade selection and reproduction

6.12 Take and reproduce the shade of the natural dentition.

6.13 Check shades, which may include the removal of a pre-loosened temporary restoration and try-in of the permanent restoration, without removal or placement of an implant abutment, as prescribed by and prior to the final fitting² by a dentist or dental specialist.

Maintenance

6.14 Provide advice on the care and maintenance of prostheses and appliances.

Medical emergencies

6.15 Manage medical emergencies that may occur during dental technology practice.

Safe practice

A dental technician will be able to:

6.16 Establish, manage, and maintain a safe working environment for patients, staff and colleagues; and to protect the public. This includes a culturally safe workplace and the routine and proper use of infection prevention and control measures.

6.17 Identify and appropriately manage potential hazards (including hazardous materials), and behavioural risks in the place of work.

6.18 Understand the principles and legal obligations of waste management and show awareness of practices used to limit unnecessary waste.

6.19 Produce and maintain accurate, time-bound, and up-to-date patient records which are secure.

6.20 Confirm with the patient any current medical condition/s or allergies they might have.

6.21 Manage a medical emergency appropriately and effectively in their workplace within their prescribed resuscitation training.

Teamwork

A dental technician will be able to:

6.22 Understand the value of interdisciplinary practice in providing patient-centred care, and work collaboratively with oral health and other health practitioners for enhanced patient outcomes.

6.23 Recognise the unique set of skills and competencies that each member of the oral health team contributes to patient care and the promotion of oral health in the whānau, hapū, iwi and community.

The practice environment

A dental technician will be able to:

6.24 Develop and comply with systems and processes in their workplace to support safe and effective patient care.

6.25 Effectively manage their own time and resources.

6.26 Describe the basic principles of practice administration and management.

6.27 Be familiar with the use of contemporary information technology tools commonly used in practice to support safe and effective care.

Patient-centred care

Patient-centred care can be defined as providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions (Institute of Medicine 2011).

It represents an all-inclusive approach. The widely accepted dimensions of patient-centred care are:

• Fast access to reliable health advice
• Effective treatment delivered by trusted professionals
• Continuity of care and smooth transitions
• Patient involvement in decisions and respect for patient preferences
• Clear, comprehensible information and support for self-care
• Involvement of, and support for, family, whānau and kaiāwhina
• Emotional support, empathy, and respect
• Attention to physical and environmental needs.

Research findings show that patient-centred care improves patient experience, creates value for services and is increasingly recognised as a critical dimension of high-quality health care³.

Culturally safe care

The Health Practitioners Competence Assurance Act 2003 requires the Council to set standards of cultural competence for oral health practitioners⁴. This includes competencies that will enable effective and respectful interaction with Māori.

The Council’s Cultural competence practice standard defines cultural competence as “an awareness of cultural diversity and the ability to function effectively and respectfully when working with and treating people of different cultural backgrounds”.

Culture includes, but is not restricted to, age or generation; gender; sexual orientation; occupation and socioeconomic status; ethnic origin or migrant experience; religious or spiritual belief; and disability.

Cultural safety extends beyond a practitioner’s cultural awareness or cultural sensitivity.

It requires the practitioner to examine themselves and the potential impact of their own culture on clinical interactions and the care they provide.

This means the practitioner needs to acknowledge and address their own biases, attitudes, assumptions, stereotypes, prejudices, characteristics, and hold themselves accountable for providing culturally safe care.

Key to providing culturally safe care is that the practitioner understands the inherent power imbalance in the practitioner-patient relationship, recognises and respects each patient as an individual, and enables meaningful two-way communication to occur.

Cultural safety requires that all people receive oral health care that takes into account their uniqueness. It is the person and/or their community, whānau or family, hapū or iwi receiving the care who determine what culturally safe care means for them.

A well-referenced definition of cultural safety is:

an environment which is spiritually, socially and emotionally safe, as well as physically safe for people; where there is no assault, challenge or denial of their identity, of who they are and what they need. It is about shared respect, shared meaning, shared knowledge and experience, of learning together with dignity, and truly listening⁵.

This definition supports the understanding that the relationship between a practitioner and patient is a partnership based on trust and respect, where communication is key in meeting the patient’s needs and goals.

Evidence-based practice

Evidence-based practice is the integration of relevant scientific evidence with the practitioner’s expertise (clinical, technical, health protection and promotion) and the patient’s or community’s needs and preferences. Evidence-based practice promotes consistency and optimal outcomes of care.

In providing evidence-based practice it is fundamental that the practitioner has relevant scientific knowledge, understands scientific method, can evaluate evidence, and works to a robust and contemporary evidence base.

Equity

In Aotearoa New Zealand, people have differences in health that are not only avoidable but unfair and unjust. Equity recognises different people with different levels of advantage require different approaches and resources to get equitable health outcomes.

• mauri ora– healthy individuals
• whānau ora– healthy families
• wai ora– healthy environments.