Notice Under the Legislation Act 2019 of Scope of Practice, Qualifications and Competencies for Oral Health Therapy Practice
Under the Legislation Act 2019, notice is given of the making of the following secondary legislation:
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Title |
Empowering provision(s) |
Administering agency |
Date made |
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Health Practitioners Competence Assurance Act 2003 |
Sections 11, 12 and 118(i) |
Dental Council |
8/12/21 |
This secondary legislation can be accessed at https://dcnz.org.nz/resources-and-publications/resources/gazette-notices/.
The following replaces the scope of practice and prescribed qualifications for oral health therapy published in the New Zealand Gazette, 14 July 2021, Notice No. 2021-gs2913 and New Zealand Gazette, 10 March 2020, Notice No. 2020-gs883, respectively.
This notice is issued by the Dental Council pursuant to sections 11, 12 and 118(i) of the Health Practitioners Competence Assurance Act 2003, to come into effect from 8 December 2021.
The practice of oral health therapy is the provision of oral health assessment, diagnosis, management, treatment and prevention of any disease, disorder or condition of the orofacial complex and associated structures in accordance with an oral health therapist’s approved education, training, experience and competence.
Oral health education, disease prevention and oral health promotion for individuals and communities are core activities, aimed at achieving and maintaining oral health as an integral part of general health.
The scope of practice encompasses the oral health therapist competencies.
Practice in this context goes wider than clinical oral health therapy practice to include teaching, research, and management, given that such roles influence clinical practice and public safety. Areas of oral health therapy practice which were not included in a practitioner’s training should not be undertaken unless the practitioner has completed appropriate training and practises to the standards required by the Standards Framework for Oral Health Practitioners.
The Council defines competence as the knowledge, skills, attitudes, and behaviours (“competencies”) an oral health practitioner must have to practise safely, competently, and professionally in their scope of practice.
This document describes the minimum competencies an oral health graduate must achieve through their education and training to be registered in the scope of oral health therapy practice.
The competencies prescribe the scope of practice for oral health therapy practice.
The competencies are presented in the following domains:
The competencies broadly describe the knowledge, skills, attitudes and behaviours expected of an oral health therapist; and are outcome focussed. The learning curriculum will provide the level and extent of detail needed to facilitate graduates’ achievement of these competencies, for registration in the scope of practice for oral health therapy.
It is assumed that all competencies are performed with a degree of quality consistent with patient and whānau well-being, and that oral health therapists can self-evaluate the quality and effectiveness of the care they provide.
There is also a clear link between a number of the competencies and the standards embodied in the standards framework (https://www.dcnz.org.nz/i-practise-in-new-zealand/standards-framework/) that registered oral health practitioners must meet.
The competencies document aims to describe the minimum competencies for a registrant in the scope of oral health therapy practice, while not restricting the ways in which education providers achieve these outcomes.
The overarching aim is to develop a well-rounded oral health therapist who is:
Each practitioner’s scope of practice is commensurate with the practitioner’s approved education, training, experience, and competence.
It is expected that over time practitioners will maintain and enhance their professional knowledge and skills for application within their scope of practice, through self-assessment, ongoing learning and professional interaction.
On the learning continuum, competence on graduation develops into confidence, proficiency, and for some ultimately excellence.
Once registered, competence must be maintained throughout a practitioner’s career in the areas they practise in. Some practitioners may choose to limit their individual practice to certain clinical areas within their scope of practice.
It is essential that practitioners critically self-reflect on their competence throughout their professional career to support their ongoing learning, or identify their own limitations and how that may impact on their practice.
Patient care in those areas where competence has not been maintained, must be referred to another suitable practitioner.
The Council will use this document as a reference in carrying out its key functions of:
Overseas registration applicants do not meet the competencies related to the New Zealand context, legislation and laws, health regulation and cultural safety. If registration is granted, these practitioners will be required to attain these competencies within a defined timeframe.
An understanding of the terms “evidence-based practice”, “patient-centred” and “culturally safe” care is key in understanding and achieving the competencies. They represent the overall approach to care practitioners are expected to develop.
Explanations of these terms can be found in the glossary on pages 19-21 and may provide further context to facilitate understanding of the competencies. The glossary also includes translation of Māori in this document.
The Council is seeking to improve Māori oral health outcomes underpinned by Te Tiriti o Waitangi. This is not a new approach and is consistent with central government policy in relation to hauora Māori and the Ministry of Health’s Whakamaua: Māori Health Action Plan 2020-2025, which has an equity focus. Recognition of health’s role to give effect to Te Tiriti is further demonstrated by the recently announced central government health sector reforms with the establishment of the new Māori Health Authority.
Oral health practitioners’ competence in relation to Māori oral health care must be informed by Te Ao Māori, Tikanga Māori and Te Reo Māori to achieve Pae Ora – healthy futures for whānau, hapū and iwi. This work, in the Council’s view, will contribute to long term oral health benefits for Māori, their whānau and hapū.
The Council recognises the input received from:
The oral health therapist competencies are founded on a number of sources including the oral health curriculums from the University of Otago and Auckland University of Technology, the New Zealand oral health therapy scope of practice and comparable international competencies.
The cultural safety aspects were further informed by the Nursing Council of New Zealand’s Guidelines for Cultural safety, the Treaty of Waitangi and Māori Health in Nursing Education and Practice (2011), the Medical Council of New Zealand’s Statement on Cultural Safety (2019).
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Patients, colleagues and the public |
An oral health therapist 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. |
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Laws and regulation |
An oral health therapist 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. |
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Professional development and ongoing competence |
An oral health therapist 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. |
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Communication |
An oral health therapist 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 their oral health condition and options for care. 2.5 Communicate openly and respectfully with colleagues, other members of the oral health team, other health professionals, other hauora providers and social organisations. |
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Culturally competent |
An oral health therapist 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 for their practice, and 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 the 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. |
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Culturally safe care |
An oral health therapist 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:
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 or family, 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 or family to enable culturally safe care. |
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Critical thinking |
An oral health therapist will be able to: 4.1 Apply contemporary scientific knowledge to oral health 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 clinical 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. |
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Application of scientific and clinical knowledge |
An oral health therapist will be able to apply scientific and clinical knowledge relating to: 5.1 General anatomy, with emphasis on head and neck, and physiology. 5.2 The aetiology, pathology, diagnosis, prevention and management of oral diseases and disorders. 5.3 General and systemic disease and disorders, including their relevance to oral health and potential impact on patient management. 5.4 Growth, development, and ageing, especially in the orofacial region; and orofacial developmental disorders. 5.5 Normal and abnormal tooth development, tooth eruption and occlusal development of the primary, mixed, and permanent dentition. 5.6 Social and behavioural sciences, and Te Ao Māori and Tikanga Māori, to support patients and whānau or family in achieving oral health and wellbeing. 5.7 Understanding the causes of Māori inequity of access and improve hauora Māori outcomes. 5.8 The core principles of infection prevention and control, including standard precautions, reprocessing of reusable items, performance testing and validation. This includes consideration of Te Ao Māori and Tikanga Māori. 5.9 Pharmacology, with a focus on medicines, rongoā Māori and therapeutic agents relevant to oral health practice. 5.10 The science of dental materials, their risks, benefits and limitations including health, safety and Te Taiao considerations. 5.11 Ionising radiation and methods of imaging relevant to oral health practice, including appropriate selection and safe use of dental radiographic techniques. |
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Clinical information gathering |
An oral health therapist will be able to effectively gather information relating to: 6.1 Patient’s presenting complaint/s, concerns, ideas, wishes and expectations, including Te Reo Māori me ona Tikanaga. 6.2 Medical, oral health, cultural, and whānau or family histories, and recognise the relationship between hauora Māori and oral health. 6.3 Extra-oral and intra-oral examination of the soft and hard tissues of the orofacial region, including intra- and extra- oral radiographic imaging of adequate diagnostic quality and photographic imaging. 6.4 The following conditions: a. dental and orofacial pain b. dental and periodontal diseases and conditions c. temporomandibular joint disorders d. oral pathology e. abnormalities of the occlusion, craniofacial disorders, dental and maxillofacial trauma. 6.5 Individual risk factors related to caries, periodontal diseases, oral cancer, and injury. |
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Diagnosis and risk determination |
An oral health therapist will be able to: 6.6 Perform or request relevant special investigations and diagnostic tests. 6.7 Analyse the complete information gathered to: a. Formulate an accurate diagnosis for dental caries and periodontal diseases or seek additional clinical opinion or refer as required. b. Determine the individual patient’s risk of oral disease or injuries. |
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Oral health care planning |
An oral health therapist will be able to analyse the information gathered and when developing a plan for care: 6.8 Understand and consider each patient’s individual preferences, needs and cultural values, their hinengaro/wairua and social situation. This includes the specific needs of patients who are young, anxious, older adults and patients with special needs in their requirements to achieve oral health equity. 6.9 Identify oral health problems, and formulate an evidence-based, patient-centred plan for care that addresses the:
6.10 Identify where the patient’s medical condition/s or rongoā Māori, medications may influence the oral health care plan and the anticipated outcomes. An oral health therapist will be able to: 6.11 Determine whether they have the knowledge, skills and competence to provide for the patient’s complete health needs and wishes and refer appropriately to another oral health or health practitioner when they do not. 6.12 Gain informed consent, appropriate for the individual, and ensure informed consent remains valid throughout. |
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Establishing and maintaining oral health |
An on oral health therapist will be able to: Guide behavioural change 6.13 Help patients understand the importance of their own tikanga/kawa and behaviours in establishing and maintaining oral health. 6.14 Apply their knowledge of behaviour change in relation to health to support and guide patients/whānau behaviours towards optimal hauora Māori and oral health. 6.15 Educate patients across the life course sharing current concepts of hauora Māori, oral health prevention, risk assessment and management of oral disease. 6.16 Work with patients and whānau to develop an oral health programme which employs strategies aimed at disease management and prevention appropriate for the patient’s disease status and risk, and their personal circumstances; and review and adjust strategies and goals as required. Preventive care 6.17 Promote periodontal health by providing patients with preventive advice (including smoking cessation) and removal of supra-and subgingival hard and soft deposits from natural teeth and implants. 6.18 Provide dietary advice and perform procedures to prevent dental caries, including fissure sealants and applying fluoride. 6.19 Recommend or supply non-prescription preventive agents. 6.20 Promote the prevention of dental injuries by providing custom-made mouthguards where indicated. Periodontal management 6.21 Manage conditions and diseases of the periodontium and perform appropriate periodontal therapy where indicated. Dental management 6.22 Manage conditions and diseases affecting the teeth, including dental caries, non-carious tooth tissue loss, tooth abnormalities and aesthetic problems (including vital tooth bleaching), and know when operative intervention is required. 6.23 Prioritise the use of techniques that conserve tooth structure and preserve pulp vitality. 6.24 Provide direct restorations that are appropriate for the nature and extent of tooth tissue loss and in the best interests of the patient, considering immediate and long-term outcomes of care, including placing stainless steel crowns on primary teeth. 6.25 Manage pulp and periapical disease in primary teeth, including acute management and vital pulp therapy (pulpotomy on primary teeth). Extractions 6.26 Extract erupted primary teeth. Pain management 6.27 Use local anaesthesia safely, appropriately and effectively; with the correct administration technique; and selecting the appropriate local anaesthetic solutions. Young patients, anxious patients, older adults and patients with special needs 6.28 Manage care for tamariki, mokopuna, rangatahi or anxious patients, older adults and patients who have special needs; and advocate for and support individuals with these needs to achieve oral health equity. Dental emergencies 6.29 Manage dental emergencies of the primary and permanent dentition including those of pulpal, periodontal, or traumatic origin, including appropriate referral. Application, administering and supplying of prescription medicines 6.30 Apply, administer and/or supply prescription medicines, for example, antibiotics to manage infection or risk of infection, management of medical emergencies, or high concentration fluoride varnishes and toothpastes, in accordance with legal and regulatory requirements. Monitoring 6.31 Evaluate and monitor the progress of treatment and oral health outcomes, in cooperation with the wider oral health team, whānau, family or kaiāwhina, where appropriate, and at regular intervals when treatment occurs over an extended period. Orthodontics 6.32 Assist the dentist or dental specialist in implementing orthodontic treatment plans through performing the following procedures:
6.33 Assist the dentist or dental specialist in implementing orthodontic treatment plans, as directed by the dentist or dental specialist who is responsible for the patient’s clinical care outcomes and is on-site at the time, through performing the following orthodontic procedures:
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Safe practice |
An oral health therapist will be able to: 6.34 Establish, manage, and maintain a safe working environment for patients, staff and colleagues; and to protect the public. This includes a culturally safe workplace, the routine and proper use of infection prevention and control measures and following safe radiation practices. 6.35 Identify and appropriately manage potential hazards (including hazardous materials), and behavioural risks in the place of work. 6.36 Understand the principles and legal obligations of waste management and show awareness of practices used to limit unnecessary waste. 6.37 Produce and maintain accurate, time-bound, and up-to-date patient records which are secure. 6.38 Complete a comprehensive medical history: medical conditions, current rongoā Māori, medications (prescribed and non-prescribed) and allergies. 6.39 Manage a medical emergency appropriately and effectively in their workplace within their prescribed resuscitation training. |
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Teamwork |
An oral health therapist will be able to: 6.40 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. 6.41 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 or family, hapū, iwi and community. |
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The practice environment |
An oral health therapist will be able to: 6.42 Develop and comply with systems and processes in their workplace to support safe and effective patient care. 6.43 Describe the skills needed to lead and manage oral health team members. 6.44 Effectively manage their own time and resources. 6.45 Describe the basic principles of practice administration and management. 6.46 Be familiar with the use of contemporary information technology tools commonly used in practice to support safe and effective care. |
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Community oral health |
An oral health therapist will be able to: 7.1 Understand the Aotearoa New Zealand oral health care system and the public health approach, including the scientific basis for it. 7.2 Understand the social determinants of health; the barriers to equitable access to health care and equity in hauroa Māori outcomes; and their impact on oral health in Aotearoa New Zealand. In particular, on the oral health status of Māori. 7.3 Engage with Māori communities in the development and delivery of oral health promotion activities. 7.4 Understand the nature, scope and contribution of dental health services research. 7.5 Understand the principles of ethics in rangahau relating to hauora Māori, health research, and the evaluation of research findings related to dentistry. 7.6 Understand health promotion principles and health behaviour models, and their application in oral health. 7.7 Understand a range of community oral health promotion strategies and their use in improving the oral health of communities. 7.8 Understand the principles of ethics in rangahau relating to hauora Māori, health research, and the evaluation of research findings related to dentistry. 7.9 Design and implement oral health promotion projects in response to the oral health needs of specific communities, and engage with whānau or family, hapū and iwi. 7.10 Work with other health professionals, educational staff, whānau or family, hapū, iwi and health navigators to promote oral health. 7.11 Evaluate the outcomes of community oral health promotion projects. |
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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:
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 care4. |
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Culturally safe care |
The Health Practitioners Competence Assurance Act 2003 requires the Council to set standards of cultural competence for oral health practitioners5. 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 safef or 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 listening6. 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. |
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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. |
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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. |
| Hangarau | Technology |
| Hapū | Group, clan, subtribe |
| Hauora | Health |
| Hauora ā-waha | Oral health |
| Hinengaro | Psychological |
| Iwi | Tribe |
| Kaiāwhina | Helper |
| Kawa | Practice, protocols |
| Kawa whakaruruhau | Cultural safety |
| Kāwanatanga | Governance |
| Kupu | Words |
| Mana motuhake | Self-determination, self-governance, independence, sovereignty |
| Matāuranga | Knowledge, wisdom, understanding |
| Mokopuna | Grandchildren |
| Ngā kaiakatanga | Competencies |
| Ōritetanga | Equity |
| Pae ora7 | Healthy futures - to live with good health and wellbeing in an environment that supports a good quality of life.
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| Rangahau | Research |
| Rangatahi | Young ones, youth |
| Ratonga | Services |
| Rongoā | Medicine, remedy |
| Tamariki | The young |
| Tapu | Sacred |
| Te Reo | Māori language |
| Te Taiao | Environmental |
| te Tiriti | Te Tiriti o Waitangi |
| Tiaki niho | Dental |
| Tikanga | Correct procedure, custom or reason/purpose |
| Tīkanga akuaku | Hygiene |
| Tino Rangatiratanga | Sovereignty |
| Tohungatanga | Competence |
| Wairua | Spiritual |
| Whānau | Extended family, family group |
| Whanaungatanga | A relationship through shared experiences and working together, providing a sense of belonging |
Dated this 5th day of November 2021.
MARIE WARNER, Chief Executive, Dental Council New Zealand.
1 Qualification obtained since 2009 onwards.
2Qualification obtained since 2008 onwards.
3 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.
4 Health Navigator New Zealand https://www.healthnavigator.org.nz/clinicians/p/patient-centred-care/.
5Section 118i of the Health Practitioners Competence Assurance Act 2003.
6 Williams, R. (1999). Cultural safety – what does it mean for our work practice? Australian and New Zealand Journal of Public Health, 23(2), 213-214.
7 https://www.health.govt.nz/our-work/populations/maori-health/he-korowai-oranga/pae-ora-healthy-futures.