Practice characteristics and service provision rates of dental hygienists in Australia

Abstract

Introduction: The registered oral health practitioner workforce in Australia, besides dentists and dental prosthetists, includes dental hygienists (DHs), dental therapists (DTs) and oral health therapists (OHTs). Dental hygienists (DHs) were first established in Australia in the late 1970s. The aim of this study was to describe service provision by DHs and assess if service provision varied by practice characteristics. Methods: A questionnaire was mailed to members of two professional associations representing DHs, DTs and OHTs. Demographic and employment characteristics and clinical activity on a self-reported typical practice day were collected. To describe practice activity, proportions of each service item of all services provided were computed, stratified by practice type. Associations between practice characteristics and service provision were assessed by comparing means and statistical differences by log binomial regression models. Results: Of 341 DHs included in analysis, 80% were employed in general practice and nearly all (96%) worked in the private sector. Service provision patterns varied with practice type. Service provision by general practice DHs was dominated by preventive services (62%) and a large proportion (41%) of services provided by DHs in specialist practice were orthodontic services. General practice DHs provided a higher mean number of scale and cleans, fluoride applications, oral examinations and intraoral radiographs per patient visit and a lower mean number of impressions and orthodontic services than specialist practice DHs (p<0.05). Having more patients aged over 45 years was associated with higher rates of scale and cleans, and oral exams (p<0.05). Conclusion: Service provision and practice characteristics of DHs varied by practice type. While practice activity was dominated by preventive services, the provision of periodontal treatments by DHs was limited. Implications for policy and/ or practice: The findings would be useful in planning and implementing oral health care policies and projecting oral health labour force data.