Dental therapists/hygienists working in remote-rural primary care: a structured review of effectiveness, efficiency, sustainability, acceptability and affordability

Abstract

The available data indicates that dental therapist/hygienists have suitable skills and could constitute a valuable asset to meet the dental demands in remote-rural areas. However, the evidence base is limited and of a poor quality. There is a need to put in place 'well-designed interventions with robust evaluation to examine cost-effectiveness and benefits to patients and the health workforce'.

The acceptability of care provided by dental auxiliaries

“…The lack of high quality data reported here is consistent with the findings of previous systematic [69][70][71][72] and traditional 8 reviews of acceptability or patient satisfaction with DAs. These reviews also had broad inclusion criteria.…”

“…These reviews also had broad inclusion criteria. Freeman and co-workers 70 could not identify any studies that sought patients' views of the acceptability of care provided by dental therapists in rural or remote settings. From an experiential perspective, the other reviews' conclusions were similar to these; DAs' patients are at least as satisfied as those of dentists across a range of clinical tasks but the quality of the evidence is low.…”

“…In addition the reference lists of recently published systematic reviews were also searched. [70][71][72]97 Nonetheless, it is possible that relevant studies have been missed.…”

“…This systematic review used critical appraisal checklists to assess bias and quality. 31,32 While other systematic reviews with broad inclusion criteria used similar approaches, 70,71 Wright and co-workers used a score rating modified from that of Downs and Black. 98 Applying their rating scale to these data would have also identified risk of bias as high and quality low.…”

Future Innovation and Research in Dental Restorative Materials

“…Those, in turn, are influenced by the education of the clinician/operator. There need not necessarily be a direct correlation between years of academic training study and effectiveness, however, as has been shown by at least short-term successes with restorations placed by nondentists (Bader et al, 2011;Freeman et al, 2013). It is tempting to assume that treatment decisions depend upon only the patient and the clinician.…”