Expectation of Dentists Towards the Role of Dental Nurses in Thai Dental Public Health

Abstract

To alleviate the shortage of dentists in the past, dental nurses had been developed to perform fundamental clinical practices.  There was no practitioner certificate for dental nurses; therefore, they were required to perform their work under the supervision of dentists who oversaw their overall performance and were the ones who defined their roles and responsibilities. Even though the number of dentists was increased recently, dental nurses were still produced.Despite the alteration of the educational program which focused on the healthcare promotion, the roles of dental nurses remained unchanged, and they were asked to perform the same clinical practices as in the past. This study aimed to understand the expectation of dentists towards the responsibility of dental nurses, using a qualitative approach.

As dental nurses were not permitted to work in private organizations, sampling was performed on a group of specifically selected dentists who were actively working with dental nurses in public health services, in local or provincial hospitals. Half of the selected dentists were in management roles and participated in an overall strategic management of dental public health. The second half of the dentists in the group had a staff position with at least 7-years’ experience and could provide valuable views on dental nurses from a worker’s perspective. Data were collected from semi-structured interviews and subsequently analyzed using content analysis. In depth interviews were conducted on 13 dentists, 11 females and 2 males aged between 31–56 years, with 7-33 years of work experience. One group believed that an increasing number of dentists would eventually meet public demand in the future and could replace dental nurses. Large hospitals would eventually acquire more dental specialists along with the technological advances and, hence, would eliminate the demand for dental nurses. In contrast, even though the number of dentists would increase, dental nurses would still play an important role in a dental health team, especially in rural areas. Improvements in salary and benefits along with the establishment of the Dental Nurse Association, issue of professional licenses and an opportunity to have clinical practices in private clinics could subdue the resignation rate or career alteration of dental nurses. Additionally, they believed that the two dental nurse curriculums, namely Diploma of Public Health (Dental Public Health) and Bachelor of Public Health (Dental Public Health) should focus only on health promotion without dental treatment.

Since dental health promotion would mitigate long-term dental issues and concentrate on solving the root cause of the problems, the number of dental patients would reduce. This would reduce the cost of the investment for dental treatment and at the same time would allow people to change their behavior, improving dental health in the future. However, some dentists in this group argue that dental nurses who received diplomas should retain the clinical practice responsibility which underlined that clinical treatment took precedence over dental health promotion. Most dentists were also not aware of the educational program of dental nurses. For example, the majority did not know any differences between 2- or 4-year dental nurse programs and the associated regulations. Therefore, it may be concluded that there was no expectation towards dental nurses. Overall, both dentists and dental nurses should adjust themselves to collaborate with other sectors, to operate in a direction that will promote health and create impact in the Thai dentistry field.