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DENTAL THERAPY ASSOCIATION OF SOUTH AFRICA
NEWS
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Tue, 25 Jul 2006
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DENTAL THERAPY DEVELOPMENT IN SOUTH AFRICA - LATEST DEVELOPMENTS
Every person develops through their lifetime
growing through the phases of their existence and
in doing so contribute to humanity either by
becoming an asset to the collective or a
liability of sorts. In our nation, we are still
growing and establishing the foundations of a new
era in society one that is democratic and just,
built on the foundations of the freedom charter
and a sound constitution protecting basic human
rights, abolishing discrimination in all sectors
of society.
Dentistry shares a significant part of the social
well being of all South Africans. More
essentially, Dental Therapy is a fundamental
profession in the health sector providing
preventative, primary and secondary oral
healthcare. According to recent needs analysis
surveys, oral health indices which isolate two of
the most common oral disease in the world
affecting all human beings are dental caries and
gum disease these disease patterns have been
reported not only to cause localized infection
and disease but has been linked as precursors to
other general medical conditions Periodontal
Disease and Dental Caries have accounted for (+-
95%) and (92%) respectively in South Africa.
The Dental Therapy profession is uniquely
designed to effectively and efficiently deal with
these conditions as recognized by the Minister of
Health in the white paper on the transformation
of Oral Health in South Africa, where she has
concurrently stated that one dentist post can be
changed to two dental therapist posts to
effectively distribute much needed services cost
effectively and specifically. Currently there are
approximately 500 registered dental therapists in
the country and the state has plans for
increasing the number of dental therapists to be
recruited.
One issue that has not been addressed is the
nature of the Dental Therapy profession. A Dental
Therapist spends three years studying at a
tertiary institution and studies many subjects
crammed into each year with little or no student
life on campus compared to other undergraduates
who spend each year completing at least four
subjects while dental therapists push through
some seven to eight courses a year. Dentists
spend two more years in tertiary institutions.
The cost of training a dental therapist is half
of that of a dentist (ministry of health).
The cost of employing a dental therapist is half
of that of a dentist and forms a strategic fit
with the provision of a basic package of dental
care service in the public sector. The workload
in the public sector involves primarily the
delivery of the basic minimum package of dental
care as prescribed by the minister of health,
which encapsulates the dental therapy profession
wholly and specifically.
The specificity to which the profession deals
with the oral health package is undeniably
profound, as it covers the need vs. deployment
issue 100%. Are Dentists redundant? Absolutely
not. All oral health professions form part of the
oral health team including specialists, nurses
and assistants.
The fundamental problem lies in the obvious
dominance of one profession over others. This
dominance exists due to the age of the dental
profession as well as apartheid policies that
restricted dental therapy enrolment still
evident today. While policy asks for a greater
ratio of dental therapists to dentists, the
current state is that for every one dental
therapist (480) there are about 12 dentists (+-
4500). Dental Therapists form a 10% ratio to that
of dentists and 50% ratio to that of oral
hygienists(1:2).
Why is the much-needed profession dwindling in
numbers?
Some of these issues relate to;
1. No concerted effort to develop the
profession. Dentists, SADA and the dental gurus
(DENTIST BASED) committee of dental deans lead
the dental profession in South Africa these
people have no interest in dental therapy, they
exist only to propagate and protect the
profession of the dentist and their existing
structures. These grandfathers of Dentistry in
South Africa have come to a dead end regarding
the dental therapy profession as they refuse to
credit the profession they created for vertical
or horizontal progression.
2. Barriers to expansion and academic
development by other threatened professions viz;
dentists (South African Dental Association SADA
and its influence on dental deans who have shown
anti-dental therapy symptoms.)
3. Entrapment efforts by so called dental
gurus and leaders to stifle and subdue dental
therapists wanting to progress by not recognizing
the profession and also not crediting dental
therapists for prior learning (contradictory
stance to the recognition of prior learning and
Skills Development Act).
4. Alienation tactics, to eliminate the
profession by excluding it from social
recognition absence of marketing by dental
traders regarding dental therapists in branding
presence or oral health initiatives eg. Smile
programme by DENIS (dentist controlled Dental
Information Systems multiple medical aid scheme
administrator refusing to pay for services
rendered by dental therapists and allocating
unfair advantages to fellow dentist colleagues -
excludes dental therapists in preventative oral
health campaigns.)
The lists of these discriminatory individuals are
endless for whatever exclusionary reasons,
profoundly in the private sector.
5. Dental Therapists are unorganized due to
a non-active association which is currently
being reorganized.
6. Dental Therapists pay structures are not
in line with pay structures for other health care
providers in the same level in the public
service, Scarce skills allowances as well as pay
progressions for senior dental therapists and
those in management posts are not paid
equitably .The discriminatory fee schedule for
the national price reference list for dental
services are hugely unjust for dental therapists
providing same services in the private sector as
dentists.
7. The Fact that nobody seems to be doing
anything constructive about these pertinent
issues leaves dental therapists feeling depressed
and remorseful about their profession as they
lose self esteem and pride in their profession
many either leave the profession, practice with
dentists who train dental therapists to provide
services beyond their scope as quoted by
executive director Dr Neil Campbell _ SADA
they blend in with dentists SADJ 2001, many
therapists continue with the struggle
8. Poor education planning and no effort for
post graduate development courses neither
horizontal nor vertical progression makes being a
dental therapist quite challenging for those
people wanting to progress from dental therapy in
the dental profession.
9. Inadequate leadership in dental therapy
as well as poor professional infrastructure
causes a widening gap between existence and
survival.
10. Dental Therapy has been abandoned by the
family of dental professions in South Africa.
There is no team effort in Dentistry in South
Africa.
Dental Therapy is a black profession in South
Africa, one that has been ostracized and
ridiculed yet it is the profession that continues
to provide specific cost effective answers for
South Africas greatest oral epidemics.
DENTAL THERAPY EMPOWERMENT STRATEGY
Dental Therapists in South Africa , in light of
the HR plan for health 2006 , call for
1. An urgent restructuring of the profession
to include as every other profession, horizontal
and vertical academic progression to the existing
three-year degree programme. This would include
outcome based course modules in the dental
specialties, healthcare management, and
accreditation of current learning at all South
African education Institutions as per the SAQA
and NQF level recognition.
2. Registration in dental specialties
following appropriate course module completion as
per the fundamentals of Outcomes Based Education.
Presently Dental therapists can perform the basic
and secondary dental services; removal of teeth
under local anesthetics, diagnosis, treatment
planning, dental x-rays, prognosis, referring to
dental specialists, scaling and polishing as well
as all classes of dental restorations.
Specialized outcomes would include outcome based
module courses in several dental specialties such
as prosthodontics, endodontics etc..
3. An end to all forms of professional
discrimination and the use of national
educational framework as a measure of academic
levels (NQF) with reference to PPS (Professional
Provident Society) Found to discriminate
against black dental therapists.
4. To be recognized by the Medicines control
council as a profession that dispenses as all
dental therapists use on a daily basis schedule 4
drugs (injectables) End the contradictory
approach adopted by the Medicines control council.
5. To re-examine the dental therapy scope of
practice and for the National Task Team (NTT) to
make recommendations for change in the
profession.
6. To involve more dental therapists in
educator roles as well as leadership roles in the
profession of dental therapy in Universities that
train Dental Therapists.
7. To establish the sovereignty of the
profession and ensure that the rights of the
profession as well as all its members are
protected by the constitution of South Africa and
eliminate any opposition, bullying or anti-dental
therapy force that would act as a detriment to
the profession or its members. To lobby the
Health Professions Council to recognize the
sovereignty of the profession and gain support
form Dental traders as well as the ministry of
Health in achieving the objectives of the
profession and its association.
The South African Dental Therapy Association
calls for an urgent meeting with the National
Minister of Health to discuss the plight of the
profession and to establish the way forward for
Dental Therapy in South Africa. The barriers to
our progression can only be overcome through
government intervention. We have exhausted our
efforts trying to approach every other avenue and
it seems we now need some intervention from our
Minister.
Are you interested in helping achieve these
objectives - contact lesley chairman of dentasa -
kzn to discuss the way forward - email :
denticare@vodamail.co.za
Posted 10:14
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1 comment
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list of collegues
dear collegue
could you provide me with a directory of dentist
in south africa ?
thank you for your kind cooperation,
Bart Vande Vannet , DDS, MSc Orth, PHD
Vrije Universiteit Brussel
Department Orthodontics
Faculteit Geneeskunde en Farmacie
Laarbeeklaan 103
1090 Jette
Belgium
e-mail : bart.vande.vannet@vub.ac.be
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