Amarasena N, Teusner D N, Brennan D S, Satur J
Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia.
Melbourne Dental School, The University of Melbourne, Melbourne, VIC, Australia.
Int J Dent Hyg. 2018 Feb;16(1):125-133. doi: 10.1111/idh.12301. Epub 2017 Aug 14.
Dental hygienists (DHs) have been practising in Australia since the early 1970s.
This study describes the clinical activity of Australian DHs.
A questionnaire was mailed to members of two professional associations representing DHs. Practitioner characteristics, employment characteristics and clinical activity on a self-reported typical practice day were collected. The proportion of each service item of all services provided was estimated. Associations between practice characteristics and service provision were assessed by log-binomial regression models.
Adjusted response rate was 60.6%. Of the DHs included in analysis (n=341), 80% were employed in general practice, and nearly all (96%) worked in the private sector. About half (53.7%) of all service provided were preventive services, and one-fourth (23.9%) were diagnostic. Service provision varied by practice and practitioner characteristics, with the largest variations observed by practice type. Unadjusted analysis showed that general practice DHs provided a higher mean number of periodontal instrumentation and coronal polishing (0.92 vs 0.26), fluoride applications (0.64 vs 0.08), oral examinations (0.51 vs 0.22) and intraoral radiographs (0.33 vs 0.07) per patient visit and a lower mean number of impressions (0.05 vs 0.17) and orthodontic services (0.02 vs 0.59) than specialist practice DHs. In adjusted analysis, rates of periodontal services also significantly varied by practice type; other associations persisted.
Service provision of DHs varied by practice type. Practice activity was dominated by provision of preventive services while provision of periodontal treatments, fissure sealants and oral examinations was relatively limited indicating areas in which DHs are possibly underutilized.
自20世纪70年代初以来，口腔保健员（DHs）就在澳大利亚开展工作。
本研究描述了澳大利亚口腔保健员的临床活动。
向代表口腔保健员的两个专业协会的成员邮寄了一份问卷。收集了从业者特征、就业特征以及在自我报告的典型工作日的临床活动。估算了所提供的所有服务中每个服务项目的比例。通过对数二项回归模型评估实践特征与服务提供之间的关联。
调整后的回复率为60.6%。在纳入分析的口腔保健员中（n = 341），80%受雇于全科医疗，几乎所有（96%）在私营部门工作。所提供的所有服务中约一半（53.7%）是预防性服务，四分之一（23.9%）是诊断性服务。服务提供因实践和从业者特征而异，其中实践类型的差异最大。未调整分析显示，与专科实践的口腔保健员相比，全科医疗的口腔保健员每次患者就诊时提供的牙周器械操作和牙冠抛光平均数量更多（0.92对0.26）、氟化物应用更多（0.64对0.08）、口腔检查更多（0.51对0.22）以及口腔内X光片更多（0.33对0.07），而印模平均数量（0.05对0.17）和正畸服务平均数量（0.02对0.59）更少。在调整分析中，牙周服务的比例也因实践类型而有显著差异；其他关联依然存在。
口腔保健员的服务提供因实践类型而异。实践活动以提供预防性服务为主，而牙周治疗、窝沟封闭和口腔检查的提供相对有限，这表明口腔保健员可能未得到充分利用的领域。
