CHANGES IN TA SK DELEGATION OF ORAL EXAMINATIONS IN THE FINNISH PDS AFTER DENTAL REFORM IN 2001

Abstract

Aim: Task delegation from dentists to auxiliaries in dental care has been considered to be a good tool for facilitating access to oral health care. The Finnish PDS employed 2200 dentists (38%), 1100 dental hygienists (19%) and 2500 dental assistants (43%) in 2013. This study aimed to investigate changes in task delegation of patient examinations during 2001-2013 in the Public Dental Service (PDS).

Methods: Using people’s unique identifiers, data on patients, their dental visits, examinations and their treatment providers’ profession were collected from the municipal databases in five PDS-units which used the same electronic patient registration and record system. These five PDS-units covered about 320,000 inhabitants. The National Institute for Health and Welfare gave ethical approval for the study. Permission to use local data was received from the directors in the PDS units. Each individual’s visits and examinations were grouped by year and by provider profession (dentist, dental hygienist and assistant) separately for the young (< 18 years) and the adults (18+ years).

Results: Altogether 214,482 examinations were conducted for 295,521 patients of whom 241,355 were examined at least once during the study period. In 2001, there were 76,508 and, in 2013, 125,691 examinations. In 2001, dentists provided 90%, dental hygienists 9% and dental assistants 1% of examinations. In 2013, the corresponding numbers were 79 %, 17% and 4%. In 2001, dental hygienists and nurses provided about 16% of all examinations for children and adolescents, 2% for patients of working age and 7% for the elderly. In 2013, the corresponding numbers were 38%, 11% and 14%. These auxiliaries had provided 18% of all examinations. The number of auxiliaries increased by 73% in 13 years.

Conclusions: In 13 years, the examinations provided by dental hygienists increased mostly among the children and adolescents. The increase is moderate compared with the increase in human resources. Dentists provided large amounts of treatment that could have been provided by less expensive personnel.