Episode Transcript
Speaker 1 (Becky) 00:00:03 Kia Ora and welcome to the Whole tooth NZ, a platform for oral health professionals by oral health professionals, where we will share the kaupapa of the oral health profession. And we will seek to speak the tooth, the whole tooth and nothing, but the truth. Welcome to Episode rua (two). Don't forget your roots. So we're talking to Helen Tane today, so exciting! She has had many years of experience with oral health service provision and in academia, she has so many accolades to her name. So sit back and relax as Helen and I have kōrero.
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Speaker 1 00:00:54 Kia Ora Helen
Speaker 2 (Helen) 00:00:55 Kia Ora Becky. Thank you. I feel very privileged to be part of your podcast.
Speaker 1 00:01:00 So, today we're gonna talk about three areas I want, um, to ask you Helen, about you and your life and how you got into the oral health space. And then also we've had some great conversations around equity and oral health too, that I hope we can tease through this podcast. So, um, yeah, the first part, tell us about yourself, Helen, tell our listeners.
Speaker 2 00:01:24 Well, I trained because back in those days we were trained as opposed to educated. Um, I was trained as a school dental nurse and I graduated in 1975 into a workforce of a hundred percent female only employment available to our profession was with the government sector as there's state services, school, dental nurse, very similar to nursing at that time, teachers, nurses, um, and school dental nurses qualified with a two year certificate. Um, I soon became, um, theory conscious that my qualification did not prepare me to be the dental therapist or to school, the intern I wanted to be. So I sought out more education and I started doing online distance study through, um, it actually wasn't online. It was distance study, um, through Waikato University and, um, picked up education, sociology and other psychology, other undergraduate papers that I found really helpful as a professional school dental nurse.
Speaker 2 00:02:29 I worked in leadership roles within the community and was part of our school dental nurses Institute to improve our, um, the outcome for our patients. So I was working at the time when we had informed consent and, um, worked with Dame, Sylvia Cartwright as one of the many health professionals to look at informed consent for children and how that would look, um, in the school dental service. Um, and I continued working and, and, um, developed my career with my ongoing study and looked at how we should be more, um, responsive to the community and, um, pushed to have our name changed to community dental therapists, because we were very much community orientated and working in the community. And during that time I had three daughters and I was very privileged to be able to still be working with my girls and, um, still studying. And then the position in Otago, um, was advertised to take our profession into the university sector. So being a strong advocate to improvement in education for our profession, I applied for the position and was the first, as you said, first dental therapist to be appointed as an academic and start our qualification in the school of dentistry in 1999.
Speaker 1 00:03:58 Wow. That's a, that is a fantastic first part of your career and it just gets better. Doesn't it? <laugh>.
Speaker 2 00:04:08 I very quickly realized the politics and the health profession, so it wasn't just about education. It was about education, um, that enlightened, um, the professions. And, um, it it's very clear to me now and I look back over the decades, how much the profession has been undermined by the politics and healthcare. And it, the, if our profession was undermined for the, um, outcome of the care that we could provide for our patients, well, then the patients suffered. So, um, while New Zealand was the first country in the world to introduce the school dental nurse model in 1921, very sadly qualification has been picked up by many other Western countries and, um, the age limit to provide the preventative care to patients, um, has been available to dental therapists who practice in Australia and United Kingdom in America and New Zealand. And at this time in June 9th, 2022, we still haven't got, we're still restricted to be treating children. And the science has told us that if we can't have a healthy family, we can't have a healthy child when it comes to our health. So we are spending millions of dollars treating the mouths of children when the, their mouths are being infected by the family around them. And the diet is not the best. So, um, unfortunately our Maori and our low socioeconomic families have still got a high incidence of oral health disease, which is completely unacceptable and completely preventable.
Speaker 1 00:05:56 Or you raise a fantastic point, Helen, that, you know, what, what is happening within our community oral health services at, in this day and age when we know what the science and the research say that prevention is the key. However, yeah, there's, there's things going on that are just preventing, um, our community oral health services to be accessible, to be, uh, functioning as they should.
Speaker 2 00:06:25 Mm-hmm. So if you, if you were to do a, a singular case report of a vulnerable child, um, it's just so evident that, that the existing enough afar, no, that have not had access to oral healthcare. Um, they don't that the care that has been provided and the DHB services for children, um, is not that accessible for our children in high need areas. Um, although we've got a very dedicated workforce, the organization of that workforce has not been responsive to the children who need the care the most. And, um, you know, we've got a wonderful workforce, but their ability to be able to do their best care that they can for the, the community is restricted both with the numbers, the lack of numbers of the workforce, but, um, also the way the organization. So we've got graduates in, in places like in the Canterbury where they can't provide a full scope of practice to the children that they treat. Um, and that, that's just an, not an isolated case. Unfortunately, there are other DHBs where therapists aren't allowed to for provide their full scope of practice and using, um, the best material. So for example, composites and, stainless steel crowns, which are common place in the industry and for the last 20 or so years, and, um, the therapists are restricted and that they just don't have easy access to those treatments, or they can't provide the care .
Speaker 1 00:08:02 Helen, You raise a great point there about fragmented workforce that we have. There's some conversation on Facebook last night, talking about, uh, the dental therapists in Southland. And they were discussing that the oral health therapists are being drawn to private and there are less and less staff, um, available in the community oral health service. And yet, how are things going out there in private for our oral health therapists as they perhaps work in isolation, uh, are they getting to use their full scope? Um, do they get to see children? So as we can see I'm going forward, I'm really interested in seeing what this health NZ is going to do, um, is going to be like for, uh, the community oral health service, because from what I can see and what I know from the conversations I've had, the community oral health service is on its last legs. Mm.
Speaker 2 00:09:01 And, and maybe that's not a bad thing. Um, although I was part of that service for, for decades, but it hasn't been responsive to the patients. It should be for the whānau, who need us the most, it's been responsive for New Zealanders who can advocate for their own health need and working in a public health service. That's not what a public health service is supposed to do. It's supposed to be providing care for the people who need the care the most. Um, but unless you can have the loudest voice and articulate your needs, your ability to be cared for in the way that you need, the care is limited if it happens at all. So if we look at as an example at our Māori communities and how many of our Māori communities actually access our healthcare as an adult, and unfortunately their stats haven't got any better in the existing community health services.
Speaker 2 00:10:00 So tomorrow when the new, um, new government sector starts and on are in healthcare, it can only get better because it can't really get any worse with the patients who need the care the most. So, you know, if you just have a common pathway for our tamariki, they access care later. Then our, the European counterparts, when they're little children, and then by the time they are 20, they're more likely to have, have missed missing teeth or filled teeth, or be in pain, or have some disfigurement of their mouth. That's left untreated. That makes it less likely for them to have employment. And all of the stats are against them because of the inability for the current community health services to be responsive to their needs.
Speaker 1 00:10:55 So what can teams of oral health therapists, dental therapists do out in the public services field? What can they be doing to shape a better oral health service?
Speaker 2 00:11:07 I think, um, the increase in numbers is really, really important. I think it's unforgivable for community oral house services to have funded the setup of dental clinics, but not have the staff to work in those clinics. We've got clinics sitting vacant right across the motu (Island), and we don't have enough staff to go into those clinics. So we've got people desperately needing the care, but the staff aren't there, they're just, they're having to do catch up. And as soon as you're doing catch up, you're treating far more complex care than if it was just a straightforward recall when the, patients were needing that accessed care.
Speaker 2 00:12:04 I think that our, our profession hasn't historically had a strong leadership. Um, I look at our profession now and I hear, um, some of the dental profession that with the, the, the professionals who've qualified in dentistry, speaking on behalf of our profession. And I don't think that's acceptable. I think once we qualify as, as an oral health therapist today, we have a responsibility like all health professionals to advocate for the importance of the care that we're skilled at and providing for, the patients that need our care. I think the, movement to take the age restriction away from our scope of practice is, is absolutely important. And as I said earlier, the Western countries around the world have taken that age restriction away because the science tells us that that's what we have to do. We, we need to be providing care across that lifespan.
Speaker 2 00:13:03 And, um, making sure that our mothers that are, have going to have babies have are healthier oral health before the baby is conceived. And especially before the baby's born, um, and helping young moms to make sure that they are doing the best for their, their little ones with, before their teeth erupt. Um, so there's, there's a whole lot of access to care issues. And, um, especially for, for our pregnant moms, um, that if have disease in the mouth and their babies are born well, it's just a given that the child is going to be most likely to have poor oral health.
Speaker 2 00:13:58 I think it's a wonderful time to be an oral health professional. I feel that it's really important that we work very hard, and focus on the research and focus on the evidence. I think people's opinions and people's assumptions about oral health: for example, that therapists should stay working with children because the child's mouth is an easy place to work, um, is a complete myth. And it's a it's concern of mine that we, we still have that myth prevailing in New Zealand, and we should be way past, you know, the science behind treating a child. It is so clear that we need to be quite skilled. It's setting up a child for life to be a compliant patient in a dental chair, to have an easy access to care. It's so important that we get that right. And therapists, for example, our new grads would be so easy for them to be treating young adults with uncomplicated care needs, as opposed to treating children who need a lot more focus and a lot more knowledge and a lot more skills to be able to provide the complex needs that a child, has to have.
Speaker 2 00:15:24 I'm hopeful that we've got the development of our leaders and our profession, that will speak up and advocate for our, for the care that they can be providing the patients. And it, it is a patient lead model of care as opposed to a professional lead model of care. And, especially in the public health service where the children, well, the person with the highest need is, has the focus of the care provided so that our care is clever care, is research based and evidence based. Um, I think with the Maori health authority, we've got some wonderful leaders that are going to be great, our lives to help our profession to do better for the patients that they treat.
Speaker 0 00:16:15 Ngā mihinui Helen for sharing your wisdom and knowledge with us about oral health in Aotearoa. I know the listeners will enjoy this just as much as I did listening back over it. It was such a pleasure and a privilege to have you on The Whole Tooth Ao/NZ, we look forward to having you back again, Helen. Join us next week, as we speak to Anna Holyoake, dental hygienist and president of Te Pūniho ora o Aotearoa, the New Zealand Oral Health Association, where she'll talk to us about being a dental hygienist and the ins and outs of being the president. Go well, oral health, professional colleagues, and friends from the WHOLE TOOTH AO/NZ Noho Ora Mai.
