Episode Transcript
Speaker 1 (Becky) 00:00:17 And welcome to The whole tooth Ao/NZ, the show that is made by oral health professionals for oral health professionals. We'll bring you the kaupapa of the oral health profession in Aotearoa to investigate the truth, the whole truth, and nothing but the truth.
Kia Ora Koutou, our guest today is Dusty Pearson, known as Dusty P, OHT. Dusty is an oral health therapist, with the passion for advocating for our professions of dental hygiene, dental therapy, and oral health therapy. Dusty has a Bachelor of Oral health from the University of Otago, where I was one of his tutors, as well as a Bachelor of Commerce in Marketing Management. Dusty has worked for district health boards in both the North and South islands, and in private practice providing dental hygiene care. Dusty is passionate about patient education and especially enjoys introducing patients to hygiene. Now, Dusty's a founding member of NZOHA and was a member of NZDHA and NZDOHTA prior to the merger, as well as a member of the International Federation of Dental Hygienists. While a student, Dusty was a BOH rep on the New Zealand Dental Students' Association. He later served on Bupa Dental Care's Clinical Advisory Panel, helping influence clinical policy for over 200 practices across Australia and New Zealand, and currently sits on the Lumino Health and Safety Committee.
Speaker 1 00:01:36 The Whole Tooth Ao/NZ is yet to be sponsored by any cutting edge dental company or organisation. This could be the opportunity for you. Call us on 0210355456.
I am so excited today that Dusty, you are going to share with us, some ideas that are very interesting, very, um, what is it? point of view, "unpopular opinions". <laugh>,
Speaker 2 (Dusty) 00:02:01 Very opinionated. Yeah, no,
Speaker 1 (Becky) 00:02:03 That, that is great. That is what we're here for. So, ngā mini Dusty, it is with much aroha that I welcome you to The Whole Tooth Ao/NZ.
Speaker 2 (Dusty) 00:02:13 Cool. Thank you so much, Becky. What an absolute pleasure. Um, yeah, so exciting. Thank you so much.
Speaker 1 00:02:18 Three areas we want to talk about today and they, you know, we could, we've already talked for 30 minutes on here, listeners, so <laugh>, we're already well warmed up. So we wanna first talk today, Dusty, your identity as an oral health professional and, um, an oral health therapist. Talk us through that.
Speaker 2 00:02:36 Yeah, thanks Becky. So, um, I'm an oral health therapist and, um, I'm not a dental hygienist. I'm not a dental therapist. So, um, we no longer train those professions as probably most of our listeners, um, know in New Zealand anymore. And that's following the Australian model, which started in 1998, where those, two professions or the training for those two professions was combined and Queensland. And that followed on from the UK model where those professions combine their training actually in the mid nineties. So they're still referred to as dental hygienists and dental therapists or dental hygienists slash dental therapists in the uk. But, um, we've actually had OHTs for quite a while, but the public doesn't really know much about 'em, especially in New Zealand because it only became a recognized profession and not in and of itself in 2007 or probably starting in 2008 when the registrations changed for that.
Speaker 1 00:03:28 There was a bit of a time lapse for that, wasn't it? Cuz I was at Otago teaching at the Faculty of dentistry then that might be when you were a student and there was a time lapse between graduation of Bachelor of Oral Health students and then getting a name. So, you know, was your identity formed, that O H T identity formed prior to actually getting it, um, recognized and registered at a regulatory level?
Speaker 2 00:03:54 Yeah. Well, um, it wasn't in my first year of OralHealth, we were student dental hygienists and student dental therapists, and we had that, you know, gap between our scopes where we were Yeah. A dental therapist for children and a dental hygienist for adults so we could diagnose and treat decay in children, but not in adults. So, yeah. Um, 17 years and 364 days old and Oh yeah. So there's a, there's some decay. This is what we're gonna do to it, and then the next day, oh, it's your birthday. Oh, sorry. I'm not sure. Um, we'll have to ask the, the dentist what, what to do because, um, now I'm a dental hygienist, so I don't know anymore. Mm-hmm. Um, and it was only in my second year that, um, or how therapy became its own, you know, profession. And that was really exciting because Yeah, especially our, you know, tutors and lecturers, I think that they really, you know, inspired us to be, OHT's especially after that point. Yeah. Recognize that we're our own separate profession. We love dental hygienists, we love dental therapists. There's no, there's no conflict. We all exist in the same space. We all want the same thing, which is, you know, improved oral health outcomes for New Zealanders.
Speaker 1 00:05:01 Yeah. You raised a great point that something that I have thought about for, uh, quite some time, that as you graduate into the field of dentistry, it's not set up for OHTs at all, and the private and public spaces, uh, haven't flexed and stretched to be able to create a space where you can flourish.
Speaker 2 00:05:23 Absolutely. I would definitely agree. And I feel like this is probably a controversial thing to say, but I think it's, the truth is that dentistry in New Zealand has been very conservative and very, yeah. Um, apprehensive, wary of new things. Like dental hygienists, my patients are shocked. My patients, a lot of new patients are in their, you know, their boomers and they're like, oh, I've never heard of a dental hygienist before. You know, so they're, oh, they've been around a long time. They've been going to the dentist for a long time. They say, I've never heard of a dental hygienist before. I've never seen one before. And I say, oh, well you still haven't seen one. Cause I'm actually an oral health therapist. And then I have a little spiel about how we used to train dental hygienists, which is doing this job. And we used to train dental therapists, which is what used to be being called the school dental nurse.
Speaker 2 00:06:08 People don't know, it was 30 years ago, 31 years ago that, um, we changed the name from Dental Nurses to Dental Well School, dental nurses to dental therapists. That's gone. The dental nurse is the assistant in the UK and in Australia, sometimes in New Zealand in, this is a different tangent, but it really grinds my gears as when New Zealand, when we refer to assistants as nurses, I'm like, when I think of a nurse, I think of a registered nurse. You go to university for three years, you're a health professional, you're qualified, you know, you provide your own care. Um, the dental assistants in New Zealand I think are also very underutilized. Um, you know, if you look at the UK where they have dental nurses, they have trained in, in anatomy. I had a patient recently who told me in America, um, you hardly ever see the dentist, the, the DA does almost everything. They take the x-rays, they take the impressions, they make the temporary crowns, the dentist just comes in and glues it on, and then walks out again. Um, you know, our workforce, and well, this goes back to what we were saying before, dentistry in New Zealand, so, I don't know...
Speaker 1 00:07:15 Siloed. We can say siloed.
Speaker 2 00:07:17 We can say just resistant to change, resistant to improvement. You know, we've got so many amazing people. Imagine all the DAs you can, you've, that you've had Becky as a therapist who would love to be a dental nurse in the context of learning more about anatomy, taking those x-rays, applying Fluoride varnish, doing all these things, you know, instead of sitting there with a suction, um, and booking the patient in, it's, it's seen in New Zealand as like a minimum wage job. You know, it's not seen as a, a good job. Like all the DAs I've worked with, who I love, I love my DAs. Um, they're often, you know, 18, they're fresh outta school and half of them either changed to get a better quote unquote job because it's not considered a lifetime career, or they trained to become OHTs. I wish I had a dollar for every time I heard you should study hygiene.
Speaker 2 00:08:12 I say, are you going to America? We don't study hygiene anymore in New Zealand. It's our health. Or they're, you know, older and they're often, you know, mums who've had kids, lots of times they have grandkids and they just want sort of a, a chill career. And that's cool. Mm-hmm. <affirmative>. So DAs, you're underutilized. Just as we are underutilized. Yeah. And just like you're saying, Becky, yeah, absolutely. Dentistry is not set up for OHTs, um, in New Zealand. And apparently when overseas OHTs, you know, from Aussie basically come to New Zealand, they say what <laugh> what's, and apparently OHT's that go overseas they say, wow, <laugh>. Yeah.
Speaker 1 00:08:57 Yeah. They're like, go treat that, that patient. Go treat their whānau. Get just the whole, like, you've got that scope. I know. Um, exactly.
Speaker 2 00:09:05 Yeah.
Speaker 1 00:09:06 A lot of progressive, um, activities happening to, uh, create patient-centered care. Um, I think we talked about that with Helen not long ago talking about are we doing practitioner centered care or patient-centered care? And, you know, wouldn't a mum and kids just really prefer that everyone's seen in the same space. And, you know, I'm not saying that I wanna work outside my scope. I am quite competent and capable to work within my scope. Um, but yeah, it, that does irk me 18year old age limit, mm-hmm. 25, absolutely. 28 <laugh>. Ok. It gets a bit different as, as they age and polypharmacy. But look, that's, that is a total another topic we can, um, have a little convo on. But yeah. Your identity, I can, I, I think we talked about earlier raising the profile of the professions mm-hmm. <affirmative> and you know, I think we've done a great thing bring our associations together. Um, you know, could we take it one step further and have one association for all oral health professionals with adequate representation as we push towards improving oral health for a very small nation. Um, yeah. Like, it's not like we've got, we've got 5 million people to improve their oral health.
Speaker 2 00:10:20 Exactly. And we've got there with the dental council, all of our professions and the dental council seems to be very proactive mm-hmm. <affirmative>,toward OHT, they have seemed to have really pushed the scope against, you know, the wishes of the dentists. Yes. So of course it would be great to have a profession, or sorry, an association where we are all together working on the same page. And, um, just going back to what you said about working within your scope as an O H T, I love my scope. I don't wanna work outside my scope. I'm so happy in my scope. I remember as a student, we would have these lectures about these complicated things and I would think, oh gosh, this sounds hard. And at the end, our lecturer would say, now if you ever see this, refer to the dentist. I love my scope
Speaker 1 00:11:08 <laugh>. Yeah. I do not want to be digging into anyone's parotid. I do not. You know, like it's not my, I do not wanna be a max-fax surgeon. I don't think I ever could. Um,
Speaker 2 00:11:19 I watch a video on YouTube on it, but I don't wanna do it <laugh>.
Speaker 1 00:11:22 Yeah, I know. I guess that just comes to that point. How can we understand each other as individual oral health professional scopes, but then how can we work together better?
Speaker 2 00:11:33 And um, just going back to what you said about identity, you know, patients walk in the room and they say, oh, are you studying to be a full dentist? Um, oh no. Um, and it's funny when I say that to my colleagues, I think they think that I'm saying that the patients think I'm so great that I should be a dentist. And I'm like, no, they're just, just confused. Like, they just think that I'm like a student. Like, um, Becky, we were talking about before the gender thing. So we're a historically female profession. We're a dominantly female profession and dentistry is far somewhere as becoming, um, female dominated profession. The definitely confusion, especially cuz my name Dusty could be gender neutral potentially. So people come in, oh, a boy one, oh, I thought you were a girl. And I say, ah ha ha ha.
Speaker 2 00:12:24 And then sometimes I say, oh, so there were 51 in my class and five of us were boys. And I say, um, the other four were, you know, new Zealanders of Asian descent. So I was the only white one. So I used to say, it's so hard being a minority, you know, as a white male <laugh>. Um, and hopefully they get that. That's a joke. Um, yeah, <laugh>. But yeah, definitely a lot of confusion, uh, especially and patients have got no idea what they're coming in for either. And I say, so the way that I frame it in my practice and the practices I've worked at is, um, cuz the patient, the patient's got no idea. You know, in America in 1906, the idea of the Dental hygienist was born as two things. A) patient education and B) prevention. Um, I think we've got way too much gum disease in New Zealand to focus just on prevention, like it's treatment, you know, I think that we are seen as the budget periodontist, but that is, um, yeah, that's a whole nother tangent that we can go into and, you know, if you want to treat perio, go for it.
Speaker 2 00:13:27 Like that's fine. But my issue is with the expectation.
Speaker 1 00:13:30 Yeah. Well it's, it's the patient expectations, isn't it? Cause they come in, so this ties totally in with your identity too. So who are you, what are you gonna do to me? And why can't you fix me? And because there's layers of care as well. They're like, well if you're gonna do this, why can't you just do everything? Exactly. You're gonna send me to someone more expensive to do more things. Well actually, you know, your gum disease is a little bit more advanced. But yeah, I guess all of this is communication. Mm-hmm. Isn't it? Yeah. It's, it's communication. It's transparency of information and also it's information. Oh yeah. Why don't people know? What don't people know about their oral health? Dusty? Why ?
Speaker 2 00:14:07 Exactly? Well, because no one's told them <laugh>.
Speaker 1 00:14:11 Yeah. So where are we going wrong? Does it start right back at, you know, preschool visits? Uh, you know, uh, will I take responsibility for that? That, um, I wasn't able to educate the families that I saw to say, this will be your life. This will be your life path of oral health and services and future dental need.
Speaker 2 00:14:28 But there's so many, there's so many, like, I don't wanna say excuses, but reasons, you know, time is like the main thing in dentistry, right? Secondly, if you're talking to, um, you know, presumably mother, a parent with young children, they <laugh> they're fried. You know, being a parent's hard and then they've probably got their little darlings, you know, potentially running around, you know, amuck. You know, there's, there's all these reasons why we can't just sit down and have this conversation, you know, and the, the parent understand. And um, you know, it's, it's a cultural thing. So everyone in New Zealand loves to bash on the, the school dental nurse. I don't think there's any more, um, you know, figure hated in New Zealand. And that's another tangent. But I basically bring that down to elitism and misogyny. Um, it's, you know, the dumb dental nurse did this, but if I'd had the real male dentist, I would've had a better outcome. You wouldn't have. I love telling people about extension for prevention and why we have minimal invasive dentistry now and why this is what we used to do because we didn't have all the things we have now. Um, but yeah, people don't understand and we can't expect or we shouldn't be expected to in one appointment completely change a person's, you know, like
Speaker 1 00:15:48 their oral health paradigm.
Speaker 2 00:15:50 Exactly. Especially a parent with little kids running around who's probably fried and you know, they've probably got a really stressful job. They've probably got a really stressful life. You know, imagine if they're in Auckland and they just drove for an hour to get to the clinic and you know, there's all these things. We're we're, the reason we're not winning is cuz we're not set up to win. Yeah.
Speaker 1 00:16:10 Well one of the reasons, I mean, I agree
Speaker 2 00:16:12 With that. Yeah, absolutely. And these patients coming in and they say, oh you know, you know, I've never heard of this before. Why do I have to come now? And I say, okay, so this is the way it works at my practice. They say the dentists are obviously looking after your teeth and they say, and hygiene, we are looking after your gums and the bone and everything that holds the teeth in. So they do up top and we do the foundations. So this is not going into what we're supposed to be doing, which is prevention and patient education. You know, we're actually in treatment because we haven't been doing the prevention for the last hundred years. Um, we've got the gum disease, we're, we are not just preventing it. And um, then I say, and the other thing is that the dentists are really good at restorative things.
Speaker 2 00:16:57 So fixing problems, doing like fillings, crowns, bridges, implants, all that kind of stuff. And I say in hygiene we're more about prevention. So trying to stop the need for that. So I do bring that in there. Um, but usually we are beyond prevention, right? <laugh>, um, well for patients I see anyway, yeah. I go, I've got my oral B flip chart from the nineties, which is my favorite and I flip through the stages of gum disease. I love talking that, um, as I'm sure you can tell. Um, but yeah, um, I'm into follow the philosophy of less scraping, more talking. Another issue is that we, we think, and we're expected to be scrapers, you know, people think that a dental hygienist and OHTs exist to remove calculus or debride. And we don't, going back 1906, patient education and prevention. That's what we should be doing. But we're seen as the budget periodontists, we're seen as the 'scraper'. I've literally had the job of dental hygienist referred to by a young person, I don't even know how they'd heard of a dental hygienist as um, someone who scrapes crap off people's teeth. And I laughed cuz it was funny. It is funny <laugh>. And I said,
Speaker 1 00:18:02 Yeah,
Speaker 2 00:18:03 That was when I was a student. I've heard that dentists referred to dental hygienists as 'gum gardeners' as like an insult. But I actually thought that was funny. I quite liked that one.
Speaker 1 00:18:15 It was quite nice, because you're playing around in the biofilm, aren't you? You're playing around in that biofilm and you are just freshening things up. And I, you know, I respect gardeners. Yeah. Because I like to garden. Um, you've covered so many fantastic points there, Dusty. There is something not right with the way we are set up. I mean, look at our patient outcomes.
Speaker 2 00:18:36 Mm-hmm.
Speaker 1 00:18:37 <affirmative>, we're not finding, um, great success in all areas, um, of oral health. And I listened to a periodontist, gosh, in the middle of the night when I couldn't sleep the other night, um, from France. Now I'll remember his name and I'll sneak it in. (Dr Jean-Marc Dersot DDS, MSc, PhD) Cause he just did this fantastic talk about prevention and he doesn't have, they don't have dental hygienists in France. So he was Oh, cool. Very interesting. Cause I typed him a comment, as it was live and I said, I'm a dental therapist. And he goes, oh, we don't have hygienists in France. So anyway,
Speaker 2 00:19:03 I'm not a hygienist.
Speaker 1 00:19:04 Yeah, no, I didn't even go there. But his presentation was really, um, he just, cause it was for doctors actually this presentation. Oh, okay. Went across what is the biofilm? What microorganisms are in the mouth that cause uh, bacteria transfer from, oral to, cardiovascular health? And I guess what struck me is he just pushed prevention for the whole presentation. You know, when your patient presents in the emergency room, when your patient is in hospital long term, their oral health must be maintained. Or you know, if it's poor oral health, it must be, you know, lifted to a certain point. Mm-hmm. <affirmative>. And he just focus, focus on the improving the, um, that patient experience and the such that he discloses, he gets them to pick a toothbrush and then brush their teeth in front of him and, you know, he, he gets them to floss in front of him.
Speaker 1 00:20:00 He takes that time. And I thought that's the first time I've, he heard a specialist say that. Um, but maybe it's a different setup in France, uh, where if they don't have a hygienist, they don't get that person to help with. Um, yeah. Things. But I guess what I'm yeah. Is once again, that communication for your patient and do you have time, um, our last topic here is less than ideal working conditions. And I feel that time is absolutely of the essence in any healthcare situation at the moment where too many people, not enough time, not enough practitioners. Um, should we go there and have a chat about less than ideal working conditions.
Speaker 2 (Dusty) 00:20:37 Yeah. So, um, going on with what you're saying about time, um, people wanna spend less money. Okay. So we'll have short appointments because if we have long appointments, they're gonna be really expensive. And then if we have short appointments, oh, we've got no time to do anything. Oh, what does the patient expect you to do? Scrape. Okay, we end up scraping. Oh, okay. Um, we don't have much time. We need to scrape lots off. Okay. We're gonna have to use high power and oh, it's, we're gonna have to be rough. Oh, it's so painful. Ow. You know, I hate coming to see you. It's so awful. Oh, no, no, no, no. Like, so yeah, this is this trap. And especially when as a clinician, we think our job is to be a scraper. Every single little scrap of calculus must come off. That's really rough.
Speaker 2 00:21:22 That's really painful. We are using high power. The calculus isn't the problem. It's the patient not clearing the plaque, which then calcifies. That's the problem. You could scrape every single little scraper calculus off scar the patient for life, they'll never come back. And they haven't, there's no intervention. You haven't changed what they're doing at home. So why would it not all come back again? You know, when you say it like this, it sounds so obvious, but when you got the patient in the chair, you know you want to get it off and it's fun. We love debridement, you know, scrape, scrape. Yeah. And then the patient's like, Hmm, it feels so good. And yeah, you've scraped everything off those lower anteriors on those four or five, maybe six more pockets around the molars. Maybe you got to, you know, stick the ultrasonic down there a little bit.
Speaker 1 (Becky) 00:22:08 How do we communicate with our patients in such a way that like, we've got all this got 15 minutes or 30 minutes with you and we've gotta change your world somehow. Um, we haven't got that, that, uh, recipe right yet. Definitely. Even though we know education, we've got promotion theories, we've got strategies, but it just, it's just, there's no room for it. And I wonder why.
Speaker 2 00:22:31 Well, part of it, Becky, is we are not setting our own agenda. We work mainly for dentists and often now for companies. And they set how long you have they set whether or not you have a da, uh, no <laugh> would be the answer foremost everyone. And they set what equipment you have, you know, they set the bar. So, and then we have to work for it. And then, oh, last time the patient came, this is what they did, scraped scrapey scrapes. So you start doing that again, you're in this trap and if you are the one to say, hold on, you know, it can go two ways or it can go a million ways, but the patient could say, oh wow, this is great. You know, now I learn all this stuff. Or they could say, you've just talked to me and told me off for 30
Speaker 1 00:23:12 Yes and there's no value. Where's the value in talking and education?
Speaker 2 00:23:16 Prophy-master. So I have airflow and I say I'm fortunate to have that, but I shouldn't really say I'm fortunate is a piece of equipment that's really valuable. We should, I shouldn't say I'm lucky to have some equipment that serves me and my patients knowledge. So, um, I get a lot of new to hygiene patients and as, um, you know, Becky said, I really enjoy new to hygiene patients. Yeah. And um, often in the first appointment I would, you know, get my oral B flip chart out, as I said, go through the gum disease, explain, you know, why you're here, what I'm doing. And part of the reason I really like to do that is because then when you go in and probe and you know, you say the numbers out loud, they're diagnosing themselves, right. So they're, you are not just saying, oh, you know, bad diagnosis outta nowhere.
Speaker 2 00:24:03 But anyway, I digress. So, um, yeah, I've got a prophy master and often in the first appointment I would just, um, do all the education, the OHI whatever, and then, um, yeah, airflow and then show the patient in the mirror and often their gum are pissing out with blood. Like that's coarse language, but like it's true. Like it's a blood bath in there and they're like, 'wow!' And you know, you can show them after you go around with the ultrasonic scaler and the hand scalers, but they think that you've been like chopping them up and stabbing them. Yeah. Like I've been waiting for years for a patient to say, oh, but that's cuz you did this to me and I've been, I was gonna, I've been waiting to pull the airflow out and spray it on their finger and show them how gentle it's, but no one's ever said it because it's so gentle.
Speaker 2 00:24:46 Yeah. Um, yeah. So, um, but in that first appointment, that's often all I'll do. And then I'll say, you come back, we're gonna do half and half with L.A. or some parts with L.A. or just one or quads whatever, you know. Um, but if you don't have a prophy master and you're not showing, you know, which is a $30,000 piece of equipment plus the powders and everything, it's like very expensive hygiene in general, It has low variable costs. So you know, you have, if you think about the dentist, you know, you've got all that equipment, all those composites, all those materials, you know, everything. The industry's very expensive, but hygiene's traditionally been quite low variable cost. You've got your scalers, your prophy cup, your prophy paste, you know, your ultrasonic - cheap, you know, it's a license to print money from the, you know, the point of the dentist.
Speaker 2 00:25:43 It really is. And you get them coming every six months or whatever. Yeah. Um, but yeah, if you don't have all that equipment and you're not showing them that you know what, and you're trying to focus on education on that first appointment, then people can feel like, yeah, there's no value. And this came up in my own practice and I said, I said, they should be paying more for this. They're getting more value out of this. I could scrape everything like I said before, and if we're not changing what they're doing at home and they're not understanding why, then it's just gonna all come back again.
Speaker 2 00:26:32 What I was taught by the, you know, the mentors I had when I started working privately, which is so many amazing general hygienists and OHTs, um, is baby them in, you know, take it really slow, baby them in, you know, every time they, they come and do a bit more or go whole hog, but I'll numb everything. You know, basically what I was told was, if you think it's gonna hurt, numb them because if it hurts, they're not gonna come back. So it's thinking, yeah, not I have to scrape everything off. It's thinking, how am I gonna set this patient up for life? If you think about, you know, the patients that we've seen as clinicians who've come in the door, say, new, new to you, what is the biggest, you know, deciding factor or how do I phrase this? Like,
Speaker 1 00:27:25 Oh, I could say, I can say for kids or parents, fear of decay, fear of tooth loss.
Speaker 2 00:27:31 It's, yeah.
Speaker 1 00:27:32 You know, um, okay. There's some that's proactive and are just like, this is part of their health regime for the year. Um, but yeah, <laugh> are just most of our behaviours driven by fear.
Speaker 2 00:27:44 Yeah. Well that's another, um, tangent we could go off on back here is the parents, when I worked, you know, at the D H B, the kids who have all the problems, you spend all the time talking about how you're gonna patch the holes and then the kids that don't have any problems, you've got tons of time. So you talk about diet and prevention, so the people are already doing it, but it's because you had the time, but you don't know how much time you need until the patient's in the chair. And then, oh wait, you know, kids haven't been seen in two years. Oh, another thing's been on the news about 15, you know, million kids waiting for GA's for, you know, 10 years and stuff like that, you know?
Speaker 1 00:28:23 Yeah. So what are we doing about it, Dusty? What are we doing about it? And that's hopefully I get to talk to a few people in the next few months who might explain, uh, you know, we as a profession have some strategies for improving oral health and how the community oral health service could be, um, enhanced or how a public-private Collab could be created. You've given some absolute gems there that are gonna get people really thinking about like, <laugh>, do we have to put up with this anymore? Do, that's the point I, you know, that that self-determination of a, of a oral health professional to be able to stand up for, for your identity as an O H T, how do you think you can raise the profile of, of your role, um, individually and collectively? What do you think? Yeah.
Speaker 2 00:29:09 Well, Becky, I mean, I feel like I'm trying to do that by fact checking. When the patient says, oh, you know, why did you decide to become a, a dental hygienist? I say, oh, I'm actually not a dental hygienist. Um, we don't make those anymore. You know, this is, you know, blah, blah, blah and explain what an OHT is. I've worked with more than one OHT who was a dental hygienist and you know, um, is now an O H T now that that's, it's now that, that's our own scope. Um, and I've heard them say, um, I'm the hygienist and I really don't like criticizing my colleagues about things like this and I don't like telling other people what to do. But you are not a dental hygienist anymore. You're an OHT, you don't have to be an O H T if you want to be a dental hygienist, you can stay one. You know, it's a choice to change
Speaker 1 00:29:55 The system creates pressure. Mm. Or the work environment creates pressure for the individual to buckle or for the collective to buckle and to create behaviors, you know, not just in identity, but in clinical, um, and treatment decisions. And that's not just in the industry. I've seen that across the board. Uh, I do keep an eye on all, uh, quite a few health arenas to see, to see where, what's, what's going wrong and, you know, thinking about solutions. So yeah, part of that solution is just clarifying things. I am this and these, this is what I do and this is what I can do for you. So, you know that, but that's hard work. Cause that's on a daily basis for one to one.
Speaker 2 00:30:37 Exactly. And when the dentist is, when the dentist is saying to the patient, you need to see the hygienist. And when receptionist saying you've got an appointment with the hygienist, I'm like, yeah, you can, you can literally say the same thing. You just say, you've got a hygiene appointment due, or you need a hygiene appointment
Speaker 1 00:30:52 What about Oral Health Therapist. Dusty P!
Speaker 2 00:30:54 Don't even have to say oral health, if you just say a hygiene appointment. But, um, one solution, Becky, that I just thought of is, um, we've got our Oral Health Association.
Speaker 1 00:31:05 <laugh>.
Speaker 2 00:31:05 Yeah. That, that's a first step. That's a good step. Um, but yeah, solutions are hard. It's so much easier to talk about the problems.
Speaker 1 00:31:14 It is. But, um, I, I like to think of solutions because that's what, that's what spins my wheels. And especially the, one of the last points we touched on about less than ideal working conditions for, um, OHTs, for DTS and for DHS working in private and public currently, what are we gonna do about it, Dusty, what are we gonna do in order to, to create a better environment? Because at the moment everything's a little bit up in the air, change is the best time to make change that suits us <laugh>. So what are we gonna do ?
Speaker 2 00:31:49 Exactly? Well, again, having that joint association is, is really good. You know, one voice, one louder, stronger voice. Um, definitely advocating for Yeah, especially to Te Whatū Ora / Health NZ to be a more unified community oral health service or whatever, you know, the future of that, um, looks like. But it's really hard to do that as an individual, I guess. Are we asking them to like advocate for us on our behalf? I don't know.
Speaker 1 00:32:20 I think so.
Speaker 2 00:32:21 Advocate, but it's really hard to advocate.
Speaker 1 00:32:25 It's, it's up to the members to, to put forward to the association, their issues, their desires for the members. It's up to the union members to be able to push the PSA or whomever, um, to say, 'Hey, look, a working conditions are less than average and you know, a treatment, uh, is compromised considerably.' Hey, the Dental Council needs to know if you can't do your care, if your, if your scope's being limited or if your scope's being stretched, the dental council needs to know that business. And um, I know that's a less than popular opinion, but it does because that's why we are regulated.
Speaker 2 00:32:59 When we're talking about how we're, you know, predominantly female profession and a historically female profession. Something, um, we sort of talked about before, you know, our work has been devolved as women's work, living in the patriarchy thing and just the crazy part of that as as dental therapists and before that school, dental nurses, you're doing dentistry, restorative dentistry, it's the same job as the dentist. Sure. It's not, you know, root canals, it's not bridges, it's not implants, stuff like that. But that stuff didn't exist until what, like the eighties, you know, dentists weren't doing that stuff routinely from 1921 when dental therapy was a meant in New Zealand. And not only that, dental therapists were doing it on kids. It's a million times harder on a child than it is on an adult. Um, and yet somehow that was the women's work and so devalued, but yet the dentist doing a lot of the same work and very similar work, although more advanced and rahdi-rah, um, is the man's work.
Speaker 2 00:33:58 So yeah, we live in the patriarchy. We've been devalued. A lot of the current workforce are probably mothers, grandmothers, and you know, your focus is probably on your kids, not your job. Often we work part-time, especially in private, um, often we work on our own or like with maybe another OT or another dental hygienist or maybe we'll work in a practice that has like multiple locations, but will be the only one there. And the other thing is we don't have lots of time to spend talking to each other in our job we see patients, our, you know, it's not like we work in a office where you can go around and do your job at or do your work at your own pace. You know, our time is filled <laugh>, every minute of it is filled. So we are not all just sitting around talking about, you know, all the issues we're having and how we can make it better. Yeah. We've sort of been pushed into the situation, pushed into it. We are where we are by our circumstances.
Speaker 1 00:35:02 Oh, Dusty, you've given us a rich and fruitful conversation today. So
Speaker 2 00:35:09 Yeah, I've got a lot of feelings.
Speaker 1 00:35:11 <laugh>, I love your feelings that they're the kind, we need these feelings to push us forward, know about our rights and responsibilities as a human beings and as an oral health professionals that we don't have to sit with what we are given. Uh, we can move forward to what we are entitled to. And um, I think that's super important. Well, Dusty, you will be back again and you will have, , another time on The Whole Tooth Aotearoa / NZ and I really appreciate that you've got your opinions and your facts and your feelings because we need them. Thank you!
Speaker 2 00:35:46 Thanks. Thank you so much, Becky. My absolute pleasure.
Speaker 1 00:35:50 Kia Ora, and thank you for listening to this episode of The Whole Tooth Ao/NZ.
Next week we'll hear from Dr. Bethy Turton. She is an assistant professor at Henry M. Goldman School of Dental Medicine at Boston University. She has got some amazing stories about spending the last decade living in Southeast Asia where she was able to set up and test care pathways for children in low resource settings. So tune in next week to hear all about this, go well our oral health, colleagues, peers, and friends, from us at The Whole Tooth Ao/NZ, noho ora mai.
