Dental Therapy in Saskatchewan and Canada

Education

Dental therapists in Canada graduate from a 2 year diploma education program which includes preclinical, clinical and didactic components. Didactic courses cover broad subject areas including the following: human anatomy and physiology; oral and dental anatomy; radiology; preventive dentistry; restorative dentistry; oral surgery; local anesthesia; infection control; client management; community health dentistry; ethics and jurisprudence.

Upon graduation it is the individual’s personal, professional and ethical responsibility to remain current in all aspects of the provision of care.

History

In the early late 1960’s and early 1970’s two separate yet related jurisdictions in Canada were struggling with the need to provide quality dental health services in their area of responsibility. The Government of Saskatchewan was grappling with the lack of dental services in rural and remote areas and the Federal government had a similar issue and concern in the Yukon and Northwest Territories. At that time, the Federal government was responsible for the delivery of health care services in the Northwest Territories and Yukon. Both governments faced the same issue: lack of qualified, accessible dental providers for many of its residents and a poor oral health status in many of the rural, in the case of Saskatchewan, and the remote and isolated areas of northern Canada. With too few dentists and unable to attract providers to these areas they both looked to alternative and innovative means to meet the basic dental needs in those areas.

Based on the success and the premise of the New Zealand dental program two schools of dental therapy were opened in 1972, one in Saskatchewan and one in the Northwest Territories. Although both schools opened at the same time they were developed and implemented independent of each other, focusing their programs to meet the specific needs in their areas.

Saskatchewan Wascana Institute of Applied Arts and Science

The government of Saskatchewan recognized that the dental health of the children of Saskatchewan was poor. There were an insufficient number of dentists in the province to meet the dental needs of the children. In addition, the geographical distribution of dentists left a large portion of the population unable to access quality dental care. In 1970 a pilot project, based on the original New Zealand dental program, was implemented in Oxbow, Saskatchewan. The project utilized two British dental nurses, two dental assistants and one dentist. The findings of the pilot project were not encouraging. In September 1972, Wascana Institute of Applied Arts and Science (WIAAS) in Regina began training dental nurses. The first class of 34 dental nurses graduated in 1974. The dental nurses were educated to provide dental services to school aged children in the Saskatchewan Health Dental Plan (SHDP), which was implemented in the fall of 1974. In the SHDP dental nurses and dental assistants worked in teams with indirect supervision by dentists, who were also employed by the SHDP. The SHDP dental nurses provided dental services in school-based dental clinics. The plan included most routine dental services such as examinations, x-rays, preventive services, fillings, primary extractions, pulpotomies, crowns, and space maintainers.

At that time a small number of dental nurses provided dental services in private practice dental offices in the province. Wascana Institute also educated dental nurses for the Manitoba government to provide dental services in the Manitoba Children’s Dental Plan. In 1981 the name “dental nurse” was replaced by “dental therapist”.

In June 1987, the Progressive Conservative (PC) government privatized the SHDP. This became the Children’s Dental Plan (CDP). The CDP covered the cost of routine dental services for children aged 5-12 in dental offices. In 1993, the Children’s Dental Plan was eliminated.

At that time a large number of dental therapists entered private practice. As well, over the next few years many dental therapists returned to Wascana Institute to take an 5-8 month course to enable them to become dental hygienists. This dental hygiene course had been in place for dental therapists to take since the late 1970's.    

Wascana Institute graduated over 500 dental therapists before its closing in 1992.

National School of Dental Therapy

At the same time the need for quality health services in northern Canada was recognized.  As a result of the isolation of the north many health care providers were not interest in providing services to the northern population on a permanent basis. As a result, many residents had to be transported to major centers to receive adequate health services including dental care. Based on the success of the New Zealand dental program an agreement was made between the University of Toronto and Medial Services Branch to implement a pilot project educating “primary dental health workers” to provide dental services to residents, adults and children, of the north. The founding objective of the program was to train northern Canadians to provide auxiliary dental care services to remote northern Canadian communities and preferably their own communities. Prior to this, the Yukon Territory had instituted a children’s dental program. In 1972 the National School of Dental Therapy (NSDT) was opened in Fort Smith, Northwest Territories. In 1974 the National School of Dental Therapy graduated 8 dental therapists. The two year pilot project was a success and Medical Services Branch of Health Canada gave approval for the continuation of dental services.  The NSDT was later relocated to Prince Albert, Saskatchewan in 1981. 

From 1972 to 1995, the operating contract for the NSDT remained with the University of Toronto.  In July 1995, in keeping with the policies of the Government of Canada in the area of Aboriginal initiatives, the operating contract was tendered and subsequently awarded to the Saskatchewan Indian Federated College (SIFC).  On June 21, 2003, Saskatchewan Indian Federated College formally changed the name to First Nations University of Canada.

The mission of the First Nations University of Canada-National School of Dental Therapy (FN UNIV-NSDT) was committed to provide a learning environment that is safe and respectful of traditional First Nations and Inuit aspirations and customs. FN Univ-NSDT assisted First Nations and Inuit communities to reach their aspirations in oral health by providing technical support, continuing education and consultative services.

The National School of Dental Therapy graduated over 400 dental therapists before its closing in 2011.  

Practice of a Dental Therapist

The scope of practice varies slightly between Provinces and/or Territories, dependent on the specific parameters outlined by the regulatory body and/or the legislation for that region of the country.

Dental Therapists provide such clinical services as diagnosing dental caries and oral conditions, taking x-rays, preventive services, including fissure sealants, administering local anesthesia, preparing for and placing restorations, primary and permanent extractions, including placing suture when needed, performing pulpotomies, preparing and placing stainless steel crowns, and fabricating and placing space maintainers.  An additional orthodontic module is available for members to take to enable them to perform basic orthodontic procedures. 

Dental Therapists also provide services related to health education and promotion such as assessing and evaluating the oral health needs of populations, including planning, developing and implementing oral health programs to address the identified needs, function, liaise and collaborate as a member of a multidisciplinary health team, plan, develop, co-ordinate and deliver presentation to teachers, caregivers, special needs groups, health professionals and colleagues, provide consultative and technical/professionals, education personnel and caregivers. 

 Saskatchewan Dental Therapists Association

The Saskatchewan Dental Nurses Act was proclaimed in 1973.  Dental Nursing became a self-regulated profession. This enabled the Saskatchewan Dental Nurses Association (SDNA) to license and regulate their own members. The SDNA was founded in April 1974. In 1981 the Saskatchewan Dental Nurses Act was replaced by the Dental Therapists Act. This marked the name change from “dental nurse” to “dental therapist” in Saskatchewan. 

In 1997, The Dental Disciplines Act was legislated. The Act includes the six dental professions in the province: dentists, dental technicians, denturists, dental hygienists, dental assistants, and dental therapists. This Act provided the authority for each individual dental profession to license and regulate their own profession. As the SDTA had this authority since its inception in 1974, this legislation provided more opportunities for employers to employ dental therapists with more flexibility. 

All members of the Saskatchewan Dental Therapists Association have graduated from a recognized school of dental therapy. All dental therapists practicing in Saskatchewan are required to be registered and licensed with the Saskatchewan Dental Therapists Association. 

The Saskatchewan Dental Therapists Association’s Council consists of the president, vice-president, eight members at large, three public representatives and the Executive Director/Registrar. The council is responsible for administering the Dental Disciplines Act and the Saskatchewan Dental Therapists Associations Bylaws. The members of council chair various committees including the Executive, Professional Conduct, Discipline, Credentials, Continuing Education, Convention, Editorial and Communications committees.  

Dental Therapists Employment

Dental therapists provide services in urban, rural, remote and isolated areas of Canada. The profession of dental therapy is practiced in all provinces and territories in Canada excluding Ontario and Quebec.  

In the Northwest Territories, Nunavut and the Yukon, dental therapists are licensed to work in local communities with the emphasis on dental care for school children.  In Atlantic Canada, Alberta and British Columbia dental therapists work in First Nations and Inuit communities. In Manitoba dental therapists work for the federal government in First Nations and Inuit communities as well as private practice.

Presently in Saskatchewan dental therapists practice in both private and public health settings within a general consultative/referral relationship with a dentist. Dental therapists are currently working in private practice, teaching institutions, as instructors and administrators; in health regions, as dental health educator/coordinators and administrators; for tribal councils, as dental therapists and administrators; and for the provincial and federal governments. 

There are currently 163 practicing dental therapists in Saskatchewan.

New Dental Therapy Program in Canada 

A new partnership between the Northern Inter-Tribal Health Authority (NITHA), Saskatchewan Polytechnic and the University of Saskatchewan (USask) has been awarded $150,000 by Indigenous Services Canada (ISC) to create a model for establishing the only accredited dental therapy program in Canada.  The program is estimated to commence the fall of 2023. (Not 2022 as previously reported.)  The program is proposed to be 6 semesters in length, running continuously, so 24 months straight through. There will be 3 campuses, Regina, Prince Albert and La Ronge. The discussions are progressing between the stakeholders. Further details will be announced as they become available.