History of Dental Therapy in Saskatchewan

history_image1In September 1972, training of dental nurses began at the Wascana Institute of Applied Arts and Science (WIAAS) in Regina. The dental division was located in the renovated nurses’ residence of the Regina General Hospital, where it remained until December1999 when it was moved to Wascana Campus.

In 1973 The Saskatchewan Dental Nurses Act was legislated. It provided the foundation for the training of dental nurses. In 1974 The Dental Care Act was legislated. It provided the framework for the Saskatchewan Health Dental Plan, which was implemented in August 1974.

In April 1974 the Saskatchewan Dental Therapists Association (SDTA) was founded. In 1981 The Saskatchewan Dental Therapists Act was legislated and the title “dental therapist” replaced “dental nurse”. Both The Saskatchewan Dental Nurses Act and The Saskatchewan Dental Therapists Act provided the authority to the SDTA to license and regulate their own profession, which at that time was unique.

The first dental nurses graduating class was in 1974 with 35 dental nurses. These 35 dental nurses were complemented with 15 dental nurses imported from Great Britain to make a complement of 50 dental nurses who implemented the Saskatchewan Health Dental Plan (SHDP) in the fall of 1974.

The dental services were provided in school-based dental clinics by licensed dental nurses and certified dental assistants who worked in teams with indirect supervision by dentists who were also employed by the Saskatchewan Health Dental Plan. The plan included most routine dental services such as examinations, x-rays, preventive services, fillings, extractions, pulpotomies, crowns, and space maintainers. Dental nurses were also trained to do mandibular blocks, which was controversial at the time.

Dental clinics were located in schools with the cooperation of school boards and the Department of Education. Dental teams visited schools on a regular basis, usually once a year. Parents were encouraged to participate in the program by accompanying their children to the clinics. There were no premiums or enrollment fees. Invitations were sent to parents with children who were eligible based on the year of birth.

In the first year of the Saskatchewan Health Dental Plan children born in 1968 (6-year olds) were eligible to enroll. They were required to be registered under the Saskatchewan Hospital and Medical Care Plans. In 1975, children aged 5, 6 and 7 were eligible; in 1976, children aged 5, 6, 7 and 8; with the SHDP continuing to expand until children age 3-15 were included. In 1981, adolescents were included in the SHDP. Some were treated by dental therapists in school clinics, while others were referred to private practice dentists to receive treatment and prevention services at no charge.

By 1987, the last year of the SHDP, there were 578 permanent dental clinics in schools throughout Saskatchewan. A few remained temporary, in which portable equipment was used. In the early years of the SHDP, transportation of children to the school clinics was often provided by SHDP staff. This was to ensure accessibility to services.

External evaluations (A Quality Evaluation of Specific Dental Services Provided by the Saskatchewan Dental Plan – February 1976; Performance of the Saskatchewan Health Dental Plan, 1974-1980 – D. W. Lewis, February 1976; Social Class and Dental Care Utilization – Evelyn Swanson, Fall 1976) of the SHDP concluded that children had no fear of the dental clinic or personnel and considered it a “routine” part of school. Dental therapists were well trained to provide prevention and treatment services, and work done by dental therapists was superior to work done by private practice dentists.

In 1987 the Saskatchewan Dental Plan employed over 400 staff in 6 regions, including dental therapists, dental assistants, dentists, administrators, support staff, dental technicians and head office staff. The client participation rate in the SHDP in 1987 was 90%.

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 age 5-12 in dental offices. In 1993, the NDP government eliminated the Children’s Dental Plan.

In 1987 when the SDHP was privatized, over 400 staff lost their jobs; the majority were women and many lived in rural communities. The Saskatchewan Health, Community Services Branch retained the 18 most senior dental therapists. These dental therapists became dental health educators and began the Saskatchewan Health, Dental Health Education Program. The program’s goal was to provide health education and preventive services to Saskatchewan children. This program was transferred to health districts in 1995 and continues today in health regions. It has expanded to include 24 dental therapists who provide a wide range of primary prevention services, health promotion, and needs assessment to people of all ages.

In 1997, The Dental Disciplines Act was legislated. This 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.

Since 1987, dental therapists have been able to broaden their roles and responsibilities and expand their opportunities. Dental therapists are currently working in a variety of settings. These include private practice, teaching institutions, such as the University of Saskatchewan and SIAST 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.

history_image2School-based dental programs delivered by dental therapist/dental assistant teams also continue in the Athabasca Health Authority, Keewatin Yatthé Health Authority, Mamawetan Churchill Regional Health Authority, Prince Albert Parkland Health Region, and the Saskatoon Health Region.

The last school of dental therapy in the province, National School of Dental Therapy in Prince Albert closed in 2011.  

In 2016, the SDTA has 241 registered members: 220 practicing dental therapists; 21 non-practicing dental therapists; and 25 affiliates.

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