none of New Zealand’s children had untreated tooth decay. This school-based model has spread to many other countries.
In 1949, Malaysia established the Malayan School for Dental Nurses, patterned after the New Zealand program. In Malaysia, health care for elementary school children is provided through a network of public and school clinics that employ dental nurses. The implementation of school-based dental programs has shown dramatic improvements in children’s oral health, reaching 96 percent of all elementary school children and 67 percent of secondary school children (Ministry of Health Malaysia, 2005). In Malaysia, dental nurses also treat toddlers and preschool children.
In 1965, Australia approved the practice of school dental nurses (now called dental therapists), largely in response to the success of the program in New Zealand. Today, the overwhelming majority of dental care for children in Australia is provided by dental therapists. Recently, the training of dental therapists and dental hygienists has been merged.
In 1972, a dental nurse program was established in Canada’s Northwest Territories under the guidance of the dental faculty at the University of Toronto. In that same year, the province of Saskatchewan began to train school dental nurses and provide dental services to children. A few years later, the province of Manitoba established a school-based program and contracted with Saskatchewan to train the school dental nurses. By the mid-1980s, the Saskatchewan Dental Service had enrolled almost all of Saskatchewan’s children, and school dental nurses examined and treated almost all of these children annually. Despite broad public support, there was opposition to these programs by dentists in both provinces that led to both programs being transferred to private practice. Saskatchewan’s program was less successful under the fee-for-service basis and was eventually eliminated.
The National School for Dental Therapy in Saskatchewan continues to train about 20 dental therapists annually in a 2-year curriculum to care for the Indian and Inuit populations on reserves and in the Northern Territories. Today, about 300 dental therapists practice in Canada, primarily in Saskatchewan, Manitoba, and the Canadian north (Nash et al., 2008). About half the dental therapists in Saskatchewan practice alongside dentists in private offices.