the tooth be told
Time for a change (again) to healthcare governance in Aotearoa. Why not? It was probably getting rather hard to justify the continuation of DHBs. Every one of these organisations had morphed into their own version of health care – and what a collection of interpretations, if the tooth truth be told.

Anywho, the stimulus for this post is the kaupapa around the release of the article; ‘Oral Health for Children in Aotearoa New Zealand – time for a change‘ prepared by a few of Aotearoa’s dental research heavyweights (

What did I get out of reading this article:-

  1. URGENT need for a shift towards much greater preventive dental care for tamariki and rangitahi. That is p.r.e.v.e.n.t.i.o.n. – imagine if preventive care was afforded the funding and time similar to restorative care!
  2. Embrace te ao māori, te reo Māori, mauri ora, niho ora – authentically engage in partnerships, grow your cultural intelligence. This will enrich your wairua, your clinical practice and grow your empathy, compassion and understanding of self and others.
  3. Let’s consider how our public and private oral health services are currently set up? Do you consider this the best model of care to meet oral health needs? Evidence (anecdotal & research) shows that the current model of care is not working well and we should do things differently going forward – but what might patient-centred appropriate, accessible oral health services actually look like? Who will be leading the troops? Will we have management and leadership with the courage, insight and knowledge to create an environment for quality evidence-based oral health practice? What measurement tools and targets align with quality care? What contingencies should be in place for when things go wrong?
  4. Acknowledgement of oral health workforce issues: pay disparities, autonomy issues, underutilisation of workforce, and my 5 cents: unremarkable union advocacy .
  5. Oral Health Advocacy for tamariki & rangatahi, I see some OPPORTUNITIES !! Te Ao Marama, New Zealand Oral Health Association, oral health professionals, oral health promoters and any other interested parties – be that squeaky wheel.
  6. Interprofessional collaboration – and I mean a collaboration that is fair, equitable and empowering. Oral health professionals – each with areas of expertise, and mutual respect for roles and skills of others.
  7. We as dental and oral health therapists and hygienists, must get on the research bandwagon. Research = evidence, meaningful and credible evidence = catalyst for change. Create the opportunity for change in your environment; meet the needs of your most vulnerable patients, heck, even your professional needs!

What is te anamata o te oranga (the future of health services)? What is going to happen with the COHS models of care and delivery of publicly funded dental services under the governance of Te Whatu Ora and Te Aka Whai Ora? Have we got alternative models of publicly funded dental care being discussed, planned, or implemented? The transition from SDS to COHS was over 15 years ago. Society’s complexity has increased in the intervening time with complexity in social structures, health, environment and education. Meaningful change with improved oral health outcomes is overdue!

If the toothy truth be told- are we about done with being a restricted and under-resourced profession? What are your barriers to change? What would need to change to allow you to do your best work, for optimal oral health outcomes especially for those who most need your skill-set, full utilisation of scope and job satisfaction? Let the tooth prevail! Becky

Much aroha to Diane Pevreal and Helen Tane for their input on this blog.


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