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J Healthc Leadersh. 2015 Mar 2;7:1-11. doi: 10.2147/JHL.S80011. eCollection 2015.

Assessment of the management factors that influence the development of preventive care in the New South Wales public dental service.

Author information

Faculty of Health and Medicine, School of Health Sciences, Oral Health, University of Newcastle, Ourimbah.
Department of Population Oral Health, Faculty of Dentistry, University of Sydney, Sydney, NSW, Australia.



Oral diseases, particularly dental caries, remain one of the most common chronic health problems for adolescents, and are a major public health concern. Public dental services in New South Wales, Australia offer free clinical care and preventive advice to all adolescents under 18 years of age, particularly those from disadvantaged backgrounds. This care is provided by dental therapists and oral health therapists (therapists). It is incumbent upon clinical directors (CDs) and health service managers (HSMs) to ensure that the appropriate clinical preventive care is offered by clinicians to all their patients. The aims of this study were to 1) explore CDs' and HSMs' perceptions of the factors that could support the delivery of preventive care to adolescents, and to 2) record the strategies they have utilized to help therapists provide preventive care to adolescents.

Subjects and methods:

In-depth, semistructured interviews were undertaken with 19 CDs and HSMs from across NSW local health districts. A framework matrix was used to systematically code data and enable key themes to be identified for analysis.


The 19 CDs and HSMs reported that fiscal accountability and meeting performance targets impacted on the levels and types of preventive care provided by therapists. Participants suggested that professional clinical structures for continuous quality improvement should be implemented and monitored, and that an adequate workforce mix and more resources for preventive dental care activities would enhance therapists' ability to provide appropriate levels of preventive care. CDs and HSMs stated that capitalizing on the strengths of visiting pediatric dental specialists and working with local health district clinical leaders would be a practical way to improve models of preventive oral health care for adolescents.


The main issue raised in this study is that preventive dentistry per se lacks strong support from the central funding agency, and that increasing prevention activities is not a simple task of changing regulations or increasing professional education.


clinical leadership; dental/oral health therapist; preventive strategies; public oral health management

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work. The findings from this study are those of the authors and do not reflect the views of the funding body or the NSW Ministry of Health.

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