Dental Board of Australia

2015/16 Annual Report Summary

At a glance: Regulating dental practitioners in 2015/16

This annual report summary provides a snapshot of our work regulating more than 20,000 registered dental practitioners in the financial year to 30 June 2016.

A more detailed profile, encompassing data relating to all 14 National Boards in Australia, is published in AHPRA and the National Boards’ 2015/16 annual report

About this report

This report provides a profession-specific view of the Dental Board of Australia’s work to manage risk to the public and regulate the profession in the public interest in 2015/16.

The Board has worked in close partnership with the Australian Health Practitioner Regulation Agency (AHPRA) to provide all Australians with a safe, qualified and competent workforce under the National Registration and Accreditation Scheme (the National Scheme).

Information included in this report is drawn from the data published in the 2015/16 annual report by AHPRA and the National Boards, and is correct as at 30 June 2016.

Whenever possible, historical data are provided to show trends over time, as well as comparisons between states and territories.

For a wider context, and to compare the profession against national data from all 14 professions regulated by National Boards under the National Scheme, this report should be read in conjunction with the 2015/16 annual report. You can download the report.

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Message from the Chair, Dental Board of Australia

The Dental Board of Australia is committed to protecting the health and safety of the public – its primary responsibility – by ensuring that only those dental practitioners who are suitably trained and qualified to practise in a competent and ethical manner are registered.

The Board works in partnership with AHPRA, and over the past year we investigated a number of allegations of dental treatment being provided by unregistered individuals. This raised significant concerns about substandard care and infection control standards.

We are also responsible for setting standards and policies that all registered dental practitioners must meet. This year has been one of ongoing review, with the implementation of a number of revised registration standards and guidelines.

In 2015/16, the Board continued working with its partners to meet the objectives of the National Scheme. As well as AHPRA, partners include the other 13 National Boards, the Australian Dental Council (ADC), the New South Wales Dental Council and health complaint entities. The Board has continued to develop strong links with other international dental regulators, including working closely with the Dental Council of New Zealand and participating in international forums such as the International Society of Dental Regulators.

In 2015, we said goodbye to four Board members and welcomed four new members to the Board. Retiring members of the Board are congratulated on their enthusiasm and commitment to an environment that supports right-touch regulation of health practitioners for the protection of the Australian public. The new members each bring a new perspective to the work of the Board.

Members of the Board in 2015/16

• Dr John Lockwood AM (Chair)
• Winthrop Professor Paul Abbott AO
• Ms Susan Aldenhoven AO
• Ms Alison von Bibra
• Mrs Jennifer Bishop
• Mr Robin Brown (from 31 August 2015)
• Dr Gerrard Condon (until 30 August 2015)
• Ms Alison Faigniez
• Mr Stephen Herrick (until 30 August 2015)
• Mr Paul House
• Mrs Kim Jones (from 31 August 2015)
• Dr Sajeev Koshy OAM (from 31 August 2015)
• Mr Michael Miceli (until 30 August 2015)
• Dr Mark Leedham (until 30 August 2015)
• Dr Kate Raymond (from 31 August 2015)
• Dr Murray Thomas

During 2015/16, the Board was supported by Executive Officer Alessandra Peck.

More information about the work of the Board, including codes, guidelines and information on registration standards, can be found on the Board website.

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Message from the AHPRA CEO and the Agency Management Committee Chair

Since the National Scheme began six years ago, AHPRA has worked in partnership with the National Boards to ensure that the community has access to a safe and competent health workforce across 14 registered health professions Australia-wide.

We rely on the expertise and insights of the National Boards to make decisions about the 657,621 health practitioners currently registered in Australia in the interests of the Australian public. It’s a role that Board members commit to with dedication and passion, and the community can be assured that its safety is always their number-one priority.

As at 30 June 2016, there were 21,741 registered dental practitioners. While they represent 3% of the total registered health workforce, the profession presents unique challenges for regulators.

Overseeing the registration and regulation of the profession is the Dental Board of Australia, with valuable input from professional and community groups. Together, they have done a great job over the past 12 months to remind dental practitioners of their responsibilities under the Health Practitioner Regulation National Law, as in force in each state and territory (the National Law), particularly in regards to new Guidelines on infection control.

The Board upholds the values of the National Scheme by taking a risk-based approach to regulatory decision-making and policy implementation, with a continued focus on finding ways to improve effectiveness, efficiencies and timeliness.

We’d like to thank the Board members, and their committees in each state and territory, for their continued commitment to ensuring a competent and flexible health workforce that meets the current and future health needs of the community.

We look forward to continuing to work in partnership with the Board.

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Year in review: Dental Board of Australia

The Dental Board of Australia’s year started with a heightened focus on the risks associated with dental practitioners failing to comply with infection prevention and control requirements.

This followed regulatory action by the Dental Council of NSW (the Council) and a serious breach of the National Law, involving a Victorian man who pretended to be a dentist and treated patients at his home. AHPRA, acting on the Board’s behalf, successfully prosecuted this individual in August 2015. This case was the first in a series of investigations that highlighted the risks patients who see unregistered practitioners face in terms of experiencing substandard care and treatment, poor hygiene and inadequate infection control.

Effective infection prevention and control is everyone’s responsibility. It should be seen as part of a safety and quality framework that underpins professional practice across all health sectors, including dental practices.

The Board and the Council worked together to remind all dental practitioners of their infection prevention and control obligations under the Board’s Guidelines on infection control. All registered dental practitioners were contacted by mail, and a fact sheet and a self-assessment tool were published to help practitioners fully understand and meet these obligations. The Board and AHPRA also published a Tips for patients fact sheet to help patients and members of the public determine whether they are receiving safe care from a registered dental practitioner.

A number of entities are involved in setting standards and monitoring compliance in this field. The Board and AHPRA hosted a stakeholder forum in October 2015 to bring these organisations together, strengthen partnerships and gain a better understanding of how to support dental practitioners to practise effective infection prevention and control. The goal is to minimise the risk of patients being exposed to transmissible infections while receiving dental treatment. Information gained from the forum will assist the Board’s review of its guidelines on infection control, which will be undertaken during 2016/17 in partnership with other National Boards.

The Board continued its work to improve registration pathways, with a particular focus on specialist registration. A revised assessment process was developed for overseas-trained dental specialists, with the ADC assessing overseas specialist qualifications for substantial equivalence to an Australian specialist program, on the Board’s behalf. The Board subsequently published a framework outlining entry-level competencies for each of the 13 approved dental specialties. This work will continue in the coming year as the Board develops an outcome-based assessment model for specialist practitioners who have trained overseas.

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Data snapshot: Regulation at work in 2015/16

The profession in brief

• The dentistry registrant base grew by 2.5% year on year, to 21,741 in 2015/16.
• New South Wales was the principal place of practice for most dental practitioners (6,580); the Northern Territory was home to the least (153).
• The age bracket with most practitioners was 30–34 (3,321 registrants).
• 827 practitioners were under 25 years of age; 59 were over 80.
• Women comprised 49% of the profession.

About our data

Data in this Board summary are drawn from the 2015/16 annual report, published by AHPRA and the National Boards. Data relating to dental practitioners have been extracted from national source data that includes all 14 health professions currently regulated under the National Law.

In the following pages, you’ll find registration data, including registrant numbers by division, age and principal place of practice, as well as data about notifications (complaints or concerns) received about dental practitioners in the financial year to 30 June 2016. Data about statutory offence complaints are also included.

For a further breakdown of data from the 2015/16 annual report by AHPRA and the National Boards, including summary reports by state and territory, go to the annual report website.

Notifications data

Notifications are complaints or concerns that are lodged with AHPRA about registered health practitioners or students practising in Australia.

Our data generally excludes complaints handled by co-regulatory jurisdictions, such as in:

• NSW, where complaints about health practitioners with this state as their principal place of practice (PPP) are not managed by the Board and AHPRA, unless the conduct occurred outside NSW. Complaints about health practitioners where the conduct occurred in NSW are handled by the Health Professional Councils Authority (HPCA) and the NSW Health Care Complaints Commission (HCCC), and
• Queensland, where complaints are received and managed by the Office of the Health Ombudsman (OHO) and may be referred to AHPRA and the relevant National Board. We are not able to report on all complaints about health practitioners in Queensland because we only have access to data relating to matters referred to us by OHO.

Note that some NSW regulatory data published in this report may vary from data published in the HPCA’s annual report. This is due to subsequent data review by the HPCA after submission of initial data to AHPRA. For more information on how complaints about health practitioners are managed in NSW, and for data about complaints made in the state, please refer to the HPCA website.

For data relating to complaints in Queensland that have not been referred to AHPRA, please refer to the OHO website.

Registration of dental practitioners

There were 21,741 dental practitioners registered in Australia in 2015/16. This represents a national increase of 2.5% from the previous year.

Dental practitioners made up 3.3% of all registered health practitioners across the National Scheme. Noting that there is a range of dental registration categories:

• 89.5% held general registration to practise dentistry, with this cohort of registrants increasing by 2.6% compared to last year

7.5% held general and specialist registration to practise dentistry, with this cohort increasing by 1.1%

0.1% held specialist only registration to practise a dental specialty, which is an increase of 15.4% 0.3% held limited registration, which allows internationally qualified dental practitioners to provide dental services under supervision. This category of registrants decreased by 10.8%, and

• 2.5% held non-practising registration and could not practise dentistry. This cohort of registrants increased by 7.1%.

The number of registered dental students was 4,810; an increase of 2.1% on 2014/15.

A total of 1,536 new applications were received for registration with the Dental Board of Australia; a decrease of 6.2% from 2014/15. Of these applications, 87.7% were for general or specialist registration, and 9.3% were requests to move to the non-practising register.

See Tables 1–4 for segmentation of registration data about dental practitioners.

As a standard part of the registration process, applicants for initial registration as a health practitioner in Australia must undergo a criminal record check. AHPRA requested 66,698 domestic and international criminal history checks for practitioners across all professions in 2015/16. Of these, 1,992 checks were carried out for dental practitioners. The checks resulted in 96 disclosable court outcomes. Conditions or undertakings were imposed on one practitioner’s registration.

Regulation of dental practitioners

In 2015/16, 1,025 notifications were received nationally (including HPCA data) about dental practitioners. This represents an increase of 33.8% on the previous year. AHPRA received and managed 497 of these matters (excluding HPCA). Notifications about dental practitioners represented 8.2% of all notifications received by AHPRA (excluding HPCA) in 2015/16.

Nationally, 1.5% of registered health practitioners received notifications this year. The percentage of the dental practitioner registrant base with notifications received during the year was 4.7%, which is 3.2% higher than the national percentage across all registered professions.

Immediate action was taken on matters concerning dental practitioners 44 times in 2015/16 (compared with 15 in 2014/15). A National Board has the power to take immediate action in relation to a health practitioner’s registration at any time, if it believes this is necessary to protect the public. Immediate action limits a practitioner’s registration by suspending or imposing conditions on it, or accepting an undertaking or surrender of the registration from the practitioner or student. This is an interim step that Boards can take while more information is gathered or while other processes are put in place.

To take immediate action, the Board must reasonably believe that:

• because of their conduct, performance or health, the practitioner poses a ‘serious risk to persons’ and that it is necessary to take immediate action to protect public health or safety, or
• the practitioner’s registration was improperly obtained, or
• the practitioner or student’s registration was cancelled or suspended in another jurisdiction.

A total of 393 notifications (excluding HPCA) relating to a registered dental practitioner were closed in 2015/16. This represents 7.5% of all matters closed across all professions.

Outcomes of the closed notifications included:

• 15.5% resulted in conditions being imposed or an undertaking accepted by the Board
• 15.8% resulted in the practitioner receiving a caution or reprimand by the Board
• 3.3% resulted in suspension or cancellation of registration by the Board, and
• 60.1% resulted in no further action being taken by the Board (no further action is taken when, based on the available information, the Board determines there is no risk to the public that requires regulatory action).

At the end of the year, there were 324 open notifications (excluding HPCA) about registered dental practitioners.

AHPRA actively monitored 141 dental practitioners (excluding HPCA)1 in relation to conditions on their registration. This represents 2.8% of all monitoring cases across all professions.

AHPRA received 196 new complaints about possible dental-related statutory offences this year. These complaints constitute 14.5% of all statutory offence matters received in 2015/16. Almost all new matters related to the use of protected titles or advertising concerns. A total of 157 statutory offence matters were considered and closed.

Statutory offences are breaches of the National Law, committed by registered health practitioners and unregistered individuals. There are a number of offences created under the National Law, including:

• unlawful use of a protected title
• performing a restricted act
• holding out (claims by individuals or organisations as to registration), and
• unlawful advertising.

See Tables 4–14 for segmentation of notifications and statutory offence data relating to dental practitioners.

Want to know more?

For more information, please refer to the full 2015/16 annual report and supplementary data tables published by AHPRA and the National Boards on the annual report website.

For an overview of the National Law as it applies to each state and territory, please see AHPRA's legisltaion.

Table 1: Registrant numbers at 30 June 2016¹

Dental practitioners	ACT	NSW	NT	QLD	SA	TAS	VIC	WA	No PPP2	Total
2015/16	402	6,580	153	4,326	1,800	356	4,972	2,548	604	21,741
2014/15	399	6,449	147	4,179	1,769	366	4,827	2,472	601	21,209
% change from 2014/15	0.80%	2.00%	4.10%	3.50%	1.80%	-2.70%	3.00%	3.10%	0.50%	2.50%

Table 2: Registrants by division and state or territory

Division	ACT	NSW	NT	QLD	SA	TAS	VIC	WA	No PPP1	Total 2015/16	Total 2014/15
Dental hygienist	42	424	12	138	262	18	219	271	28	1,414	1,373
Dental hygienist and dental prosthetist		2		1						3	3
Dental hygienist and dental prosthetist and dental therapist		1					1			2	2
Dental hygienist and dental therapist	11	65	7	146	61	2	126	54	8	480	483
Dental hygienist and dental therapist and dentist				2						2	0
Dental hygienist and dental therapist and oral health therapist				1						1	0
Dental hygienist and dentist		2		1						3	2
Dental hygienist and oral health therapist		2			1			3		6	6
Dental prosthetist	16	409	4	271	63	48	351	85	3	1,250	1,245
Dental prosthetist and dental therapist							1			1	1
Dental prosthetist and dentist							1			1	1
Dental therapist	18	212	15	180	85	48	159	289	10	1,016	1,063
Dental therapist and dentist							1			1	0
Dental therapist and oral health therapist								4		4	2
Dentist	294	5,135	106	3,225	1,174	229	3,814	1,737	550	16,264	15,888
Dentist and oral health therapist		1			1					2	1
Oral health therapist	21	327	9	361	153	11	299	105	5	1,291	1,139
Total 2015/16	402	6,580	153	4,326	1,800	356	4,972	2,548	604	21,741
Total 2014/15	399	6,449	147	4,179	1,769	366	4,827	2,472	601		21,209

Table 3: Registrants by age

Dental practitioners	U-25	25-29	30-34	35-39	40-44	45-49	50-54	55-59	60-64	65-69	70-74	75-79	80+	Not available	Total
2015/16	827	3,059	3,321	2,920	2,372	2,078	2,044	2,220	1,474	875	363	129	59		21,741
2014/15	851	2,974	3,232	2,670	2,386	2,048	2,086	2,202	1,404	841	323	131	59	2	21,209

Table 4: Registrants by gender

Dental practitioners	ACT	NSW	NT	QLD	SA	TAS	VIC	WA	No PPP1	Total
Total 2015/16	402	6,580	153	4,326	1,800	356	4,972	2,548	604	21,741
Female	229	2,989	80	2,071	1,001	161	2,499	1,449	258	10,737
Male	173	3,591	73	2,255	799	195	2,473	1,099	346	11,004
Total 2014/15	399	6,449	147	4,179	1,769	366	4,827	2,472	601	21,209
Female	219	2,879	75	1,984	971	167	2,383	1,409	244	10,331
Male	180	3,570	72	2,195	798	199	2,444	1,063	357	10,878

Table 5: Notifications received by state or territory¹

Dental practitioners	ACT	NSW2	NT	QLD3	SA	TAS	VIC	WA	No PPP4	Subtotal	HPCA5	Total
2015/16 (PPP)6	16	12	6	167	55	14	138	86	3	497	528	1,025
2014/15 (PPP)	26	3	8	84	55	12	168	71	1	428	338	766
2014/15 (Responsible Office) 7	27		7	72	57	10	186	69		428	338	766

Table 6: Notifications received by division and state or territory (excluding HPCA)¹

Division	ACT	NSW2	NT	QLD3	SA	TAS	VIC	WA	No PPP4	Total 2015/16	Total 2014/15
Dental hygienist				1	1			1		3	5
Dental hygienist and dental therapist				4	3					7	1
Dental prosthetist	1		2	7	3	1	6	3		23	21
Dental therapist				2						2	2
Dentist	14	12	4	151	46	13	129	81		450	372
Oral health therapist				2	2		1			5	2
Unknown practitioner5	1						2	1	3	7	25
Total 2015/16 (PPP)6	16	12	6	167	55	14	138	86	3	497
Total 2014/15 (PPP)	26	3	8	84	55	12	168	71	1		428
Total 2014/15 (Responsible Office)7	27		7	72	57	10	186	69			428

Table 7: Percentage of registrant base with notifications received, by state or territory

Dental practitioners	ACT	NSW (including HPCA)1	NT	QLD	SA	TAS	VIC	WA	No PPP2	Total
2015/16 (PPP)3	4.00%	8.20%	3.90%	3.90%	3.10%	3.90%	2.80%	3.40%	0.50%	4.70%
2014/15 (PPP)	6.50%	5.30%	5.40%	2.00%	3.10%	3.30%	3.50%	2.90%	0.20%	3.60%
2014/15 (Responsible Office)4	6.80%	5.20%	4.80%	1.70%	3.20%	2.70%	3.90%	2.80%		3.60%

Table 8: Immediate action cases by division and state or territory (excluding HPCA)

Division	ACT	NSW	NT	QLD	SA	TAS	VIC	WA	No PPP1	Total 2015/16	Total 2014/15
Dental hygienist										0	1
Dental prosthetist					1					1	0
Dental therapist							1			1	2
Dentist	1			4	1		5	31		42	12
Total 2015/16 (PPP)2	1	0	0	4	2	0	6	31	0	44
Total 2014/15 (PPP)	1	2	0	1	6	0	1	4	0		15
Total 2014/15 (Responsible Office)3	1		0	1	6	0	3	4			15

Table 9: Notifications closed, by state or territory (including HPCA)

Dental practitioners	ACT	NSW1	NT	QLD	SA	TAS	VIC	WA	No PPP2	Subtotal	HPCA3	Total
2015/16 (PPP)4	24	12	12	98	38	15	125	64	5	393	401	794
2014/15 (PPP)	30	44	9	116	45	13	231	49	1	538	311	849
2014/15 (Responsible Office)5	34		10	104	47	13	280	50		538	311	849

Table 10: Notifications closed, by division and state or territory (excluding HPCA)¹

Division	ACT	NSW2	NT	QLD	SA	TAS	VIC	WA	No PPP3	Total 2015/16	Total 2014/15
Dental hygienist				1				1		2	4
Dental hygienist and dental therapist				3	1					4	2
Dental hygienist and oral health therapist										0	1
Dental prosthetist	2		2	2	1	2	1	6		16	20
Dental therapist				1						1	4
Dentist	21	11	4	90	35	13	122	56	2	354	447
Oral health therapist				1	1		1			3	4
Unknown practitioner4	1	1	6				1	1	3	13	56
Total 2015/16 (PPP)5	24	12	12	98	38	15	125	64	5	393
Total 2014/15 (PPP)	30	44	9	116	45	13	231	49	1		538
Total 2014/15 (Responsible Office)6	34		10	104	47	13	280	50			538

Table 11: Notifications closed, by division and stage at closure (excluding HPCA)¹

Division	Assessment2	Health or performance assessment3	Investigation	Panel hearing	Tribunal hearing	Total 2015/16	Total 2014/15
Dental hygienist	1			1		2	4
Dental hygienist and dental therapist	3		1			4	2
Dental hygienist and oral health therapist						0	1
Dental prosthetist	7		8		1	16	20
Dental therapist	1					1	4
Dentist	225	10	103	7	9	354	447
Oral health therapist	3					3	4
Unknown practitioner4	6				7	13	56
Total 2015/16	246	10	112	8	17	393
Total 2014/15	329	17	171	11	10		538

Table 12: Notifications closed, by division and outcome at closure (excluding HPCA)¹

Division	Dental hygienist	Dental hygienist and dental therapist	Dental hygienist and oral health therapist	Dental prosthetist	Dental therapist	Dentist	Oral health therapist	Unknown practitioner2	Total 2015/16	Total 2014/15
No further action3	1	3		6		217	3	6	236	274
Health complaints entity to retain				3		7			10	85
Refer all or part of the notification to another body						9			9	3
Caution	1			2		58			61	74
Reprimand						1			1	1
Accept undertaking				2		14			16	24
Fine registrant									0	1
Impose conditions		1		2	1	41			45	68
Practitioner surrender of registration									0	1
Suspend registration						1			1	1
Cancel registration						5		7	12	5
Proceedings withdrawn				1		1			2	1
Total 2015/16	2	4	0	16	1	354	3	13	393
Total 2014/15	4	2	1	20	4	447	4	56		538

Table 13: Active monitoring cases at 30 June 2016, by stream (including HPCA)¹

Dental practitioners	Total 2015/16	Total 2014/15
Conduct	52	69
Health	33	43
Performance	79	77
Prohibited practitioner/student	6	0
Suitability/eligibility2	24	22
Total	194	211

Table 14: Statutory offence complaints received and closed, by type of offence and jurisdiction¹

Offence	ACT	NSW2	NT	QLD3	SA	TAS	VIC	WA	No PPP2	Total 2015/16	Total 2014/15
Title protections (s.113-120): Received		2		9			4	4	8	27	16
Title protections (s.113-120): Closed		1		7				3	4	15	17
Practice protections (s.121-123): Received							1		3	4	2
Practice protections (s.121-123): Closed				2					1	3	1
Advertising breach (s.133): Received	2	41		21	2	1	46	10	39	162	89
Advertising breach (s.133): Closed	2	47	1	20	6	3	28	13	16	136	95
Directing or inciting unprofessional conduct/professional misconduct (s.136): Received										0	2
Directing or inciting unprofessional conduct/professional misconduct (s.136): Closed									2	2	1
Other offence: Received							2		1	3	0
Other offence: Closed							1			1	0
Total 2015/16 (PPP)3: Received	2	43	0	30	2	1	53	14	51	196
Total 2015/16 (PPP)3: Closed	2	48	1	29	6	3	29	16	23	157
Total 2014/15 (PPP)3: Received	3	14	1	19	11	1	34	13	13		109
Total 2014/15 (PPP)3: Closed	4	2	0	22	10	1	34	32	9		114