The Division of Labor in Periodontitis Care: A Deep Dive into the Roles of Hygienists, Dentists, and Students in Norway
A register-based study conducted in Norway provides invaluable insight into the structured and collaborative approach to periodontitis (gum disease) treatment within its national dental health system. By analyzing data from the Norwegian Health Economic Administration, the research maps out exactly how treatment responsibility is distributed among various dental professionals, including private general dental practitioners (GDPs), periodontists (specialists), dental hygienists, and even dental students.
The findings offer a model for efficiency and quality of care, highlighting the distinct yet complementary roles each professional group plays in maintaining the population’s oral health.
Key Distribution of the Treatment Load
The study established that only about 4.4% of the population aged 20 years and older was treated for periodontitis in the observed period. While this frequency appears low, the study concludes that it is sufficient to maintain major tooth retention (preventing significant tooth loss) for the population, a finding supported by long-term clinical data showing marked improvements in periodontal parameters over the last four decades in Norway.
The treatment load is effectively distributed:
Private General Dental Practitioners (GDPs): These dentists shoulder the largest portion of the overall care, performing 43.8% of the total periodontal treatment. They are the first line of defense and management for the majority of patients.
Dental Hygienists (DHs): Hygienists play a crucial and non-surgical role, contributing 22.5% of the total periodontal treatment. Their focus is primarily on non-surgical interventions, which are critical for initial disease control and long-term maintenance. Furthermore, hygienists accounted for 8% of the total man-labor years dedicated to periodontal work in private practice.
Periodontists (Specialists): Specialists are reserved for advanced and complex cases. They perform a substantial 74.6% of all surgical treatments and are also responsible for a significant 32.8% of non-surgical care, indicating their role as experts in complex non-surgical management.
Associated Factors and Demographics
The study also shed light on patient demographics and geographical distribution:
Gender and Age: Periodontitis treatment was more frequent among females (55%) than males (45%). The highest prevalence of treatment was observed in the 60–69 age group, underscoring the necessity of intensive care as patients age.
Geographical Variation: Treatment frequency varied geographically, peaking in areas with dental schools and a higher density of periodontists (like Oslo and Bergen). However, even geographically remote and sparsely populated counties without any resident periodontists still showed a decent treatment frequency, suggesting the robust role of GDPs and hygienists in providing essential care across the nation.
Implications for a Collaborative Dental System
This register-based research reinforces the value of a multidisciplinary approach to oral healthcare. By clearly defining roles, the Norwegian model ensures maximum efficiency:
Hygienists focus on preventative and non-surgical foundational therapy, effectively managing the disease's early and maintenance phases.
GDPs serve as comprehensive managers, integrating periodontal health into overall patient care.
Periodontists ensure that advanced disease and surgical needs are met with specialized expertise.
The fact that this distributed system is sufficient to maintain high tooth retention highlights the success of delegating tasks and establishing clear competencies among different dental professionals.
Original Article Details
Original Title: Treatment of periodontitis by dental hygienists, dentists, and dental students and associated factors: a register-based study in Norway
Source: BMC Oral Health