Abstract||Each of the seven investigations described in this thesis relate to the dental workforce in New Zealand (NZ). A variety of approaches were used to identify key trends in the NZ dental workforce, with a particular emphasis on comparing dental therapists, dental hygienists and dentists, and determining differences among dentists according to gender and immigrant status.
Nation-wide postal surveys of dentists, dental therapists, and dental hygienists were undertaken to determine the working practices and career satisfaction of each type of oral health professional. A longitudinal analysis of the dentist workforce was then undertaken to describe changes in the NZ dentist workforce over time. An investigation of the job stressors and coping strategies of New Zealand dentists followed. This led to a qualitative study of the experiences of immigrant dentists in NZ, which sought further detail regarding the concerns raised by the Stress Study. The final investigation was a survey of the self-reported occupational health of NZ dentists, which built on from the results of the preceding studies.
There were substantial differences in the working practices of male and female dentists. A greater proportion of female dentists had taken a career break of six weeks or more, usually to care for children. Larger proportions of women worked as employees or practice associates, and worked part-time. Women also planned to retire earlier than male respondents. Men were more active in continuing professional education and had higher career satisfaction.
The career satisfaction of dental therapists and dental hygienists was similar, but dental therapists were much less satisfied with their income, and few felt a valued part of the dental community. Although many dental hygienists had taken substantial career breaks for childrearing, they were shorter than those taken by dental therapists. More therapists than hygienists planed to retire within the next 10 years.
Over the nine-year period from 1997 to 2005, there was a significant increase in the number of women and overseas-trained dentists in the workforce. The proportion of dentists working in small towns decreased, and the percentage working part-time increased. The involvement of dentists in continuing professional development increased during that time.
There was considerable variation in the number of stressors experienced by dentists, with overseas-qualified practitioners reported experiencing more stressors more frequently than did those trained in NZ. There were differences in the strategies used by male and female dentists to manage stress.
Most immigrant dentists had found the dental registration examination process to be difficult and stressful. Uncertainty about the content of the examination and the high costs involved were key factors. Contact with practicing dentists during this time was found to be helpful.
Overall, most dentists had good general health, but physical fitness levels were not ideal. The prevalence of hand dermatoses and musculoskeletal problems was high, with around 60% of dentists experiencing pain or discomfort. Workplace bullying was reported by 20% of dentists, and over 25% had experienced a violent or abusive incident.
There is a need for ongoing monitoring of the workforce, particularly as the gender distribution (and societal trends and expectations) continues to change. Further support systems for immigrant dentists would be beneficial. Female and rural dentists also have unique circumstances and increased risk of professional isolation. Researchers and the professions will watch with interest the changes over the next decade as dual-qualified auxiliaries enter the dental workforce and public dental services are redeveloped.