US dentists sue to stop NZ-trained workers

The American Dental Association (ADA) has filed a lawsuit in Anchorage, Alaska, to stop New Zealand-trained dental workers treating Inuit and Indians in remote villages in the state.

In a lawsuit filed in the state's Superior Court, the association said the dental aides trained at Otago University's dental school were performing extractions, surgeries and other irreversible procedures, allegedly in violation of state licensing laws.

Much of the work has been done in rural villages, where there are no dentists and where the rate of tooth decay is two-and-a-half times that of the rest of the nation. Among those being treated are Athabascan and Tsimshian Indians and Inupiat and Yupik Eskimos.

The ADA, joined by the Alaska Dental Society and several dentists in private practice, argued the programme could put patients at risk. Bob Brandjord, president of the association, claimed in a statement that the lawsuit was about "bringing quality care to all Alaskans".

The two-year diploma of dental therapy courses in Dunedin, trained the workers in line with New Zealand dental nurses, to carry out preventative and restorative dental care.

The students arrived in Otago in February 2003 to begin their training, but since graduation have faced a barrage of criticism from some members of the US Congress -- and the ADA -- as having insufficient experience, and having the risk of doing permanent harm to their patients.

Other members of Congress from the mainland states outside Alaska have said they accept the benefits of bringing dental therapists to some rural areas -- but don't want to see the practice come to their own backyards.

The quality of the Otago training is expected to be a pivotal point in any court battle over whether medical training has been sacrificed for increased access to dental care.

Defenders of say the programme is legal under the federal Community Health Aide Programme. It is funded by private and federal grants and students must go through a rigorous assessment before they are selected to attend Otago's dental school.

Once aides are certified through the federal Indian Health Service they can be hired by local providers to work under the general supervision of a dentist, and have to be recertified every two years.

But the ADA has complained that the dental aides are only required to have a high school diploma before their training, but once trained at Otago, they provide services that "professional" dentists spend years studying.

The ADA has also argued that services performed by dental aides exceed the intent of the federal law.

The row has been branded a "turf war" by Ron Nagel, a dentist and manager of the dental health aide programme for the Alaska Native Tribal Health Consortium, who negotiated the Dunedin training programme in mid-2002.

Dr Nagel told said he knew of no permanent damage from dental therapists working around the world and he criticised the Amercian Dental Association campaign.

Mary Williard, a licensed dentist in the western Alaska town of Bethel, said the two dental aides she supervised had done excellent work on fillings, extractions, baby tooth crowns and cleanings.

The lawsuit was based on unfounded fears, she said.

- NZPA