Tauira whakaako niho

Ka tirohia e tēnei pepa tūranga ngā huringa o mua me ngā au o nāianei i roto i te mātauranga me te mahi niho, me ngā ngana ki te matapae i te heke mai. Kei te tūtaki te mātauranga me te mahi niho, inā koa i muri mai i te mate urutā COVID-19. E whā ngā mana matua e hangai ana ki te heke mai: te pikinga o te utu o te mātauranga, te korenga o te ngaiotanga o te tiaki niho, te whakakotahitanga o te tiaki niho, me ngā whanaketanga hangarau. Ka taea e te mātauranga niho te whakauru i te ako whaiaro, te ako matatau, te ako kore-tukutahi, te ako ranu, te ako kanohi ki te kanohi me te ako mariko, e whakarato ana i ngā ākonga ki ngā tīmatanga me ngā mutunga maha. Waihoki, ka ranu ngā tari niho, me te tiaki tūroro kanohi ki te kanohi me te mariko e wātea ana. Ka whakanui ake te mohio horihori i te whai huatanga o te tātaritanga, te maimoatanga me te whakahaere tari.
"Kei te whakawhiti huarahi te mātauranga niho me te mahi niho" e whakahuatia pinepinetia ana i roto i ā mātou kōrero ngaio. He mārama ake tēnei kōrero i nāianei i tō te tau 1995 (1). He mea nui kia mōhio ki te whanaungatanga i waenga i te mātauranga niho me te mahi niho nā te mea e awe ana rāua tetahi i tetahi. Heoi anō, me whai whakaaro ki ngā au o te wā roa e hanga ana i ēnei wāhanga kia mārama ai ki te āhuatanga o nāianei.
Ko te pūtake o te mātauranga niho ka taea te whai i tētahi tauira ako mahi ā-ringa kore whaimana i tukuna ai te mahi mai i tētahi kaimahi ki tētahi atu. I te whakatuwheratanga o te kura niho tuatahi i Baltimore i te tau 1840, ka whanake tēnei tikanga hei pūnaha kura whaimana ake. Nō nā tata nei kua rerekē haere ngā mātauranga niho mai i te mātauranga ā-papa ki te mātauranga tohatoha mā te whakamahi i ngā wāhi haumanu maha me ngā tauira ranu e kapi ana i ngā taunekeneke mariko me te kanohi ki te kanohi, me te whakanui ake i ngā wero i puta mai i te mate urutā COVID-19 e whanake haere ana.
I roto i ngā tau 183 mai i te whakatūnga o te Kura Rongoā Niho o Baltimore, te kura niho tuatahi i te Hononga o Amerika, kua tino rerekē te āhua o te mātauranga niho. Kua neke te mātauranga niho mai i ngā kura ngaio tūmataiti, whai hua, motuhake ki ngā whare wānanga, kore-whai hua. I eke te maha o ngā kura niho i te Hononga o Amerika ki te 57 i te tau 1900, ā, i heke ki te 38 i te tau 1930 i muri i te whakaputanga o te pūrongo a Gies (2), kātahi ka hoki ki te 60 i ngā tau 1970. Whai muri i te katinga me te whakatuwheratanga anō i ngā tau 1980, kua eke te maha o ngā kura ki te 72, ā, e whitu atu ngā kura e whakamaheretia ana kia whakatuwheratia i roto i ngā tau 2-3 e whai ake nei (3).
I taua wā anō, kei te uaua haere ngā wāhanga o te mātauranga niho. I te tīmatanga, kotahi te ākonga, kotahi te kaiako, kotahi te tūroro me te kotahi te wāhi tinana ka ranea. Heoi, i roto i ngā tau 183 kua pahure ake nei, kua tipu haere, kua kanorau hoki ngā akoranga, ngā wāhi rongoā, ngā taiao haumanu-mua, ngā taiao akomanga, me ngā taiao whakatauira. Kua tāpirihia te kounga me te kanorau o ngā kaiako, ngā tikanga whakamātautau ōkawa, me ngā wāhanga ture me te hanganga ture maha-taumata hei whakarei ake i te wheako mātauranga whānui.
Kua tino rerekē hoki te utu mō te mātauranga niho, ā, kua piki ake te taumahatanga o te nama a ngā ākonga. I ngā wāhanga tuatahi, me whai whakangungu ōkawa mai i tētahi tākuta niho, ā, i muri i te 1–2 tau, ka taea e ngā ākonga te mahi takitahi. I te tīmatanga, he mea tūpono noa te whakahaere i te mahi niho i te United States, ā, ko Alabama te kāwanatanga tuatahi ki te whakahaere i te tau 1841. Nō te tau 1910, ka noho ko te raihana kāwanatanga hei mea whakahau i ngā kāwanatanga katoa. I waenganui o te rautau 19, tata ki te $100 te utu mō te kura, he moni nui. I te whakatuwheratanga o te kura niho tuatahi i te tau 1840, ka noho noa ngā utu kura mai i te $100 ki te $200. Neke atu i te 140 tau (1880 ki te 2020), kua piki ake te utu kura i tētahi kura niho tūmataiti noa i te United States mā te 555 ngā wā, e 25 ngā wā e nui ake ana i te pikinga utu (4). I te tau 2023, ko te nama toharite o ngā tauira kura niho hou ka $280,700 (5).
Ko te hītori maha o te mahi niho e horapa ana puta noa i ngā momo maimoatanga, ia maimoatanga e puta ana i ngā wā rerekē o tōna wā whānui (Pikitia 1). Kei roto i ēnei taumata ko te niho tango niho, koinei te momo maimoatanga tuatahi; te niho whakaora me te niho rerekē, i tīmata i te tau 1728 i te wā o Pierre Fauchard, e kiia ana e te tini ko ia te "matua o te mahi niho", i runga i te mahi niho ārai, i tīmata i te tau 1945. Te Tātaritanga; I puta te mahi niho e hangai ana ki te niho i ngā tau 1960 me te whanaketanga o te hangarau whakapūkawa wai, i te wā i noho ai te huware, ngā wai waha me ngā kiko hei kī ki te tātaritanga i ngā mate ā-rohe me ngā mate pūnaha. Kei te whakawhanakehia he maimoatanga hou e whakarato ana i te hauora waha i runga i te whakahoutanga me te whakahaere i te microbiome, e whakatakoto ana i te ara mo te heke mai o te mahi niho. Ko te pātai matua ko te aha te ōwehenga o ēnei momo mahi niho rerekē a muri ake nei.
Pikitia 1. Ngā wāhanga hītori o te mahi niho. I tangohia mai i The Illustrated Encyclopedia of Dental History nā Andrew Spielman. https://historyofdentistryandmedicine.com/a-timeline-of-the-history-of-dentistry/. I tāia anō me te whakaaetanga.
Nā tēnei panonitanga kua hurihia te mahi niho mai i te arotahi ā-ringa anake (te tango, te whakakapi me te mahi niho whakaora) ki tētahi e whakahaerehia ana e ngā āhuatanga matū me te koiora (te mahi niho ārai) ā, kei te neke inaianei ki te mara o te hauora waha ngota (te mahi niho whakaora). me te hangai ki ngā whakahaere microbiome.
I puta tētahi atu whanaketanga nui i roto i te hītori o te mahi niho: mai i tētahi huarahi whānui ki te maimoatanga niho (i te nuinga o tōna hītori) ki tētahi tauira motuhake ake (tīmata i te tau 1920 pea) e tohuhia ana e te ahurei o te umanga niho. Kei te neke haere te mahi niho ki ngā momo tiaki whaiaro e whakaata ana i tētahi huarahi tairongo me te whaiaro ki te hauora o te waha.
I taua wā anō, i neke ngā momo mahi niho tōmua mai i ngā tākuta niho nekeneke e whakarato ana i ngā ratonga ki ngā wāhi rerekē (te nuinga o ngā whare niho i mua i te rautau 19) ki tētahi tauira tiaki niho tūmau (rautau 19 ki nāianei). Heoi, i ngā tau tōmua o te tekau tau 2000, me te taenga mai o te teledentistry, i puta mai tētahi momo ratonga tiaki niho ranu i whakakotahi i ngā ratonga kanohi ki te kanohi tuku iho me ngā taunekeneke matihiko mamao, ā, nā reira i rerekē ai te huarahi e tukuna ai te tiaki niho.
I taua wā anō, i rerekē anō te āhua o te mahi niho, mai i te mahi niho tūmataiti (i roto i te nuinga o ngā rautau 19 me te 20) ki te mahi rōpū nā tetahi, neke atu rānei, ngā tākuta niho (tīmata i ngā tau 1970). Te whakawhiti ki tētahi whakahaere kamupene niho (DSO) (te nuinga i ngā tau 20 kua hipa). Ko tēnei ia hou whakamiharo, e rongonui ana i waenga i ngā tauira taitamariki, e whakaatu ana i te huringa o ngā hanganga kaiwhakarato tiaki niho me te ia ki te whakapūmau i te mahi niho ki te mahi hauora i ngā tekau tau kua pahure. Kua tino rerekē te hanganga mana o ngā mahi niho takitahi i roto i ngā tau 16 kua hipa. I roto i te hunga 65 tau te pakeke, neke atu rānei, i heke paku te mana whaiaro o tētahi mahi niho mā te 1%, i roto i te hunga kei raro iho i te 30 tau te pakeke, he nui ake te hekenga, tae atu ki te 15% (6). I kitea i roto i tētahi rangahau o te Karaehe o te tau 2023 e 34% o ngā tauira e whakamahere ana ki te whakauru ki tētahi mahi tūmataiti i muri i te tohu i whakaaro ki te whakauru atu ki tētahi DSO, he tau kua rua i roto noa i ngā tau e rima (5). E whakaatu ana tēnei panoni i ngā rerekētanga whakatupuranga i roto i ngā tauira mana pupuri e paingia ana e ngā tohunga niho taitamariki nā te nui ake o ngā mōrearea, ngā taumahatanga whakahaere me ngā utu o te whakahaere i tētahi mahi motuhake. Ka werohia hoki e te whakaurunga o te mahi niho ki roto i te umanga te mana motuhake tuku iho o ngā tākuta niho.
Kua rerekē haere te ture me te tirotiro niho i te Hononga o Amerika. I te wā koroni, kāore i tino kitea te tirotiro. I te tau 1923, kua tipu tēnei hanganga hei whare e whā (Pikitia 2). I roto i ngā tau 100 e whai ake nei, kua tino whānui te taiao ture, ā, kua whānui ake ngā mana tirotiro ki te 45 pea ngā tari kāwanatanga, ā-rohe, ā-motu, ā-kōmihana, me ngā tari whakahaere. E whakaatu ana tēnei ahunga whakamua i te pikinga nui o te uaua me te kanorau o te hanganga ture me te kawenga whakahaere o te mahi niho me te mātauranga i te Hononga o Amerika.
E whā ngā mana kaha e wero ana i te mātauranga me te mahi niho tuku iho. Kei roto i ēnei ko te utu o te mātauranga, ngā whanaketanga hangarau pēnei i te mooni mariko me te mooni whakanui, te matauranga horihori, te teleniho, te maimoatanga niho "kore-whakaekenga", arā, ko te maimoatanga kore-whakaekenga e mahia ana e te maha o ngā kaiwhakarato taumata waenga me te marea, me te whakakotahitanga o ngā mahi niho ki te kamupene.
Ka pā te tuatahi ki te mātauranga, ka pā te tuatoru me te tuawhā ki te mahi, ā, ka pā te tuarua ki ngā mea e rua. Ka matapakihia pototia ēnei wāhanga i raro nei, ā, ka whakatuwhera i te tautohetohe mō te huarahi e taea ai te ahu whakamua ki te mātauranga me te mahi niho.
Ahakoa kua kōrero poto tātou mō ngā utu mātauranga o nāianei, he mea tika kia tirohia hohonutia te hiahia ki te aro atu ki ngā utu ā muri ake nei ka akiaki i ngā kura ki te mahi i ngā whakarerekētanga rautaki. Ina koa, ka piki haere te hiahia ki te whakaiti i ngā utu whakahaere me ngā utu kura mā te whakamahi i ngā taputapu whai hua ake. Ko te huarahi tino whai hua ki te whakapiki i te whai huatanga ko ngā whanaketanga hangarau ka taea te whakaiti nui i te utu whānui o te whakarato mātauranga.
Ko te utu mō te kura niho e pā ana ki ngā utu o ngā kaiako, ngā kaimahi whakahaere, me ngā whakapaunga whakahaere, tae atu ki ngā whakapaunga e pā ana ki te whare hauora. Nā ngā wheako tata nei me te mate urutā COVID-19 kua whakaatu i te kaha ki te haere tonu i te mātauranga niho kounga teitei mai i tawhiti ahakoa kua kati ngā tari niho tūturu. Mā tēnei ka taea te tuku i ngā akoranga maha ma te mamati, ā, ka whakaitihia te hiahia mō ngā kaiako ki te whakamahi i ngā rauemi tiritahi. Mā tēnei nekehanga ka taea e ngā whare niho maha te tiritiri i te marautanga me ngā kaiako mai i tawhiti a meake nei, ka whakakorea te hiahia mō te mana whakahaere, ā, ka arahi pea ki te whakahekenga nui o ngā utu whakahaere me te utu kaiako.
Hei tāpiritanga, ko te whakaurunga o ngā whakatauira mooni mariko (VR) me ngā whakatauira mooni whakanuia (AR) ki roto i te mātauranga haumanu-mua kore-tukutahi he taahiraa whakarerekētanga. Ka taea e tēnei auahatanga te whakataurite i te urupare me te whakatutukitanga o ngā pūkenga takitahi i ngā tere rerekē, he rite ki ngā kaupapa whakangungu pailate rererangi e whakamahi ana i ngā whakatauira hei whakawhanake i ngā pūkenga. Kei tēnei huarahi te kaha ki te huri i te mātauranga niho haumanu-mua mā te waihanga i tētahi taiao ako whai hua ake, paerewa ake hoki.
Kei te whakamahia te VR i roto i ngā kura hauora me ngā kura niho i tēnei wā. Anei ētahi tauira. Ko te HoloAnatomy, i whakawhanakehia e te Whare Wānanga o Case Western Reserve, e whakarato ana i ngā āheinga mooni whakanui e āhei ai ngā ākonga hauora ki te taunekeneke ki ngā tauira anatomical holographic 3D mō te ako hōhonu. Ko tētahi atu kaupapa, ko TouchSurgery, e tuku ana i tētahi tauira pokanga VR e āhei ai ngā tohunga hauora ki te mahi i ngā momo tikanga pokanga i roto i tētahi taiao 3D tūturu. Ko te arotahi a Osso VR ki te whakangungu pokanga, ā, e whakarato ana i tētahi taiao mariko e taea ai e ngā tohunga hauora te mahi pokanga me te whakapai ake i ō rātou pūkenga mā te whakatauira tūturu. Hei whakamutunga, ka tuku a Virti i ngā whakatauira VR me AR mō te whakangungu urupare ohorere. Ka taea e ngā tohunga hauora te mahi ki te whakautu ki ngā ohorere hauora i roto i ngā horopaki o te ao tūturu.
Ko ētahi tauira o te whakamahinga o te AI ko ngā whakatauira tūroro mariko AI, e āhei ai ngā ākonga niho ki te mahi i ngā tikanga rerekē i roto i tētahi taiao mariko tūturu, haumaru hoki (7). Tērā pea kei roto i ēnei whakatauira ngā whakamātautau tātaritanga, ngā mahere maimoatanga, me ngā tikanga mahi-ā-ringa.
a) Ka whakamahia e ngā tūāpapa ako urutau ngā rauropi matauranga horihori hei whakarite i ngā ihirangi mātauranga i runga i te ahunga whakamua, te momo ako me te mahi a ngā ākonga takitahi. Ka taea e ēnei tūāpapa te whakarato i ngā whakamātautau whaiaro, ngā kōwae taunekeneke, me ngā rauemi kua whakaritea hei whakatutuki i ngā matea ako motuhake.
b) Ka taea e ngā tono matauranga horihori te tātari i ngā whakaahua tātaritanga, pērā i ngā hihi-X, ngā kiriata ā-waha rānei, ā, ka taea hoki te tuku urupare tonu ki ngā pūkenga whakamaori a ngā ākonga. Ka āwhina tēnei i ngā ākonga ki te whakapai ake i tō rātou kaha ki te tātaritanga i ngā mate ā-waha.
c) Mā ngā tono mooni mariko me ngā tono mooni whakanuia e whakakahangia ana e te matauranga horihori ka hangaia he wheako ako rumaki. Ka taea e ngā ākonga te ako i ngā tauira 3D taipitopito o te hanganga niho, te taunekeneke me ngā tūroro mariko, me te mahi i ngā tikanga pokanga i roto i te taiao haumanu whakaata.
d) Ka tautoko te matauranga horihori i te ako tawhiti mā te whakarato i ngā tūāpapa mātauranga tawhiti. Ka taea e ngā ākonga te whai wāhi atu ki ngā kauhau mariko, ngā huihuinga tukutuku me ngā kōrerorero tahi. Kei roto pea i ngā āhuatanga o te AI te tuhi aunoa, ngā karetao kōrerorero Q&A, me ngā tātaritanga whakauru ākonga.
e) Kei te mahi tahi ngā kamupene hangarau me ngā kaiwhakarato hauora me ngā whare wānanga ki te whakarato i ngā ihirangi mātauranga mā roto i ā rātou tūāpapa. Kei roto pea i tēnei ihirangi ngā tuhinga, ngā ataata, me ngā rauemi tauwhitiwhiti e kapi ana i ngā kaupapa niho me te hauora. Hei tauira, kei a Coursera te Frontiers in Dental Medicine and Dentistry mai i te Whare Wānanga o Pennsylvania, Dentistry 101 mai i te Whare Wānanga o Michigan, me ngā Dental Materials mai i te Whare Wānanga o Hong Kong. Kei a MIT OpenCourseWare te urunga kore utu ki ngā akoranga Neuroscience me ētahi atu.
f) Hei whakamutunga, he maha ngā akoranga niho kore utu a Khan Academy e kapi ana i ngā kaupapa pēnei i te hanganga ā-waha, ngā rauemi niho, me ngā akoranga pūtaiao taketake e tukuna ana e ngā kura hauora me ngā kura niho.
Ko tētahi atu tikanga ko te whakarato i te tiaki niho mariko, kore-whakaekenga. Kua noho te teledentistry hei huarahi kē atu ki te tiaki niho kanohi ki te kanohi auau.
I te mea he iti ake te whakaekenga o ngā mahi ārai niho, ka iti ake te hiahia o ngā tākuta niho ki te mahi i ngā mahi katoa e tukuna ana i ngā tari niho i tēnei wā. Ka taea e ētahi atu kaiwhakarato hauora pērā i ngā tākuta niho, ngā tākuta niho matatau, ngā kaiwhakaora niho, ngā nēhi niho, tae atu ki ngā kaiako, ngā tākuta, ngā nēhi me ngā mātua te whakarato i ētahi tiaki kore-whakaekenga, ka kore ai e whakaekenga te mahi niho. Ina tae atu ki ngā whata toa hokohoko kore-whakaekenga te mahi niho ārai (te whūroiti, ngā mea whakama niho, ngā piri niho rūpahu, ngā mea tiaki waha, me ngā rongoā mamae), ka tukuna pea ētahi ratonga e ngā kaiwhakarato taumata waenga me ngā kaiwhakarato kore-toi.
I te mutunga, he mea noa iho te wā ka huihui mai te whakapono kore whakapono me te telenistriction ki te whakarato i te tiaki niho kore-whakaeke i ngā wā katoa, i ngā wāhi katoa.
Ko tētahi atu āhuatanga o te mātauranga niho me te tiaki niho ko te whai wāhi mai o ngā hangarau nui me te whakamahinga o te mātauranga horihori ki te mātauranga me te tiaki niho. He maha ngā kamupene hangarau nui e mahi tahi ana me ngā whakahaere hauora, ngā rōpū kore-moni, me ngā whare mātauranga hei whakatairanga i ngā kaupapa mātauranga hauora. He maha ngā kamupene hangarau nui e piki haere ana te hiahia ki te whakamahi i ā rātou tūāpapa me ngā hangarau hei whakarato mōhiohio, rauemi me ngā ihirangi mātauranga e pā ana ki te hauora ā-waha me te hauora whānui. Ko ētahi tauira ko:
a) Ka whakawhanakehia, ka whakatairangahia hoki e ngā kamupene hangarau ngā taupānga me ngā tūāpapa e pā ana ki te hauora e whakarato ana i ngā ihirangi mātauranga mō ngā kaupapa hauora. Ka taea e ēnei taupānga te whakarato i ngā mōhiohio kai hauora, te aroturuki i te inu wai, te whakamahara i ngā kaiwhakamahi ki te paraihe i ō rātou niho, te whakarato tohutohu whānui mō te pupuri i te akuaku waha pai, me te whakarato kōrero niho mariko, tohutohu hauora waha rānei. I roto i tētahi rangahau Medline i te tau 2022, i kitea e Thurzo me ētahi atu (8) ko ngā rangahau niho e pā ana ki te matauranga horihori i uru atu ki te radiology 26.36%, te orthodontics 18.31%, te rōrahi whānui 17.10%, te prosthodontics 12.09%, te pokanga 11.87%, me te mātauranga 5.63%.
b) Whakamahia te mātauranga horihori hei whakawhanake i ngā kaiawhina hauora e whakarato ana i ngā mōhiohio hauora whaiaro me ngā taunakitanga. Ko ngā tono mātauranga horihori i whakawhanakehia e ngā kamupene hangarau e whakaatu ana i te pūmanawa mō te tātari whakaahua niho me te tautuhi mate. Hei tauira, ka āwhina ngā rauropi mātauranga horihori ki te tātari i ngā whakaahua X-ray niho pērā i ngā hihi-X me ngā karapa CBCT hei tautuhi i ngā āhuatanga pērā i te pirau niho, te mate periodontal me ngā āhuatanga rerekē. Ka whakapai ake hoki i te mārama o ngā whakaahua niho, ka āwhina i ngā tākuta niho ki te tiro pai ake i ngā taipitopito me te whakatau tika i ngā mate.
c) Waihoki, ka arotakehia e ngā rauropi matauranga horihori ngā raraunga haumanu, tae atu ki te hohonutanga o te tirotiro niho, te mumura o te kapia (9) me ētahi atu āhuatanga e tika ana, hei matapae me te tautuhi i te mate niho. Ka tātarihia e te tauira aromatawai mōrearea e whakamahia ana e te AI ngā raraunga tūroro, tae atu ki te hītori hauora, ngā āhuatanga o te noho me ngā putanga haumanu, hei matapae i te mōrearea o te whakawhanake i ngā mate waha motuhake. I tēnei wā, me whakawhanake tonu ngā tauira matauranga horihori hei tautuhi i te ngaronga o te wheua niho (10).
d) Ko tētahi atu pūmanawa ko te whakamahinga o te matauranga horihori hei whakawhanake i ngā mahere maimoatanga i roto i te orthodontics me te orthognathic surgery (11) hei aroturuki i te nekehanga o ngā niho me te hanga anō i ngā tauira matihiko 3D (12) hei āwhina i te matapae i te nekehanga o ngā niho me te arotau i te whakamahere orthodontics o te nekehanga o ngā niho. wawaotanga pokanga (13).
e) Ka tātarihia e ngā pūnaha matauranga horihori ngā whakaahua i whiwhihia mā te whakamahi i ngā kāmera ā-waha, i ētahi atu taputapu whakaahua rānei hei tautuhi i ngā āhuatanga rerekē, i ngā tohu pea rānei o te mate pukupuku waha (14). Kua whakangungua ngā rauropi matauranga horihori hei tautuhi me te whakarōpū i ngā whara o te waha, tae atu ki ngā mate pukupuku, ngā papa mā, whero rānei, me ngā whara kino (14, 15). He rawe te matauranga horihori ki te whakatau i ngā mate, engari me tūpato ina tae ki te whakatau pokanga.
f) I roto i te mahi niho tamariki, ka whakamahia te mātauranga horihori hei kite i ngā whara pirau, hei whakapai ake i te tika me te whai huatanga o te whakaahua tātaritanga, hei whakapai ake i te ataahua o te maimoatanga, hei whakatauira i ngā putanga, hei matapae i ngā mate waha, me te whakatairanga i te hauora (16, 17).
g) Ka whakamahia te mātauranga horihori hei whakahaere i ngā mahi me ngā kaiawhina mariko me ngā karetao kōrerorero e whakamahia ana e te AI hei āwhina i te whakarite i ngā wā hui me te whakautu i ngā pātai taketake a te tūroro. Mā te hangarau mōhio reo e whakamahia ana e te AI ka taea e ngā tākuta niho te tuhi i ngā tuhipoka haumanu, ka whakaiti i te wā tuhi. Waihoki, kei te whakahaere te AI i te mahi niho mamao mā te whakahohe i ngā kōrero mamao, ka taea e ngā tākuta niho te aromatawai i ngā tūroro me te tuku taunakitanga me te kore e hiahiatia he haerenga kanohi ki te kanohi.
Ko te panonitanga o te mātauranga niho he whakawhiti mai i te tauira pokapū ki te huarahi hangarau, ā, he whānui ake te noho. E kitea ana te wehewehenga o te mātauranga niho i te mea e mōhiotia ana ka taea te tuku tika i ētahi āhuatanga o te ako i runga ipurangi mā te whakamahi i ngā whakatauira me ngā urupare e ahu mai ana i te matauranga horihori. Ko tēnei wehenga mai i te tauira tuku iho e wero ana i te hiahia ki te whakarato i ngā mātauranga katoa i raro i te tuanui kotahi i te wā kotahi.
I runga i te tauira o te whakangungu pailate rererangi, ka taea te tuku i ngā ihirangi mātauranga niho ā muri ake nei ki ngā pokapū hangarau motuhake, he rite ki te mahi a ngā pae Prometric i roto i ngā whakamātautau. Ko te tikanga o tēnei whakaritenga hou, kāore e hiahiatia kia tīmata, kia whakamutua hoki e ngā ākonga tā rātou haerenga mātauranga me tētahi huinga "hoa akomanga" kua whakaritea. Engari, ka whakawhanakehia he kaupapa whakarite i runga i te whakatutukitanga o ngā pūkenga motuhake. Ka arotahi ēnei pūkenga ki te manawanui, kaua ki te ākonga, ā, ka hāngai ki te wā, pērā i nāianei.
Ahakoa e hiahiatia tonutia ana he wheako mahi ā-ringa mō te mātauranga haumanu, kāore e hiahiatia he hanganga rōpū pakari. Ka taea e ngā ākonga te whai wāhi atu ki ēnei āhuatanga mahi ā-ringa i ngā wā rerekē, i roto i ngā horopaki haumanu maha, me ngā rōpū rerekē. Ka noho te mātauranga mariko hei wāhanga matua o ngā akoranga me ngā wāhanga o mua-haumanu, me te whakanui i te ngāwari mā te ako kore-tukutahi. He rerekē, ka whai whakatakotoranga ranu te wāhanga haumanu, e whakakotahi ana i ngā wheako kanohi ki te kanohi me ngā wāhanga mariko.
Ko te āhua motuhake, whakakotahi, tukutahi, me te kore tukutahi o tēnei tauira mātauranga whaiaro ka hua mai he painga ōhanga nui ki ngā ākonga. I taua wā anō, ka āwhina i te whakaiti i ngā tūranga tuku iho o ngā kaiako, ngā kaimahi, me ngā kaiwhakahaere o ngā kura niho, me te arotake anō i te wāhi e hiahiatia ana. Nō reira, ko te heke mai o te mātauranga niho ka ahu mai i tētahi tauira hihiri me te whai hua e urutau ana ki ngā hiahia hurihuri o ngā ākonga me te ahumahi.
Ko te tauira kua whakaarohia he huarahi kotahi noa iho hei whakatutuki i te whai huatanga utu i roto i te mātauranga niho; me whakauru he tātaritanga whānui i te utu katoa me te roa o te mātauranga kāreti me te mātauranga niho. Mā te whakaiti i te roa o te mātauranga whānui ka whakaiti pea i ngā utu pea. Hei tauira, ko te mahi o nāianei o te whakauru ākonga i muri i te tau tuatahi o te kāreti mō tētahi wāhanga iti o ngā ākonga ka whai wāhi pea ki tēnei hekenga. Hei tāpiri, ka taea te whakapoto i te roa o te mātauranga niho mā te whakarite kia whakahaua ētahi akoranga pūtaiao taketake. Ko tētahi atu huarahi hei whakanui ake i te whai huatanga, hei penapena wā, hei whakaiti hoki i ngā utu ko te whakauru i te DDS ki te mātauranga paerua.
I roto i te tekau tau kua pahure ake nei, kua kite te rāngai hauora i te pikinga ake o ngā hanumitanga me ngā hoko i roto i te inihua hauora, ngā ratonga hauora, ngā toa mekameka me ngā whare rongoā. Nā tēnei ia i ara ake ai ngā "whare hauora iti," e whakarato ana i te tiaki ārai mate whānui i roto i ngā wāhi maha. Kua whakauruhia e ngā kaihokohoko nui pērā i a Walmart me CVS te mahi niho ki roto i ēnei whare hauora, me te utu i ngā tohunga ki te whakarato i te tiaki pokanga me te ārai mate māmā, me te wero i ngā tauira utu tuku iho.
Mā te whakauru i ngā ratonga niho ki roto i te pūnaha hauora whānui ka taea te huri i te urunga atu ki te tiaki hauora mā te whakarato i ngā ratonga tiaki hauora whānui, tae atu ki te tiaki ārai whānui, ngā werohanga, ngā rongoā whakahaunga, me te tiaki hauora ā-waha, i te utu iti iho. Ka horapa ngā mahi ngāwari ki ngā tukanga nama me te whakauru i ngā mōhiohio tūroro i waenga i ngā kaiwhakarato tiaki hauora.
Kei te aro nui ēnei whare hauora whakarerekē ki te ārai me te tiaki hauora whānui, ina koa ka neke te utu inihua ki ngā aromatawai e ahu mai ana i ngā putanga, ka huri i ngā whanaketanga o te tiaki hauora me te whakatairanga i tētahi huarahi whānui ki te oranga o te tūroro. I taua wā anō, ko te whakaurunga o te tiaki niho ki roto i te umanga me te tipu o ngā mahi iti ka huri pea ngā tākuta niho hei kaimahi, kaua hei rangatira mahi motuhake.
I te pikinga nui o te taupori kaumātua, kei te tata te ara ake o tētahi o ngā wero nui e pā ana ki te mahi niho haumanu. Ki te tangohia mai i te taupori turanga o te 57 miriona Amerikana 65 tau te pakeke, neke atu rānei i te tau 2022, e matapaetia ana ka eke te tokomaha o ngā Amerikana i roto i te rōpū tau kotahi ki te 80 miriona i te tau 2050, e ai ki ngā matapae a te Tari Tatauranga o Amerika. He rite tēnei ki te pikinga o te ōwehenga o ngā kaumātua i roto i te 5% o te taupori katoa o Amerika (18). I te hurihanga o ngā taupori, e matapaetia ana he pikinga ōrite o te maha o ngā whara ā-waha i roto i ngā kaumātua. Ko te tikanga tēnei kei te piki haere te hiahia mō ngā ratonga niho e aro ana ki ngā matea hauora ā-waha motuhake o ngā kaumātua (19, 20).
I te tumanako atu ki ngā whanaketanga hangarau, e tumanakohia ana ka tukuna e ngā tākuta niho o te heke mai ngā pūnaha maimoatanga ranu e whakauru ana i ngā ratonga mamao me te whakakotahitanga o te rongoā tawhiti me te whakawhitiwhiti kōrero kanohi ki te kanohi. Ko te āhua o te maimoatanga e huri haere ana e whakaatu ana i te nekehanga ki te tiaki koiora, ngota ngota, me te tiaki whaiaro (Pikitia 1). Me whakawhānui ake ngā tohunga hauora i ō rātou mōhiotanga koiora me te whai wāhi nui ki ngā whanaketanga pūtaiao.
Mā tēnei taiao whakarerekētanga ka āwhina i te whanaketanga o ngā tohungatanga niho motuhake, me ngā tākuta niho-endocrinologist, ngā tākuta niho-periodontic, ngā tākuta niho-waha, ngā tākuta niho me ngā taote niho-waha e ārahi ana i te whakamahinga o te niho whakaora. He rite tonu tēnei whanaketanga ki te ia whānui ake ki ngā huarahi matatau ake, whaiaro ake hoki ki te tiaki i te waha.
Kāore he pōro karaihe a tetahi hei matapae i te heke mai. Heoi, ka piki ake ngā pēhanga mai i ngā utu mātauranga, te whakaurunga o te mahi ki roto i ngā umanga, me ngā whanaketanga hangarau i ngā tekau tau e haere ake nei, ka whakarato i ngā huarahi kē atu he iti ake te utu me te whai hua ake ki te tauira o nāianei o te mātauranga niho. I taua wā anō, ka whakaratohia e te noho kore tikanga me ngā whanaketanga hangarau i roto i te mahi niho he whai hua ake, he whai hua ake, he whānui ake hoki ngā whai wāhitanga mō te ārai me te tiaki.
Kei roto i te tuhinga/rauemi tāpiri ngā rauemi taketake i whakaaturia i roto i te rangahau, ā, mēnā he pātai anō tāu, ka taea te tuku atu ki te kaituhi e pā ana.