What's the Scope of Practice of Dental Therapists in the UK?

Over the years, I have worked with Dental Therapists across lots of different settings. A question that gets asked a lot, is what can Dental Therapists actually do... what's in their scope of practice?

What does Scope of Practice mean?

Scope of practice, according to the dental regulator, the General Dental Council, is the skills and abilities each registrant group can have. This can develop and change throughout a person's career as their skills develop through training and development. 

What can Therapists do?

The scope of practice of dental therapists is wide and a lot of dentistry can be provided by therapists. There is a movement to use more skill mix and therapists to provide dental care in the UK due to workforce issues and this will free up other dental professionals to provide other elements of care. The list is long, but includes:
  • Dental examination
  • Prescribing, interpreting and reporting on common radiographs
  • Diagnose and treatment plan with their competence
  • Periodontal examination, treatment planning, treatment (sub and supragingival debridement)
  • Administer local anaesthetic
  • Smoking cessation
  • Preventative care
  • Oral cancer screening
  • Apply topical treatments e.g. fluoride varnish
  • Place rubber dam
  • Take impressions
  • Take photos
  • Care for implants
  • Direct restorations on primary and permanent teeth
  • Place preformed metal crowns on primary teeth
  • Pulpotomies in primary teeth
  • Extraction of primary teeth
  • Administer inhalation sedation with further training
  • Facial aesthetics with further training
  • Tooth whitening with further training
  • Remove sutures once a dentist has checked the wound

What is Direct Access?

Direct Access was introduced in the UK in 2013 where patients would be able to see a dental therapist without having to see a dentist first. This means that they would be able to provide treatment within their scope of practice directly to patients so long as they felt confident and competent to do so. 

What needs a Prescription from a Dentist?

Although patients are able to see therapists directly, any Prescription Only Medicine (POM) will need to prescribed by a dentist unless the practice or service has a Patient Group Directive (PGD) in place. This will include:

  • Local anaesthetic (including topical)
  • Fluoride varnish
  • Tooth whitening
  • Botulinum toxin 
  • Nitrous Oxide sedation (inhalation sedation)
Ultimately, whatever your registration type when deciding if you can provide a certain treatment, you should ask yourself 3 questions:

  1. Have I had training to do this?
  2. Am I competent to provide this?
  3. Am I indemnified to do this?
So when in doubt, speak to your indemnity! 

Are you a therapist? Do you see patients via Direct Access? What's your experiences of this? Please leave them in the comments below. 

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