Opening doors into dental care

Dentistry is not all about a trip to the dentist - with other dental professionals now allowed to be a patient's first port of call for oral healthcare and treatment, we look at your options.

Dentistry has altered a lot in the UK in the past few years. Last year, the rules changed to allow dental hygienists and therapists to treat patients directly without them first having to see a dentist. This means that for those of you who have a fear of the dentist or wish to have your oral health monitored by someone other than a dentist, the doors have been opened if you wish to access care and treatments in another way.

With the NHS changing its approach to delivering dentistry and being much more inclusive of other dental professionals, the UK is simply following a trend that, in other countries elsewhere in the world, works well for dental patients.

Paying a visit to a hygienist or therapist is NOT an alternative to the dentist - you still need to see one for your more complex treatments, but the new rules do mean more options, which is great news for you.

You can visit a therapist or hygienist without seeing a dentist for an initial screening, including an oral cancer screening and you can receive treatment they have been trained to perform (check the list of what they can do at the bottom of this article).

And, if you need treatment outside their role, they can simply recommend a referral to a dentist. This means you have more choice and access to services.

You may also find that, in the long run, you may save money. Preventative measures, such as good oral hygiene advice and regular oral health checks, are the main role of a hygienist and therapist and so patients with healthy gums are less likely to require further dentistry. The training of hygienists and therapists is based around disease prevention that means they spend lots of time developing skills and techniques to reduce the risk of disease.

Here, leading dental therapist, Melonie Prebble, answers some FAQs:

What can a hygienist and therapist do that my dentist cannot?

Your dentist can do all of the things a dental hygienist and therapist can do, although most dentists refer to a hygienist or therapist. Commonly, a dentist will refer patients for hygiene maintenance, periodontal therapy and fillings. Equally, for services beyond the scope of a dental therapist or hygienist, clients are referred to appropriate healthcare professionals.

Am I better off getting my teeth cleaned and seeking oral health advice from a hygienist and therapist?
Yes. Visit the professional who has trained specifically to do the job.

I want tooth whitening - can a dental hygienist or therapist do this?
We can perform teeth whitening although, as a regulated profession, patients requiring this treatment have to be assessed by a dentist first. Be aware! Don't have a non-professional whiten your teeth - it's illegal!

I want a thorough check of the state of my oral health - who should I go to?

It's important you choose a professional you feel you can trust and that the person informs you of everything they do and see. Whether it's a dentist, hygienist or a therapist, the person should take time to perform a thorough examination of your mouth, teeth and jaws and then provide you with this information. It's important to know that hygienists and therapists are not a replacement for a dentist, just an extension of a team and they increase patients' access to dental services.

Since the rules changed and patients can now visit you directly, how much has your workload increased?

I have seen a steady increase in patient numbers; patients are specifically requesting hygienist and therapy services. In the past, they would have had to book with the dentist first.

Are people much more aware of the state of their teeth/oral health?

Most definitely, yes! With more access to information, individuals are learning more and more about the impacts of oral disease before they meet me. I meet more people who understand the risks to their overall health and also those who appreciate the debilitating effects of poor oral health and tooth loss. I think we do still need to raise awareness of oral cancer and oral cancer screening as this is still on the increase.

Does having good teeth lead to better prospects?

Yes, it seems that good oral health increases confidence and prospects.

Is dentistry now part of an overall beauty regime?
For some people, yes it is. I think we have a way to go, though. Dental health should be a part of your regime, whether the emphasis for you is beauty, heath or otherwise. Dental professionals want to provide people with the access to services that keep them healthy and oral care and maintenance should be a regime based around prevention.

What a dental hygienist and/or therapist can do:

  • Provides clinical and educational care to help you achieve and maintain good oral hygiene 
  • Uniquely qualified to assist in the prevention and treatment of oral disease 
  • Focuses on preventing gum disease by scaling and polishing teeth 
  • Develops home care plans with patients to maintain their oral health 
  • Cleans teeth efficiently (a far more complex and skilled procedure than most people realise!)
  • Identifies those areas where patients have difficulty in removing plaque and work with them to modify their toothbrushing technique to ensure effective cleaning
  • Applies topical fluorides and fissure sealants to reduce tooth decay 
  • Takes dental radiographs and undertakes monitoring and screening procedures
  • Gives specific preventative advice including: nutritional guidance, smoking cessation
  • Whitens teeth following an assessment with a dentist.

Dental therapists can also…

• Undertake restorative procedures (fillings) on adult teeth and primary (milk) teeth. Place pre-formed crowns, carry out pulp treatments and extract primary teeth under local anaesthetic

What is so unique about a dental therapist?

A therapist has the training to perform fillings as well as carrying out preventative treatment. Historically we provided care primarily for children, although today we provide treatment for adults as well. There is evidence that shows dental therapists are excellent at caring for anxious patients in any dental setting and their dedicated training means the standards of their clinical work are extremely high.


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