We have removed our barrier to Direct Access for some dental care professionals after considering the impact on patient safety. In the past every member of the dental team had to work on the prescription of a dentist. This meant that patients had to be seen by a dentist before being treated by any other member of the dental team.
Following a detailed review of evidence and a full discussion at a Council meeting on 28 March 2013, it was agreed this should change as outlined below.
We have also produced additional guidance for registrants along with some Q and As:
Direct Access guidance
Dental hygienists and dental therapists
Dental hygienists and dental therapists can carry out their full scope of practice without prescription and without the patient having to see a dentist first.
Dental hygienists and dental therapists must be confident that they have the skills and competences required to treat patients direct before doing so. A period of practice working to a dentist’s prescription is a good way for registrants to assess this.
Registrants who qualified since 2002 covered the full scope of practice in their training, while those who trained before 2002 may not have covered everything. However, many of these registrants will have addressed this via top-up training, CPD and experience. Those who qualified before 2002, or those who have not applied their skills recently, must review their training and experience to ensure they are competent to undertake all the duties within their scope of practice.
Dental nurses can participate in preventative programmes without the patient having to see a dentist first.
Orthodontic therapists should continue to carry out the majority of their work under the prescription of a dentist.
Orthodontic therapists can carry out Index of Orthodontic Treatment Need (IOTN) screening without the patient having to see a dentist first.
Clinical dental technicians
Clinical dental technicians should continue to see patients direct for the provision and maintenance of full dentures only and should otherwise carry out their other work on the prescription of a dentist.
However the Council stated that with the potential for further training for CDTs this decision could be reviewed.
Clinical dental technicians who see patients in a clinic should ensure that they are trained and equipped to deal with medical emergencies, including CPR and the use of a defibrillator.
Clinical dental technicians' premises, in which patients are seen clinically, must have a defibrillator. This is because the
GDC endorses the Resuscitation Council’s guidance that all primary care settings should have a defibrillator. (The GDC
considers a CDT premises in which patients are seen clinically amounts to a primary care setting).
The GDC does not expect clinical dental technicians to hold an emergency drugs kit or be trained in the use of emergency drugs.
The GDC does not consider the legalities which prevent clinical dental technicians from having emergency drugs kits prevents them from operating an independent practice.
The work of a dental technician (other than repairs) should continue to be carried out on the prescription of a dentist.
Dental professionals are encouraged to get in touch with the GDC if they have any questions.
- All registrants must be trained, competent and indemnified for any tasks they undertake.
- All registrants must continue to work within their scope of practice regardless of these changes.
- All registrants must continue to follow the GDC’s Standards for the Dental Team.
- Dental care professionals do not have to offer direct access and should not be made to offer it.