Assessing your own scope of practice

Pravleen is a dentist who has been working in NHS dentistry for 15 years. 

Patient history

Billy presents with a history of pain in an upper first permanent molar (26) that has now subsided. A clinical examination reveals a large MOD amalgam restoration in the 26 that the patient says was placed about a year ago. An X-ray shows that the restoration is very deep/close to the pulp with widening of the periodontal ligament and root canal curvature of approximately 30°. A vitality test reveals a mixed response. The likely diagnosis is chronic pulpitis.  

Treatment options

Pravleen discusses the treatment options with Billy. These include:

Billy opts for option 2 as he doesn’t want to lose the tooth. 

Pravleen now needs to assess his own scope to decide whether he can provide the care himself or refer to another dentist. 

In addition, Billy’s case is on the border of complexity between Level 1 and 2 so may require a referral depending on the specific case details.

Questions Pravleen needs to consider are: 

This scenario demonstrates how to consider your own scope of practice boundaries in a clinical context. Dental professionals must appropriately assess each case to reflect and decide on the best course of treatment.  See the table below for a framework to guide your decision making.

For more information, see the GDCs Scope of practice guidelines.