In 2013 the GDC removed its barrier to Direct Access for some dental care professionals after considering the impact on patient safety. Before then, 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.
This page explains which members of the dental team can see patients under direct access and what they can do. We have also produced additional guidance for registrants and some FAQs.
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. The only exception to this is toothwhitening, which must still be carried out on prescription from a dentist.
Dental hygienists and therapists must be confident that they have the skills and competences to treat patients direct. A period of practice working to a dentist’s prescription is a good way to assess this.
Hygienists and therapists who qualified since 2002 should have covered the full scope of practice in their training, while those who trained before 2002 may not have covered everything. However, many will have addressed this via top-up training, CPD and experience. Those who are unsure whether there are any gaps in their training should contact the dental school where they received their qualification, and check with their indemnifiers before undertaking any new duties.
Hygienists and therapists who:
- qualified before 2002, or
- have identified gaps in their training, or
- 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 hygienists and therapists who come across something outside their competence when seeing a patient directly, must advise the patient that they should be referred to a dentist.
Dental nurses can participate in preventative programmes without the patient having to see a dentist first.
Orthodontic therapists can carry out Index of Orthodontic Treatment Need (IOTN) screening without the patient having to see a dentist first.
Orthodontic therapists should continue to carry out the rest of their work under the prescription of a dentist.
Clinical dental technicians
Clinical dental technicians should continue to see patients direct for the provision and maintenance of full dentures only and should otherwise work to the prescription of a dentist.
The position has not changed. 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 work within their scope of practice.
- All registrants must continue to follow the GDC’s Standards for the Dental Team.