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Skill Mix and the Profession

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  Posted by: The Probe      12th June 2016

Awais Ali is in his fifth and final year of Dentistry at the University of Manchester and a recent recipient of the Association of Dental Groups (ADG) Gold Award for the Undergraduate Skill Mix in Dentistry Category. Passionate about dentistry and motivated to develop his skills and understanding, Awais reflects on both the effective use of skill mix within the dental team and how this affects one’s own development.

To deliver effective and efficient dental care in the future we must ensure “the right number of people with the right skills are in the right place at the right time to provide the right services to the right people”.[i] Skill mix can be discussed as substitution of roles; where another professional replaces an individual with a greater skill set, and supplementation of roles; where an individual completes items on a treatment plan in conjunction with another.

The use of skill mix is also integral to the delivery of patient care, as each individual within the workplace has an important role. Consequently, it is crucial that all professionals – dental nurses, dental therapists and dentists alike – remain committed to gaining understanding and advancing their skills. Only then do I believe professionals would be able to make full use of their skill mix, maximise their productiveness and improve patient satisfaction.

Dental nurses, for instance, could improve their skill mix through the completion of further education and additional training. The National Examining Board for Dental Nurses provides a number of post-qualification courses, including training on sedation, radiology, implantology and oral health education. With preventative dentistry currently at the forefront of the profession, such courses could prove to be hugely beneficial.

A prime example of this is the recent implementation of a Screening Tool, which can be provided by dental nurses to facilitate the screening of patients between assessments made by a general dental practitioner (GDP). Not only could this alter scope of practice, but it also suggests that the skill mix of a dental nurse is evolving.

The skill mix of a dental therapist is equally as important to the provision of care within the practice, particularly as some suggest they could perform approximately 80% of tasks in NHS settings.[ii],[iii] With research also stating that examinations consume as much as 34% of total patient contact with GDPs,i it is clear that time could be saved if certain tasks were delegated to other dental professionals, and the skill mix within each role was extended.

I think it is also important to consider how working as a multi disciplinary team to combine expertise from a wide variety of specialities could improve the delivery of patient care, particularly for cancer patients and other complex cases. Plus, patients are living longer, so the benefits of transferring greater responsibility to dental care professionals can only multiply. Ultimately, it seems that the solution to delivering quality care, is to maximise skill mix, thoroughly utilise the team, extend or adapt role responsibilities and add new dimensions to patient care with a multi disciplinary team approach.

From an ethical perspective, we as professionals are also responsible for improving the nation’s oral health. Thus, for our patients’ best interests, and to ensure that effective and efficient dental care is delivered, it is crucial that we encourage and support the use of skill mix.

From my own personal experience, I have found that fully utilising one’s own skill mix is advantageous to the rest of the team and vice versa. We are after all, only as strong as our weakest link. In dental school we have complete support from the university and experienced NHS staff. Thus, thanks to the skill mix that surrounds me, when it comes to making difficult decisions, I feel completely confident that I can manage and treat patients appropriately and effectively. Consequently, I feel that the provision of a support system from professionals with a more advanced skill mix is crucial to those who are less experienced.

Overall, my experience of skill mix has shed a new light over dentistry. I am aware that there are a huge amount of useful skills to learn and I look forward to exploring them. Going forward, I think that it is important we all play our part to ensure that the workplace of the future employs a skill mix that safeguards patients and makes full use of the scope of practice.

For more information about the ADG visit


[i] Birch S. Health human resource planning for the new millennium. Inputs in the production of health, illness and recovery in populations. Can J Nurs Res 2002; 33:109-114.

[ii] Wanyonyi KL, Radford DR, Harper PR, Gallagher JE. Alternative scenarios: harnessing mid-level providers and evidence-based practice in primary dental care in England through operational research. Human Resources for Health. 2015; 13:78. Accessed online April 2016 at

[iii] Harris R, Burnside G. The role of dental therapists working in four personal dental service pilots: type of patients seen, work undertaken and cost-effectiveness within the context of the dental practice. British Dental Journal. 2004; 197: 491-496. Accessed online April 2016 at

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