Lauren Long explores the changing role of dental hygienists and dental therapists treating patients under direct access
Whether working independently under a direct access arrangement, or under the prescription of a dentist, dental hygienists and dental therapists often lead the way in patient care and are fundamental to the long-term success of today’s dental practices. Direct access has been the catalyst to the changing role of dental hygienists and therapists across both the private and NHS sectors in the last decade, in terms of progression, integration and utilisation.
Integrating direct access
Direct access was introduced in 2013 when the General Dental Council (GDC) removed its barrier to direct access for some dental care professionals after considering the impact on patient safety. This meant dental hygienists, dental therapists and, in some cases, clinical dental technicians, were able to carry out their full scope of practice without the patient having to see a dentist first.
Dental Therapist and NSK Ikigai Educator, Lauren Long, explains: “For patients, direct access means they now have easier access to a range of dental professionals without referral from a dentist.
“Patients can approach hygienists and therapists directly for treatment within our scope of practice, as well as screening for conditions such as oral cancer, something previously only dentist could do.
“We can also make a direct referral to a relevant dental professional if the patient’s condition is outside our scope of practice.
“I think the whole practice team really benefits when we all embrace direct access. It’s not only good for patients, who can be seen more easily to get the treatment they need, it brings more patients into the practice who are able to access the additional range of services the team provides.”
Information and consent
It is important to ensure patients are fully informed before and at the time of booking a direct access appointment to ensure they know which professional they are seeing and the possible limitations of direct access. Information that should be provided includes what treatment the dental hygienist or therapist will provide on the day, what treatment they can offer following consultation, and where they will refer the patient should treatment be required that they cannot provide.
Legislative changes
Previously, under direct access, dental hygienists and therapists could administer treatments such as local anaesthetic and high-strength fluoride, but only after obtaining a prescription from a dentist, otherwise known as a patient-specific direction (PSD), or having a document known as a patient group direction (PGD) in place.
In a recent move to increase the capacity and efficacy of oral health care in the UK, changes to the Human Medicines Regulations 2012 (effective June 26, 2024) enable dental hygienists and therapists across the UK to legally supply and administer specific prescription-only medicines (POMs) under an exemption mechanism without needing a PSD or a PGD.
This move, initiated by the British Society of Dental Hygiene & Therapy (BSDHT) and the British Association of Dental Therapists (BADT) back in 2013, and developed over the past 11 years, aligns with the broader objectives of the NHS Long Term Workforce Plan, which aims to bolster direct patient care while liberating dentists to tackle more complex procedures within the NHS framework.
The GDC has welcomed this change, stating that it will improve direct access for patients to dental hygienists and therapists, while promoting better use of the skill mix in the dental team.
There is no obligation for dental hygienists or therapists to administer and supply medicines under the exemptions noted above. However, all dental hygienists and therapists, regardless of previous training, experience, and qualifications, should ensure they are appropriately trained, competent and indemnified to supply and administer specific medicines under the exemptions mechanism, encouraging them to select a course that follows the developed training curriculum.
A time of change
The approval of exemptions for dental hygienists and therapists to administer specific medications is a big forward step in the delivery of oral health care, directly benefiting patients and the dental profession alike.
“For a hygienist or therapist, it will make our job easier and more straightforward in terms of giving the care that our patients need,” says Lauren. “From our point of view, and from the patients’ point of view, it’s only a good thing, reducing dependency on dentists for prescriptions while allowing us to practice to our full potential.”
With these regulatory changes, the role of dental hygienists and therapists is ready to expand significantly, aligning with the government’s proposals to rebuild dentistry for the long term, reform the dental contract, and shift the focus towards prevention.
NSK is dedicated to supporting dental hygienists and therapists as a vital cog in the wheel of preventive dentistry with equipment that is designed and manufactured with the needs of these dental professionals in mind.
Alongside this, NSK Ikigai provides an active community and professional hub that underscores the crucial role dental professionals play in oral health and the wider healthcare arena, providing a platform that allows fellow professionals to learn new skills, follow key opinion leaders and develop new professional relationships.
To find out more about the NSK Ikigai Oral Health Community and to get details of the Spring 2025 oral health webinars and face-to-face hands-on events visit https://mynsk.co.uk/ikigai/
The Ultimate Guide to Direct Access
Don’t miss Lauren Long’s appearance alongside a star-studded panel of experts, including Jason Wong (Chief Dental Officer for England), Fiona Sandom, Michaela O’Neill, Anna Middleton, Bill Sharpling, Lauren Long, Miranda Steeples, Sab Bhandal, Debbie Hemington and Simone Ruzario, in The Ultimate Guide to Direct Access!
The series covers all you need to know about Direct Access, from what it is to how it can be implemented, what the benefits are to patients and practices, and what the future may hold.
Watch now at https://www.youtube.com/@theprobemag
Episode 1 – What is Direct Access:
Episode 2 – Benefits for the Patients:
Episode 3 – Benefits for the Practice
Episode 4 – How to implement Direct Access
Episode 5: New Powers and The Future
