Direct access? We don’t always need a BDS

As a retired dentist and a long admirer of BDJ editor, Stephen Hancocks, I might be expected to take his part in this disagreement between him and the hygienists over Direct Access (DA). Sorry Stephen, but I don’t. I think you are wrong.

A couple of conversations I had last week might illustrate this.

The first was with a dental nurse I had trained 30 years ago. She was on a course to learn to provide dermal fillers, something that in those days I would not have even regarded as dentistry.

The other was with a dentist who pointed out that if people can do body piercing with no medical qualifications, why can’t a hygienist scale teeth without a prescription?

Why can only a dentist replace a filling without reference to someone else? A patient should have the right to choose which dental professional carries out their treatment.

Stephen talks about the ‘diagnostic experience’ of the dentist. Really? When the 2006 contract came in, suddenly multiple crowns and fillings we off the menu. Dentists’ diagnoses suddenly included extractions rather than fillings.

Even the authors of the hygienists’  letter propose that the newly qualified should wait five years before being allowed to practice under direct access and only seek to diagnose within scope. Why not the same for newly qualified dentists?

The new way of working currently being piloted means most dentistry can be delivered without the need for BDS after your name.

And that includes, in my view, the oral health assessment. No Government will pay a dentist top rate to do a job that a DCP can do.

Despite being a Type 2 Diabetic my care is carried out, and done well if not better, by nurses, not doctors. It is time that we dentists got used to this ‘new way of working’.

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