A healthy word – new year, new workflow

A healthy word – the return to practiceAnna Middleton explains how qualifying as a dental therapist opens up a whole new way of working with the rest of the dental team.

Those who know me, know how passionate I am about changing the way we deliver oral health to patients. That is why I started my business ‘London Hygienist’.

For those that don’t know me, my business was founded off the back of direct access. At present I am currently seeing five to 10 new patients a week.

Originally, as a hygienist, most of these patients I found myself before referring to one of the clinicians at the practice to complete restorative or cosmetic procedures.

One of the main reasons I returned to university to become a dental therapist was so that I could expand my direct access business to offer more services and continue to improve access to dental care for the public.

Both clinics I work at were delighted by the news of me becoming a therapist. Particularly how this will now improve workflow. Especially with extended appointment times to allow compliance with our COVID-19 SOPs.

Here are some of the ways in which I am working with my new patients as well as supporting the other clinicians with my newfound skills.

Focusing on ‘the sexy stuff’

Both the clinics I work in are extremely busy, multi-disciplinary practices with plenty of work for everyone.

I work very closely with two periodontists who routinely refer non-surgical debridement and maintenance to me. As well as help treatment plan my complex direct access cases.

This frees them up to focus on what I like the call ‘the sexy stuff’ that they are specialists in.

No patients start any smile makeover journey without a visit to the hygienist. Now, if patients need small restorations, then the dentists refer them to me in that same visit.

Again, this frees up time for them to do more consults or higher yielding treatments such as bonding, veneers and Invisalign.

What happens when a patient sees me?

I spend an hour with any new patients taking a full dental history, charting, taking radiographs/photos where necessary and taking a digital scan.

I perform my EMS ‘guided biofilm therapy’ cleaning. Then we still have time to treatment plan with the patients if they need any further treatment or wish to discuss treatments such as whitening and Invisalign.

As for our existing patients, we have informed them of my new qualifications. We explained that I can carry out clinical assessments in their hygiene appointments if they are happy for me to do so; bearing in mind I’ve been co-treating some of them for nearly six years, so they know me and trust me.

This approach is not only saving them money, but also a separate visit to the dentist. A dentist, may I add, that is already working at maximum capacity.

Obviously, I have a fantastic team behind me. Anything I am not sure of then I can refer on appropriately. More times than not the dentist is happy to pop in to have a quick chat with the patient and check anything I want clarification on.

Scope of practice

We have also started to let parents know that I can do children’s clinical examinations in the hygiene appointment if they are happy for me to do so.

I have a Patient Group Directive from Benji Blum of www.dentaldirectives.co.uk meaning I do not need to obtain a prescription from the dentist for fluoride or local anaesthetic, again saving everyone time and extra visits.

I also keep a close eye on patients who are currently undertaking Invisalign treatment. This is to ensure their clinical charting and radiographs are up to date.

In some cases I even remove attachments during a hygiene visit and help patients start their whitening. As well as take any further scans that they may need.

Our in-house orthodontist has also started referring primary teeth extractions to me. Again I can do this whilst carrying out routine hygiene treatment and help prepare patients for their orthodontic journey with oral hygiene advice.

Gaining more autonomy

All of this came about simply by informing the team of my scope of practice and talking to the clinicians to see if any of my new skills would be of service to them.

Some might fear that they are ‘taking work away’ from the dentists. But it will surprise you to find out there are certain elements of our role that they did not know about. As well as certain procedures that they themselves do not want to carry out.

I am passionate about helping more hygienists and therapists utilise their full scope of practice and gain more autonomy.

I will be delivering a webinar exploring this more at this year’s Online Dentistry Show in March. So stayed tuned to learn more.


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