Cat Edney talks us through the impact of rising costs on the role of the dental hygienist and therapist.
Cat Edney is a multi-award-winning dental hygienist and therapist who runs The Modern Therapist. This is a series of courses aimed at educating dental therapists in providing exceptional restorations, in settings where they are supported and respected as autonomous clinicians.
We recently shared the findings of the Dentistry Census on pay and earnings within the profession. At the start of the year, Dentistry – in collaboration with DD – published its first ever Dentistry Census, the biggest ever survey of dental professionals in the UK.
Here, we look at this in the context of the rising costs, inflation and what this volatile financial landscape means for those working within dentistry, beginning with Cat Edney’s thoughts on dental hygienists and therapists.
Has the dental hygienist and therapist been undervalued by many practices up until now?
There has long been a level of confusion and misunderstanding as to what value all DCPs can bring to a dental business. Let alone the value that is added to the patient journey when a practice fully adopts shared care and team working philosophies.
I have often written about the ‘scale and polish’ set rate hygiene room model being outdated. Filling a dental hygienist’s diary with one rate per hour hygiene appointments limits the autonomy of the clinician to decide on treatment required for their patients. This is due to standard appointment times being set in stone and often booked for months in advance.
But it also limits the income that can be generated in that surgery, and for the clinician.
This is likely a symptom of hourly rate contracts and practice owners historically wanting to be better able to predict their outgoings.
Where the dental hygienist is encouraged to work to their full scope, with freedom to book appointments as they deem appropriate to their patients and on a percentage-based pay that reflects the income they generate for their surgery, practices are likely to see a rise in income and more value from each patient that is treated.
For those who travel to different sites, should they consider increasing their hourly rates to factor in the increased cost of travel?
If a practice is asking their employee to travel between sites, then they absolutely should be factoring in the cost of their travel or being reimbursed for this.
However, I really urge the dental hygienist and therapist to consider working as independent contractors. Set their rates as they deem appropriate – following consultation and negotiation with the business that they contract their services to.
This offers better control over managing price increases. It also improves the ability to take an active role in developing their income.
How can the utilisation of a dental therapist’s skillset help practices meet patient demand whilst remaining economically viable?
There has been much discussion in recent months about the untapped workforce of dental therapists. I am a staunch believer in shared care and utilising the dental therapist’s full skill set. I believe that many of the 4,000-plus registered dental therapists in the UK would relish the opportunity to work in the way they were trained.
However, I do not believe that the recent changes to the NHS contract go far enough. They don’t completely support this utilisation and correct the economic difficulties in providing NHS care.
Conversely, when dental care is provided on a fee-per-item basis, the true benefit of dental therapy provision is easily demonstrable. Many of the 4,000 dental therapists are already working in surgery providing hygiene care. Their surgery income would be greatly uplifted if direct restorations were passed into their diaries.
This referral of direct, often less profitable, restorations would, in turn, open up the diaries of our BDS colleagues.
They could better fill their time with indirect restorations, endodontics, extractions and orthodontics. Thus, making the dentist’s diary far more profitable without losing any income to the practice.
Into practice
There is also a lot to be said for dental therapists conducting their examinations. But also for them referring these more profitable treatments to general dental practitioners or specialists. This further reduces the time the dentist spends on low-income activities and allowing them to cherry pick the treatments that interest them.
Shared care settings like this are increasing in popularity as associates are able to focus on treatment that they perhaps enjoy more or have a special interest in.
There has been a shift recently with more practices looking at implementing dental therapy. Many dental therapists are also accessing further training in order to retain the skills they were trained to have.
I have seen a huge influx of dental therapists accessing my composite and direct access courses. The story is often the same – they believe it is time we put dental therapy into practice.
This is why I developed The Modern Therapist series of courses. They educate dental therapists to provide exceptional restorations in settings where they are supported and respected as autonomous clinicians.
Read more on the Dentistry Census and the cost of living crisis:
- Dentistry Census – what does the cost of living crisis mean for dental nurses?
- Dentistry Census – dentistry and the cost of living crisis.
Acknowledgement of Dentistry Census
From August to September 2021, we carried out the first ever Dentistry Census. This is the most comprehensive survey the UK dental profession has seen.
Dentistry, in collaboration with DD, undertook the extensive survey to explore the current state of the profession.
We would like to thank all the dental professionals who took part in the Dentistry Census. We would also like to thank DD for their support.
*The Dentistry Census is based on a survey of 816 dental professionals from across the four nations. It was undertaken from August – September 2021, in collaboration with DD using Surveymonkey to collect the data.
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