Why dental hygienists and dental therapists are the future


As part of our Future of Dentistry campaign, Cat Edney and Lauren Long set out why it’s so important that dental hygienists and dental therapists are properly utilised – and how this is changing dentistry. 

Why are you so passionate about utilising dental hygienists and dental therapists?

Cat Edney (CE): I’ve been qualified since 2008. I was really excited to get out into practice – I really loved therapy.

The reason that I went into training to be a dental therapist is because I love the artistry of dentistry and the fact that you are an engineer, an artist and a healthcare provider.

I got into practice, was super excited to carry out my full scope but was utterly and desperately let down. There just wasn’t the opportunity for me to do that for years.

I was extremely fortunate that my training was paid for by bursary by the NHS. But even in the NHS, I wasn’t finding any opportunity to work to scope. I developed my own thought process around the situation and developed my own understanding of how dental practices run, looking at them as a business and seeing how inefficient most dental practices are. Many of them stick to this really basic ‘one man band’ route.

I just couldn’t hold it in any longer – I decided I was going to have to be more vocal about why dental therapy needs to get put back into practice.

‘It works brilliantly for everyone’

Lauren Long (LL): I had a very similar experience to Cat. At university, we trained alongside dentists and had exactly the same direct restorative skills as they did. We think we were prepped for the real world, but we didn’t really have much kind of real world experience.

We thought we’re going to graduate and we’re going to come out and there’s going to be dental therapy jobs. I think we’re slightly better in Scotland at utilising dental therapists – but it’s still not as good as we would like it to be.

You have all these therapy skills, but you’re doing rigid 30-minute hygiene visits. When I first graduated, I was doing 15-minute NHS hygiene visits. A bit like Cat, I was thinking this is not what we trained for.

At my current practice, we all work into the same system where a lot of the restorative work is passed on. We work within our scope as therapists while the dentists all have their own special interests or their own niche that they can work towards. It just works brilliantly for everybody.

I think seeing how it works in real life really spurred me on to spread the word. I’ve had therapists message me saying my practice principal is quite sceptical and doesn’t know about really what therapists can do. Sometimes that’s half the battle! I tell them to just ask them to give it a try for a few months and see how it goes – barely anyone has gone back afterwards.

We use the phrase ‘utilising dental therapists’ a lot. What do you actually mean by that?

CE: First of all, I think it’s really important to also talk about dental hygienists, as well as dental therapists. In the profession, dental hygienists and dental therapists are often lumped together and a lot of us are duly qualified – myself and Lauren included.

I think a basic way of looking at it would be to look at a hygienist model, which Lauren has touched on already. Your hygienist is able to do a huge variety of treatments for patients, yet, quite often, you’ll find you’ll go into a practice and they’ll be doing a half an hour scale. It’s the same for every single patient – and the same fee for every single patient. And that’s all they really expected to do.

A lot of people don’t fully understand what that hygienist is capable of. As a result, you have this limited ability to create income in the practice or in that surgery. They’re not charging more for the complex treatments that they can actually do – the periodontal treatment or for fissure sealants, for example. They can place rubber dam, they can do fluoride treatments – there’s so much more that your hygienist can be doing.

I do think it’s changing. But keeping dental hygienists on a purely scale and polish model is a huge waste of everyone’s time. And then when you look at a therapist, all you’re adding to that therapist model is that they can then also do restoration. Anything direct in the mouth, anything that doesn’t involve the lab, is possible with your therapist.

If a dentist is doing check-ups, or composites or algorithms, or anything direct in the patient’s mouth– realistically, what they’re doing is earning the low profits appointments. Instead, they should be spending their time doing higher profit appointments and all the things that we can’t do.

Handing over autonomy

LL: I don’t really know how this set time model came about. To me, it’s always been a bit confusing, because I feel dentists have always tended to have total clinical autonomy over their book. But I think handing that autonomy over to the hygienist and the therapist is important because they know what they’re capable of.

The BSP and ESP perio guidelines really feed into this model as well. They really encourage us to be spending time with patients to offer them these kinds of treatment so we can help. Obviously, the aim is always to get our patients healthier. We’re not just talking about elective treatments – even on a basic level, it’s having that time to spend with your patient and having a protocol.

It’s having everyone in the office singing from the same hymn sheet. I can look at a patient and once I’ve assessed them, I’ll know what appointments I need, and what length of time I want. It’s good for us to have that.

Watch the full interview in the video above.

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