Are dental therapists used to their full potential in the UK?

Last week, we asked if dental therapists are being used to their full potential in the UK – here’s what the profession thinks…

Dentistry’s Big Questions is a brand new feature exploring the hot topics of the profession.

We kicked it off last week with our very first question: Are dental therapists used to their full potential in the UK?

Are dental therapists overlooked? Should practices be using them more effectively? If so, how? Are there any disadvantages to doing this?

Based on our poll, some 87% believe dental therapists are not used to the their potential in UK dentistry.

Hear what the profession said below…

Scroll to the bottom for next week’s Big Question.

Anna Peterson, dental therapist

Dental therapists are completely overlooked in my opinion. We shouldn’t just be used as a hygienist. Financially we can be more profitable to a practice if we are doing the check ups, restorative and periodontal work.

A dentist’s book shouldn’t be filled with exams and fillings when it could be crowns, bridges, inlays, implants, aligner treatment, veneers. Therapists want to do more, most of us love doing our full scope.

I always think… who is the most appropriate clinician to do this work? You wouldn’t have an endodontist or oral surgeon doing routine examinations on patients. I work in a therapist-led practice and it works really well.

Sakina Syed, dental hygienist

Not at all! We need to engage with the dental community groups, association and the general public to raise awareness of the role.

It is a better, progressive outlook for newly qualified dental therapists which still requires a lot of work but increasingly hard for those who qualified as a dental therapist years ago and find it hard to now implement without a structured training plan.

The NHS six month return back to work is a good concept but not when there are not enough placements and the time frame of uptake of the placement is a matter of two weeks.

I’m calling on dental universities to get on board with this.

Debbie Hemington, British Association of Dental Therapists (BADT) president

There needs to be more provision for refresher courses for de-skilled therapists. Programmes requiring six month placements are difficult for people with stable jobs already. The funding has to come from somewhere though!

It’s a myth that therapists can save NHS dentistry. Why would they w./..ant to work under a contract that dentists are leaving in droves? Plus there are no NHS benefits for them currently either.

Ibrahim Numan, dental therapist

No. However there are so many layers to this question. I’ve implemented dental therapy into many practices I’ve worked at and, honestly, in some models it does not work as well.

I completely agree that dental therapy cannot fix the NHS problem, and dental therapists shouldn’t be used as the answer, the contract is broken. In private practice, dental therapist can definitely be utilised and this fight has been going on for years and years.

However, obviously competence is super important, refresher courses and access to these courses must increase. Finding a supportive practice and a mentor makes a huge difference.

Lauren Long, dental therapist

When utilised well, dental therapists can be an absolutely vital part of the practice team. As Anna Peterson said, it’s all about directing patient care to the appropriate clinician and maximising the skills and job satisfaction of everyone in the practice.

Unfortunately, we really are underutilised, and many have deskilled.

I’m lucky that I’ve been able to work to my full scope since graduating 15 years ago and now work as clinical director for a small corporate who really believe in the skills we have to offer as therapists. I really think there’s so much untapped potential out there in our profession and hope we can continue to take steps forward.

Miranda Steeples, British Society of Dental Hygiene and Therapy (BSDHT) president

Not at all. There needs to be a culture change within dentistry and outside of it.

The public need to know who we are and what we can do, then ask for it, and the the culture in dentistry must change to facilitate this

Tiffani Hutchinson, dental hygienist, dental therapy student

Thankfully I’m working in a very supportive practice who are allowing me to gain my dental therapy qualification using them as my placement with the hopes of utilising my full skills upon qualification.

Sadly I know lots of my dental therapist friends who are not being utilised, or being used to do the work that the dentists dislike. I

think it’s a big mix of misunderstanding the role, both by colleagues and general public, and possibly finances – some may not feel its worth it to be referring work to others, but I also feel the incentives are not there for therapists to be utilising their skillset.

Ella Samuel, dental therapist

I 100% think dental therapists are under utilised in dentistry! For those leaving university having a dual qualification, unless you hop straight into a therapy role it’s so hard to maintain that skill and then have it be utilised further.

I’m very lucky to be in a position to strengthen and utilise my therapy skills in an incredibly supportive practice, but I do hope there is room in the future for more individuals like me who wish to develop their skills post-university.

Heather Power, dental practice manager

[This is] something we are really striving for at our practice – it makes so much sense for therapists to utilise their full scope, but we find the biggest challenge is educating our patients: ‘What do you mean you want the hygienist to do my filling?’

Dr Sal, endodontist

It ultimately boils down to how experienced the therapist is or the skills and knowledge they possess. The practice should adapt an amicable approach in hiring more therapist where they utilise the skill mix.

NHS leaflets showing the scope of practice of therapists should be made available to the public. The public can get easier appointments with the therapist than waiting for it to be done by the dentist.

There is a plethora of overseas qualified dentists too who are registered as therapists for which the route has been closed last year. The practice should adopt a streamlined process of proper delegation and referral of those treatments not within scope of therapist.

I genuinely feel they shouldn’t be limited to hygiene only. The dentist can then focus on delivering band 3 treatments.

Jagjit Malhi, dental therapist

Sadly not, but working with a supportive practice makes all the difference.

Changing the mindset of other practices and associates who have never worked with a therapist can often be a challenge, but it’s always worth giving it a try ‘if you don’t ask you don’t get’, and generally I find that they eventually get on board 

Christopher Gardiner, practice principle

No they’re not. So much depends on the practice culture and leadership.

Unfortunately, a narrative is being created that utilising therapists will save NHS dentistry, rather than encouraging patient centred, high functioning and high quality dental teams.

Emma Anastasi, CEO of Diamond Dental Staff

Absolutely not. Many practices do not know how to, or don’t have the resources (or time) to implement the role into practice, in view of change management. From over six years of experience, the conversations I have had with practices are that they are unsure how well the other clinicians will take to having a dental therapist in the practice, and equally how open they would be to refer their patients on for treatment. They often ask how they would manage the dental therapist’s diary if the appointment list had different lengths of treatment, and worry that this would create space for missed hygienist appointments.

On the flip of that, I have so many frustrated therapists and hygienists that want therapy work, that feel unfulfilled in their role as they are not completing their full scope of practice, sharing that they feel like their skills are wasted and that they are a devalued team member.

Dental therapists have been the solution from the get go. I do feel it’s the fear of change that is holding practices back. When delivering my consultancy, I always hear, ‘This is how we’ve always done it’.

Practices need guidance, reassurance and some hand holding for them to feel ready to make any changes in the practice. We all know how disruptive it can be for patients. The whole team needs to be trained and onboard with how to manage the patients and this role needs to be celebrated throughout the practice.

Kaye Higgs, dental therapist and aesthetics practitioner

Definitely not… dentistry would be in such a better place if we’re utilised dental therapists properly from the beginning with the right incentives

The next Big Question is: Are dental nurses paid enough?

What do you think? Let’s get a discussion going – email your thoughts to [email protected] to feature in our follow-up article in which we will share the views from across the profession.

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