Hygiene and therapy-led dentistry: a new standard of care

Zain Remy discusses how a hygiene and therapy-led model promotes clinical excellence, a team approach and an enhanced patient journey.

Auckland Cosmetic Dental Clinic, an independent, fully private clinic, is all about the patient journey. Clinical excellence and teamwork are at the heart of our core values. This is evident from our dental hygiene and therapy-led model, where direct access using a dental directive in collaboration with our dental hygienists and therapist has been implemented.

Our hygiene and therapy team work together to lead their own clinics. The hygienists carry out hygiene appointments following the full BSP guidelines as well as cosmetic whitening under prescription of dentists. Our dental therapists ensure that patients are clinically stable, with emphasis on high quality general dentistry. This involves carrying out dental health checks including oral cancer screening, appropriate X-rays and implementing our traffic light system on every tooth to form a complete diagnosis.

No more crammed diaries

There is a full support system in place with dedicated referral slots within the dentist’s diaries that the dental therapists can use if a treatment is out of their clinical scope or comfort zone. Each dental therapist has been encouraged to take appropriate clinical imagery for dental records, which can also be presented during training days to the full clinical team for open discussions.

I’ve worked in several practices before I bought my own to create this vision. I found that time was a huge factor in the success rate for favourable treatments and outcomes for all dental professionals. I have never agreed with the notion that speed equals success. There is some overlap working in confined spaces and intricate attention to detail to other medical professions. A surgeon would never think to rush an operation, so why would you rush dental treatments in a confined space on a small tooth?

Speaking to many dental hygienists and dental therapists, there is a common theme of patient treatments being squeezed into an already crammed diary. I do not understand that, as a dentist, if it takes one hour to do a composite filling, why would it be fair to give a shorter time slot for a dental therapist to carry out the same treatment?

Support system

One of the ways I am able to support dental hygienists and therapists is if they are all employed by the clinic. This helps to build trust and keeps myself accountable for their courses and investing time into each individual clinician to fulfil their true potential. This has led to clinicians having a high level of confidence when treating patients due to the support system in place.

When it comes to possible treatment failure, which can happen to the best of us even after prior planning, we have developed a holistic learning approach to understand the failures and ensure that the clinicians are in a safe space to discuss, learn and reflect.

Tackling patient barriers

Of course, there have been barriers with patients accepting this alternative approach and it has taken dedication from the full dental team in explaining the value of these clinicians to our patients. While this has been challenging, this new found acceptance has been achieved by educating patients through letters, social media and in person conversations.

Face to face interactions have been the most powerful source of communication for us. We recently held an open day and welcomed our patients into the clinic to meet our team. The day was a huge success with many patients now understanding the value of seeing dental hygienists and dental therapists for their routine maintenance.

This model may not be for every dental practice and it takes trust, time and effort as well as a driven team to empower our hygienists and dental therapists. These clinicians face their own barriers with one I recall making the rounds on social media. A meme from a press conference by Prime Minister Rishi Sunak who forgot to mention ‘dental’ in front of therapist. This may have been a running joke but it really does impact the general public’s perception of dental therapists.

Team approach

Dental therapists need a powerful voice and it’s the responsibility of the whole dental profession to provide this. Smile-Fast have already recognised the worth of dental therapists by asking them to lead aspects of their direct course. This is a concept I fully support, and in the future I plan to offer training academies from our clinic led by our hygiene and dental therapy team.

My personal observation within our profession, is that while the majority of what we do is general dentistry, there is a resistance to refer to a dental hygienist or dental therapist. My advice to all young dentists is that you are never too young in your career to develop or advance your clinical skills as soon as you qualify. By developing your skills in this way, you would see value in working actively in a team approach with dental hygienists and therapists.

To all dental hygienists and therapists, if a dental practice is not providing you the support and time for treatments and you feel undervalued, raise this! If it continues, move on to a dental practice that will embrace you. Creating a clinical portfolio will make you a powerful candidate, not only to dental practices, but most importantly – your patients!

I believe that the government, NHS and dental practices are missing a valuable trick and are too fixated on dentists providing general dentistry. Who knows, it could be the hygienists and dental therapists that save the profession!

With thanks to our sponsor, NSK.

Celebrating National Dental Hygienist and Dental Therapist Day:

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