Tom Chaston explores how new legislation is reshaping the roles of dental hygienists and dental therapists, bringing greater autonomy, fresh challenges and new indemnity considerations.
Recent legislative changes bring greater autonomy for dental hygienists and dental therapists, unlocking new opportunities and responsibilities. With these advancements come fresh challenges, particularly around indemnity and professional protection. Understanding the implications is key to ensuring safe, effective care and compliance.
More autonomy, more responsibility
For years, dental hygienists and dental therapists have worked within defined parameters, often under the prescription of a dentist. Now, legislation has broadened their professional remit in a number of key ways:
- Direct access granted: dental hygienists and dental therapists can now carry out their full scope of practice without a prescription and without the patient having to see a dentist first, except for tooth whitening, which must still be carried out on prescription from a dentist. This shift allows them to provide care more efficiently and take a more proactive role in patient treatment
- POM exemptions: new legislation permits dental hygienists and dental therapists to administer, sell or supply certain prescription-only medicines (POMs) without needing a dentist’s direction, although this does not extend to full prescribing rights (more on this later)
- NHS treatment approved: under a provider’s contract, dental hygienists and dental therapists can now deliver NHS treatments to their full scope of practice (eg dental therapists can provide fillings as part of restorative care, both professions can provide preventive care and sealants etc). This aims to alleviate pressures on NHS dentistry and improve patient access to treatment
- Greater clinical accountability: while this autonomy brings new opportunities, it also means that dental professionals must ensure they have the necessary training and competencies to work independently. A period of supervised practice remains essential to build confidence and ensure clinical competence.
These changes are designed to streamline patient care, reduce waiting times, and make better use of the skills within the dental team. For patients, this means faster access to essential treatments, fewer delays in preventive care, and more opportunities to receive treatment directly from a dental hygienist or dental therapist, especially significant in areas where access to dentists is limited.
However, with greater independence comes the need for heightened awareness around professional responsibilities, particularly in relation to indemnity.
Stay covered, stay protected
To ensure they are fully covered, dental hygienists and dental therapists should ask their indemnity provider the following key questions:
- Does the policy include full coverage for the expanded scope of practice under the 2024 legislative changes?
- Are there any exclusions or conditions that may restrict indemnity for new responsibilities?
- Does the provider offer dentolegal support with advisors who are up to date with these regulatory developments?
- In the event of a patient complaint or legal action, what level of coverage is provided for legal fees and potential compensation?
Beyond individual protection, practices must also ensure they are covered for vicarious liability claims. Increasingly, legal action is not just directed at individual clinicians but at the practice itself. Therefore, ensuring that the business is adequately insured is equally crucial.
Indemnity and POMs
One of the most significant updates is the ability for trained dental hygienists and dental therapists to administer, sell, or supply certain POMs without requiring a patient-specific direction (PSD) or patient group directive (PGD) from a dentist. These exemptions apply only in specific cases – such as local anaesthetic and high-strength fluoride – rather than granting broader prescribing rights.
Given these changes, while professionals may find that their existing indemnity already covers their expanded scope of practice, others may need to update their policy. Reviewing individual arrangements is essential, as some policies may contain exclusions or limitations that restrict coverage for newly expanded services. Practitioners should confirm with their indemnity provider that all aspects of their updated role are fully covered.
Without adequate indemnity, a practitioner could face serious legal and financial consequences. Performing a treatment without the right cover may leave them personally responsible for all legal costs and compensation claims. Moreover, inadequate coverage could place them in breach of the General Dental Council’s (GDC) requirements, potentially leading to a fitness to practice investigation – a scenario that could significantly impact a professional career.
Training is a must-have
While these changes create exciting opportunities for dental hygienists and dental therapists, they also necessitate a commitment to continuous learning. The GDC expects professionals to complete accredited training to ensure they have the competencies required to work safely and effectively under these new exemptions.
The GDC also strongly encourages dental hygienists and dental therapists to choose courses aligned with the BSDHT’s (British Society of Dental Hygiene and Therapy) recommended training curriculum, reinforcing best practice and high clinical standards.
Whatever courses are chosen, the GDC would likely expect this training to include a competency sign-off, whether through an e-learning course or in-person training with verifiable CPD accreditation.
Dental practices also play a pivotal role in supporting their teams through this transition. Key areas of focus should include:
- Providing access to training that aligns with GDC standards, ensuring all team members are competent and confident in administering POMs
- Encouraging regular CPD to help dental hygienists and dental therapists stay updated with best practices and regulatory changes
- Fostering a supportive environment where professionals can share experiences and seek guidance on the new responsibilities.
By taking a proactive approach, individual dental professionals and practices can ensure they navigate these changes smoothly, providing the highest standard of care while maintaining regulatory compliance.
As the profession prepares to celebrate National Dental Hygienist and Dental Therapist Day on 1 May, it is an ideal time to reflect on these advances and the increasing recognition of the critical work these professionals do. With the right training, protection and support, this new era of practice presents an exciting opportunity for growth, autonomy and enhanced patient care.
Read more from the National Dental Hygienist and Dental Therapist Day campaign:
- Tides of change: progress and headwinds for dental therapists
- Life as a dental hygienist in Ireland
- The rise of the NHS dental therapist: life at the coalface
- Military to community dentistry: a journey of adventure and resilience
- Why patient awareness is more important than ever
- Unlocking the power of therapy-led care
- From prevention to policy: the power of dental hygienists and therapists.
With thanks to our sponsor, NSK.
