Clinical Significance
Use of dental hygienists
Among residents of care or nursing homes, oral disease often requires preventive care, active monitoring, and sometimes intervention. Increasing numbers of older adults retain their natural teeth, although they may be heavily restored. However, access to dental care in nursing homes is often limited, which means that problems can become more severe and require more expertise to manage. If the majority of nursing home residents require simple dental treatment, it could be delivered by a
The 2010 Welsh dental care home survey data were reviewed retrospectively and cross-referenced to the GDC scope of practice document for guidance on direct access. Noted were the clinical opinion of treatment need and special care skill levels required.
Of the 655 care home residents surveyed, 22% had treatment needs that a dental hygienist alone could manage and 27% had needs that a dental therapist could handle. For hygienists or therapists with special care dental experience, the needs of residents could be fully met in 43% up to 53% of cases, respectively. The difference reflects the proportion of restorations that also require endodontic treatment. Dentists with special care experience could address all the care needs of 90% of residents,
Direct access is not yet possible in the United Kingdom without changes in regulations or legislation. However, a significant proportion of patients in care homes in Wales could be managed by dental professionals other than dentists. A potentially more efficient model of care delivery would be an initial examination by a dental hygienist or therapist, who meets as many care needs as possible. Many care home residents would not need to see a dentist. Clinical Significance Use of dental hygienists
Monaghan NP, Morgan MZ: What proportion of dental care in care homes could be met by direct access to dental therapists or dental hygienists? Br Dent J 219:531-534, 2015
Reprints available from NP Monaghan, Dental Public Health, Public Health Wales, Temple of Peace and Health, Cardiff, CF10 3NW; e-mail: [email protected]