Elsevier

Dental Abstracts

Volume 62, Issue 5, September–October 2017, Pages 262-263
Dental Abstracts

The Big Picture
Status of expanded function mid-level providers

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Background

Nearly 4 years ago the General Dental Council (GDC) in the United Kingdom abolished the requirement that patients be referred by a dentist to seek care from a dental hygienist or therapist. Many dentists remain unconvinced that direct access is a good idea, expressing concerns regarding having hygienists and dually qualified hygienist/therapists do diagnosis and treatment planning, perform risk assessments, make referral decisions, and (for therapists) place restorations. These concerns are

Methods

The 243 GDC-registered hygienists and dually qualified hygienist/therapists were identified through a Google search. Each received an online survey through the University of Edinburgh, and those not completing the survey were contacted by mail. The final sample consisted of 86 respondents (response rate of 48% based on an initial response of 179 individuals).

Results

Seventy-three percent of the respondents reported having a very favorable view of the GDC’s decision to permit direct access. Eighty-one percent believed that there were advantages for the hygienists and therapists involved, whereas 80% saw advantages for dentists (Fig 4).

The impact of direct access was evaluated on the basis of various aspects of care by 80 of the respondents whose practice situations offered direct access to care. Ninety percent said direct access patients formed a small

Discussion

Although many of the comments were positive, the survey indicated that there are some areas that are lacking in the view of these dental hygienists and therapists. In particular, they would like to have more training, more support from dental nurses and other personnel, and a change to the regulations regarding periodontal treatment delivery.

Clinical Significance

There is obviously some frustration on the part of these expanded duty dental practitioners, but the results they achieve, the care

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Turner S, Ross M: Direct access: How is it working? Br Dent J 222:191-197, 2017

Reprints available from S Turner, Univ of Edinburgh, Edinburgh Dental Inst, 4th Flr, Lauriston Bldg, Lauriston Pl, Edinburgh, EH3 9HA; e-mail: [email protected]

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