Nutrition and dental care

Dental care – Who will look after your teeth?


The provision of dental care in the UK is changing and this short text aims to inform the general public about these changes, and update knowledge of who does what in dentistry!

Historically, dental treatment was predominantly undertaken by dentists, some of whom may have employed a dental hygienist, in addition to a dental nurse, to undertake more specialised periodontal (gum) treatment and preventive care.


One of the best ways to look after your health is to look after your teeth. As you get older, if you’ve looked after your teeth, you look better and feel better about yourself. Your face doesn’t look as drawn and you can eat and talk easier. Regular visits to dentists such as Eclipse Dental Care to look after your smile can make the world of difference to how you feel. If you don’t look after your teeth, tooth decay, gum disease and all sorts of oral problems are likely to occur, leaving you with blackened teeth, gaps in your smile, and disease. Throughout your life there it is imperative that you look after your teeth.  


However, recent developments now mean that a number of dental professionals in addition to hygienists, may be involved in the delivery of treatment for different groups of patients.

Dental Care Professionals (BDA) are made up of a group of individuals who are directly or indirectly involved in the dental and oral care of the public. The role of this increasingly important group has changed significantly in recent times, and further changes are likely in the foreseeable future. The modernisation of dentistry throughout the UK dictates that the existing workforce takes account of the substantial contribution which can be made by BDA, in addressing the unacceptable levels of dental and oral disease which exist in many parts of the country.

The generic group of BDA is made up of dental nurses, dental hygienists, dental therapists, dually qualified hygienist-therapists and dental technicians. Two new groups of professionals are about to join this group, these being clinical dental technicians and orthodontic therapists. As from 31st July 2012, all BDA will be statutorily registered with the General Dental Council.


Prior to this, only dentists, dental hygienists, therapists and hygienist-therapists had to undergo this, but registration of all groups of professionals will ensure further protection to the public, and an assurance that individuals have undertaken appropriate training thus allowing them to enter the register. It is perhaps useful to describe the role of each individual within the dental team to establish their clinical remit, so that the public is aware of the professional position of each team member.


Dental nurse
Dental nurses play a major role in the care of patients and provide clinical support to other members of the dental team by assisting in numerous clinical procedures in all areas of dentistry. These may be in specialist teams, for example oral surgery or orthodontics, or in a more generalised field such as in general dental practice or the salaried dental services.


They are skilled individuals who ensure a high standard of infection control within the clinical environment and promote and maintain health and safety in the workplace. A large number of dental nurses hold additional specialist qualifications for example in oral health education and promotion, special care dentistry, radiography and sedation, amongst others. Often, dental nurses with a qualification in oral health promotion and education are involved in teaching patients about how disease develops and how to avoid it, making communication a very important part of their role.


Dental hygienist
Dental hygienists undertake a two year training programme and are clinical practitioners whose considerable expertise lies in the prevention of caries (tooth decay) and the treatment and prevention of periodontal (gum) disease. They are also educated to identify other oral conditions that may occur in the mouth which may require referral to a specialist, and to undertake smoking cessation techniques for patients in the prevention of oral cancer.


In addition to having an educational role in disease prevention, they are able to work in all sectors of dentistry and carry out treatment for both adult and child patients. They undertake a rigorous training programme and, on completion of their education, they are awarded a Diploma in Dental Hygiene. A number of dental hygienists hold qualifications in other health-care related disciplines, for example health education and promotion & public health.


Dually qualified hygienist-therapist
In response to the acknowledged lack of dentists throughout the UK, the hygienist training programme has been extended to include teaching in restorative procedures for both the child and adult population. These dually-qualified personnel undertake comprehensive education which, on completion of either a 27 month programme in a dental hospital or a BSc in Oral Health Science in a University dental school, renders them competent to treat much of the routine dental disease which exists in the population.


Their clinical training, in terms of restoring teeth with fillings is comparable with that which dentists receive during their undergraduate programme. This means that dentists are in a position to undertake more specialised procedures, for example crowns, bridges, implants and root canal treatments.

Recent changes to the legislation governing the practice of BDAs, particularly in relation to those who can work in the patient’s mouth i.e. dental hygienists, hygienist-therapists and clinical dental technicians, means that they are now able to conduct the ‘business of dentistry’. As a result of this, they will be able to open their own practices and accept money directly from patients for treatment they have provided. Clearly, this will mean that access to dental care for patients will be more widely available, which is a very positive development.


This move has been supported by the Office of Fair Trading since 2013, and simply means that patients may well have much, or all of their treatment carried out by a hygienist-therapist and not by a dentist, as was likely to be the case in the past.


Of course, should a patient present with a problem which is outwith the clinical remit of the hygienist-therapist, they would automatically be referred on to the appropriate person, who could either be a dentist or other specialist. This can be likened to medicine where often nurse practitioners, nurse consultants and nurses specialists are responsible for much of the required treatment, but they liaise and communicate with the doctor, referring on as required.

As the situation stands at the moment, a patient will still initially have to be examined by a dentist, but thereafter, they will not be bound to have their treatment carried out by the same dentist. This means they can attend an appropriately qualified BDA of their choice to have treatment completed.


This has been compared to the practice of opticians where a prescription is given to the patient, and the patient has the freedom to attend whoever they so wish for the provision of eyewear. It is likely that the number of hygienist-therapists in training will increase and, as a result, they will become much more apparent in the dental workforce, and patients will consequently be more familiar with their role in the dental team.


Dental technician
Dental Technicians are healthcare professionals whose scope of work includes the design, construction, repair or alteration of dental appliances or prostheses. These prostheses include crowns, bridges, veneers, dentures, implants and other appliances which may be necessary as part of the sophisticated technology which is involved in dentistry of today.


They work in commercial laboratories, dental practices, hospitals and the Armed Forces and undertake work prescribed by a dentist. They are the experts in terms of the technological aspects of patient care and often, they specialise in one area of dentistry.


More on keeping you mouth clean and your teeth and gums healthy to provide better health-efficiency