By Fiona Ellwood

The Society of British Dental Nurses continues to raise awareness of Dental Support Workers1 and questions why these individuals are not following a training pathway that would enhance the current dental nursing workforce.

Prior to mandatory registration, City and Guilds provided a level 2 in dental nursing, which was such a vital step for those entering into the field of dentistry either straight from school or as a second career. Sadly, it did not meet the requirement to enable individuals to work chairside or become registrants - perhaps just simply poor timing. Still, it allowed individuals and the team to work together and make informed decisions for the workplace.

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As we battle to attract people into the profession,2 surely we need to think differently, but is the Dental Support Worker role muddying the waters here? We are keen to understand what their role is, particularly as this role is now apparent in both England and Scotland3 and because it appears to be focused on dental nursing skills. More than this we also hope to explore where and how these support workers are being employed and what it is that allows them to undertake all of the activities assigned to them, without being on a training pathway for dental nurses.

The dental nurse student

Student dental nurses are generally employed and undertake all dental nursing primary duties under the supervision of a dentist and other members of the team who are trained to supervise and support the students.4 Working alongside a registered and knowledgeable dental nurse is so important and it has the potential to provide the student with a greater chance of being successful in their qualification and a confident practitioner.

Dental nurse students must be either ‘in training' and that means in training in the workplace and waiting to begin training on an approved General Dental Council (GDC) training course or someone undertaking an approved dental nurse training course, who is employed. Those in training must be supervised and mentored throughout their training. The level of support and supervision provision depends on their skill sets and the progression of the individual. The student should be included in their training pathway design and the decisions that are made.

Commonly, the approved dental nursing courses tend to be set at level 3 or are equivalent to a level 3 qualification, although there are a number of higher level dental nursing courses that are becoming more popular. Most courses take 12-24 months to complete and are framed as work-based learning vocational courses. On completion, students can apply to become registrants of the GDC.

When you compare the role of the student dental nurse with the dental support worker in Table 1, and the role of the health care support worker in Scotland in Box 1, you can see why the Society is concerned. We feel it is important to highlight that the Society seeks to gain reassurance that these individuals will be well trained and have clarity of their role and responsibilities, as well as their limitations - this is of equal importance. It is also important that there is an obvious difference for patients so that they can be confident that the dental nurse supporting them is a registered dental professional or a dental nurse student in training, whilst the support worker supports the professional team.

Table 1 The role of student dental nurse compared to the role of dental support worker
Full size table

The Society is questioning the use of the title, given that the term ‘dental' must be approved for use by the GDC, and believes that the scope of their work and the support to clinicians could be misleading and confusing for patients. There is also the potential for mission creep on the one hand and the risk of these roles being abused on the other. Patient safety has to be a priority and that is associated with the safe and effective delivery of care and the maintenance of a safe working environment, with excellent infection prevention and control and clinical governance.

The Society is baffled as to why the investment is not forthcoming to train and support those already in the profession or who wish to train.

Support workers, assistants, and associates are certainly trending again, but unless they become part of the solution and head into traineeship with a career to aim for, we are just as likely to see a high turnover of dental support workers and feel the repercussions from the dental nurse registrants. What we must not see is dental nurse substitution; this is a backward step in our eyes. The Society is baffled as to why the investment is not forthcoming to train and support those already in the profession or who wish to train.

On a final note, the Society is also considering the impact on the professional status of the existing workforce. Registration was a long time coming and it came with a price tag and what we can be sure about is that we need to do more to encourage people to join the profession and provide opportunities for success so that they stay.

The Society has brought this to the attention of the GDC on more than one occasion. We would be delighted to receive feedback on these thoughts. Visit www.sbdn.org.uk.