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Scope of practice: orthodontic therapists

BDJ Team volume 5, Article number: 18057 (2018) | Download Citation

An up-to-date focus on the scope of practice of one group of dental care professionals (DCPs), as described by the General Dental Council (GDC).

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‘Scope of practice’ means what you are trained and competent to do. It describes the areas in which you have the knowledge, skills and experience to practise safely and effectively in the best interests of patients. The GDC's full document on the scope of practice of all dental registrants, published in 2013 and updated in 2017, can be found at https://www.gdc-uk.org/professionals/registers/reg-types.

Orthodontic therapists

Orthodontic therapists are registered dental professionals who carry out certain parts of orthodontic treatment under prescription from a dentist. For statistics, see Figs 1-2 and Table 1.

Figure 1: Orthodontic therapists on the GDC register (March 2018)
Figure 1
Figure 2: Orthodontic therapists by UK region (March 2018)
Figure 2
Table 1: Dental care professionals with more than one title (March 2018)

As an orthodontic therapist, you can undertake the following if you are trained, competent and indemnified:

  • Clean and prepare tooth surfaces ready for orthodontic treatment

  • Identify, select, use and maintain appropriate instruments

  • Insert passive removable orthodontic appliances

  • Insert removable appliances activated or adjusted by a dentist

  • Remove fixed appliances, orthodontic adhesives and cement

  • Identify, select, prepare and place auxiliaries

  • Take impressions

  • Pour, cast and trim study models

  • Make a patient's orthodontic appliance safe in the absence of a dentist

  • Fit orthodontic headgear

  • Fit orthodontic facebows which have been adjusted by a dentist

  • Take occlusal records including orthognathic facebow readings

  • Take intra and extra-oral photographs

  • Place brackets and bands

  • Prepare, insert, adjust and remove archwires previously prescribed or, where necessary, activated by a dentist

  • Give advice on appliance care and oral health instruction

  • Fit tooth separators

  • Fit bonded retainers

  • Carry out index of orthodontic treatment need (iotn) screening either under the direction of a dentist or direct to patients

  • Make appropriate referrals to other healthcare professionals

  • Keep full, accurate and contemporaneous patient records

  • Give appropriate patient advice.

Additional skills which orthodontic therapists could develop include:

  • Applying fluoride varnish to the prescription of a dentist

  • Repairing the acrylic component part of orthodontic appliances

  • Measuring and recording plaque indices

  • Removing sutures after the wound has been checked by a dentist.

Orthodontic therapists do not:

  • Modify prescribed archwires

  • Give local analgesia

  • Remove sub-gingival deposits

  • Re-cement crowns

  • Place temporary dressings

  • Diagnose disease

  • Treatment plan.

These tasks are reserved for dental hygienists, dental therapists or dentists.

Orthodontic therapists do not carry out laboratory work other than that listed above as that is reserved to dental technicians and clinical dental technicians (CDTs).

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https://doi.org/10.1038/bdjteam.2018.57

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