Scope of practice: dental hygienists

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    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).

    Dental hygienists

    Dental hygienists are registered dental professionals who help patients maintain their oral health by preventing and treating periodontal disease and promoting good oral health practice. They carry out treatment direct to patients or under prescription from a dentist. For statistics, see Figs 1-2 and Table 1.

    Figure 1

    Dental hygienists on the GDC register (March 2018)

    Figure 2

    Dental hygienists by UK region (March 2018)

    Table 1 Dental care professionals with more than one title (March 2018)

    As a dental hygienist, you can undertake the following if you are trained, competent and indemnified:

    • Provide dental hygiene care to a wide range of patients

    • Obtain a detailed dental history from patients and evaluate their medical history

    • Carry out a clinical examination within their competence

    • Complete periodontal examination and charting and use indices to screen and monitor periodontal disease

    • Diagnose and treatment plan within their competence

    • Prescribe radiographs

    • Take process and interpret various film views used in general dental practice

    • Plan the delivery of care for patients

    • Give appropriate patient advice

    • Provide preventive oral care to patients and liaise with dentists over the treatment of caries, periodontal disease and tooth wear

    • Undertake supragingival and subgingival scaling and root surface debridement using manual and powered instruments

    • Use appropriate anti-microbial therapy to manage plaque related diseases

    • Adjust restored surfaces in relation to periodontal treatment

    • Apply topical treatments and fissure sealants

    • Give patients advice on how to stop smoking

    • Take intra and extra-oral photographs

    • Give infiltration and inferior dental block analgesia

    • Place temporary dressings and re-cement crowns with temporary cement

    • Place rubber dam

    • Take impressions

    • Care of implants and treatment of peri-implant tissues

    • Identify anatomical features, recognise abnormalities and interpret common pathology

    • Carry out oral cancer screening

    • If necessary, refer patients to other healthcare professionals

    • Keep full, accurate and contemporaneous patient records

    • If working on prescription, vary the detail but not the direction of the prescription according to patient needs.

    Additional skills which dental hygienists might develop include:

    • Tooth whitening to the prescription of a dentist

    • Administering inhalation sedation

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

    Dental hygienists do not:

    • Restore teeth

    • Carry out pulp treatments

    • Adjust unrestored surfaces

    • Extract teeth.

    Other skills are reserved to orthodontic therapists, dental technicians, clinical dental technicians or dentists.

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    Scope of practice: dental hygienists. BDJ Team 5, 18072 (2018) doi:10.1038/bdjteam.2018.72

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