T levels - a new route into dentistry

Michael Wheeler explains the benefits of the new T level educational courses to the dental profession.


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Technical or T levels are new courses which will follow GSCEs and will be equivalent to three A levels.1 They will be one of the choices for students after completing their GCSEs along with:

  • Apprenticeships, for students who wish to learn a specific occupation 'on the job', having already made that career choice

  • A levels, for students who wish to continue their academic education.2

The concept of T levels or technical education reform came from the 'Report of the Independent Panel on Technical Education' chaired by David Sainsbury and published April 2016.3 T levels will provide an opportunity for individuals to undertake a mixture of classroom learning and 'on the job' experience for at least 45 days of the two-year course. T levels are currently planned in 25 main subject areas, ranging from accountancy to science.

They will provide the knowledge and experience needed to open the door for skilled employment, further study or an apprenticeship. More importantly, they will give individuals an opportunity to experience the wider skill sets available in a subject area, to give them a better opportunity to choose a career choice that may suit them better and which they may not even have known existed.

There are in fact nearly 350 individual job roles within healthcare in the United Kingdom.4 When health or the NHS is mentioned in the media, the focus is always on doctors and nurses, hardly ever dentists or dental nurses, let alone dental hygienists and dental therapists, dental technicians, orthodontic therapists or clincal dental technicians. T levels have been developed with employers and providers working together with the Department of Education (in England) and the Institute of Apprenticeships and Technical Education. T level courses are technical qualifications which will include the following compulsory elements:

  • Core theory, concepts and skills for an industry area eg health

  • Specialist skills for an industry area eg dental nurse or dental technician

  • An industry placement with an employer

  • A minimum standard in maths, english and digital skills (if not already achieved).

The exit award will be a T level in the subject area specialism, awarded by a nationally recognised educational awarding body. It will be graded with a pass, merit or distinction, with grades also highlighted to future employers within the core and specialist skills area.

The dental team is captured in two main subject areas:

  • Dental nurses - within the health subject area

  • Dental technicians - within the health and science subject area.

Awarding organisations for the health and health science subject areas will have to ensure that students have up to date knowledge of the legal and regulatory obligations relating to employment in the occupations relevant to the T level and understand the implications of these for their work. For example, a student undertaking the health subject area would learn about the role of the General Dental Council and other health regulatory bodies, the role of NHS Improvement and the Care Quality Commission.

They would undergo a disclosing and barring check and receive an occupational health screening and a hepatitis B vaccination, CPR and safeguarding training so they have undergone the necessary checks to take an active part in health care delivery during their industry placement. This will increase their employment chances on completion of the T level award.

The core content relates to the whole route pathway, eg the focus of the health subject area covers aspects such as:

  • The healthcare sector - diversity of employers, range of occupations, public health, national health policies

  • Providing person centred care - communication and listening skills, liberty protection safeguards, the six Cs: care, compassion, communication, courage, commitment and competence

  • Health and wellbeing - support a person's health comfort and wellbeing

  • Further science concepts - human anatomy and physiology, common diseases and disorders

  • Health and safety regulations applicable in the healthcare sector - health and safety regulations, first aid at work, manual handling

  • Infection prevention and control in health specific settings - use of personal protective equipment, hand washing, antimicrobial resistances, procedures in disinfection and sterilisation

  • Managing personal information - storing and protecting personal information.

The above core content will be very generic to a range of health care settings. During year two the student will choose an occupational specialism in the health sector these are:

  • Dental nursing

  • Supporting healthcare (healthcare assistant eg in a care home)

  • Supporting the adult nursing team

  • Supporting the midwifery team

  • Supporting the operating theatre team

  • Supporting the mental health team

  • Supporting the care of children and young people.

A student undertaking the dental nurse specialism for example will go on to learn specific skills and knowledge related to dental care and cover the following areas:

  • Legislation, regulations and health and safety eg, GDC Standards for the dental team, Scope of practice of individual dental team members

  • Infection control - centred on HTM 01-05

  • Instruments and equipment used in a dental surgery

  • Oral anatomy and physiology

  • Dental treatment procedures supporting the delivery of restorative, preventive dentistry and oral surgery

  • Duty of care - applied to the dental setting

  • Dental disease and its prevention - including advising patients.

The healthcare science route follows a similar pattern; the core component consists of the following:

  • Working within the health and science areas of employment, eg pathology, food, material and dental laboratories

  • Health, safety and environmental regulations

  • Managing information and data

  • Good scientific and clinical practice

  • Core science concepts eg cell biology, immunology, structure of materials and relationship with physical and chemical properties.

Students wishing to develop their skills in the area of dental technology will then focus on the following as their specialism:

  • Legislation, regulations and health and safety eg GDC Standards for the dental team, Scope of practice of individual dental team members

  • Safe operation and maintenance of instruments and equipment used in a dental laboratory

  • Oral anatomy and physiology

  • Dental laboratory procedures - casting models, making bite blocks, special trays

  • Duty of care - applied to the dental laboratory setting

  • Dental materials and emerging technology.

Completion of a T level will permit young people, especially those going on to an apprenticeship, to gain accredited prior learning for their study to date, providing them with an opportunity to complete their mandatory training in a quicker time.

The integration of dental nursing and dental technology into T levels is the first time the dental skills sets have been incorporated into a national education programme which highlights not only these professions but the wider dental team for future career opportunities.

T levels in digital production, design and development, design, surveying and planning and education will start to be delivered by training providers such as further education colleges and schools in 2020, with health-related T levels in 2021.

Although the core curriculum for both health and health science will be very knowledge based and require little specialist equipment, introduction of the specialism does provide a challenge for dentistry. Training providers will be mandated to provide the core health subject areas, but not all the specialisms; this will be down to local need. To ensure that dental nursing and dental technology and their skill sets are not forgotten about, local dental committees, dental hospitals, large dental corporates, large dental laboratory owners and local workforce action boards are encouraged to liaise with their local education providers.

For dental practice and dental laboratory owners as well as salaried services, employing a student who has completed a T level with a dental specialism provides them with an employee who is 'ready for work'. Not only will they have undergone the necessary health checks, safeguarding etc, they will have the basic knowledge, skills and behaviours to work in the dental environment, understand it and have made a career choice for the future, which should aid recruitment and retention.

For further information regarding T levels visit: https://www.instituteforapprenticeships.org/about/technical-education/


  1. 1.

    UK Government. Introduction of T levels updated 31 January 2019. Available at: https://www.gov.uk/government/publications/introduction-of-t-levels/introduction-of-t-levels (accessed April 2019).

  2. 2.

    UK Government. School leaving age. Available at: https://www.gov.uk/know-when-you-can-leave-school (accessed April 2019).

  3. 3.

    Department of Business, Innovation and Skills/Department of Education. Report of the Independent Panel on Technical Education. 2016. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/536046/Report_of_the_Independent_Panel_on_Technical_Education.pdf (accessed April 2019)

  4. 4.

    NHS Careers. Is a health career right for you? Leeds Health Education England. 2019. Available at : https://www.healthcareers.nhs.uk/career-planning/health-career-right-you (accessed April 2019).

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Correspondence to Michael Wheeler.

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Wheeler, M. T levels - a new route into dentistry. BDJ Team 6, 10–11 (2019). https://doi.org/10.1038/s41407-019-0104-8

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