Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

The role of dental hygienists and therapists in paediatric oral healthcare in Scotland


Introduction The scope of practice of qualified dental hygienists and therapists allows them to undertake non-surgical periodontal screening, treatment and preventive care, and to diagnose and treatment plan. Therapists are also qualified to restore primary and secondary teeth, and to extract primary teeth. Both professions may see patients directly without needing a dentist's referral. In Scotland, they operate in a context of relatively poor but improving child oral health.

Aim To investigate provision of dental care to children, including challenges encountered, by dental hygienists and therapists in the Scottish General Dental Service (GDS).

Method An online survey of Scotland-based, GDC-registered dental hygienists and therapists in the GDS.

Results Of 426 potential respondents, 194 (46%) responded, including 113 hygienists. Thirty hygienists and six therapists did not currently see child patients. Lack of referrals from dentists/specialisation by other team members, financial/contract reasons and lack of demand were the reasons given. Of those who did see children, most were therapists. Responsibility for preventive paediatric care was evenly split, with 71 (46%) citing the hygienist or therapist and 69 (45%) the dentist. Sixty-five (43%) reported barriers, most commonly relating to parents and children themselves. Time pressures, cost implications for practice and parents, and a number of practice and regulatory barriers were also mentioned.

Discussion The response rate is considered to be very good. Limiting factors regarding provision of paediatric dental care include lack of referrals from GDPs and financial or contractual issues.

Conclusion There appears to be considerable underuse of hygienists and therapists in respect to paediatric dental care.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Fig. 1
Fig. 2
Fig. 3
Fig. 4


  1. 1.

    Scottish Dental Epidemiological Co-ordinating Committee. Scotland's National Dental Inspection Programme. 2003. Available at (accessed February 2020).

  2. 2.

    Scottish Government. An Action Plan for Improving Oral Health and Modernising NHS Dental Services in Scotland. 2005. Available online at (accessed October 2016).

  3. 3.

    NDIP, ISD Scotland and NHS Scotland. National Dental Inspection Programme (NDIP) 2014: Report of the 2014 Detailed National Dental Inspection Programme of Primary 1 children and the Basic Inspection of Primary 1 and Primary 7 children. 2014. Available at (accessed February 2020).

  4. 4.

    Health and Social Care Information Centre. Children's Dental Health Survey: Executive Summary - England, Wales and Northern Ireland. 2013. Available at (accessed February 2020).

  5. 5.

    General Dental Council. Direct access. 2019. Available at (accessed February 2020).

  6. 6.

    Nuffield Foundation. Education and Training of Personnel Auxiliary to Dentistry. London: Nuffield Foundation, 1993.

  7. 7.

    Koh R, Pukallus M, Kularatna S et al. Relative cost-effectiveness of home visits and telephone contacts in preventing early childhood caries. Community Dent Oral Epidemiol 2015; 43: 560-568.

  8. 8.

    Arrow P; Klobas E. Minimum intervention dentistry approach to managing early childhood caries: a randomized control trial. Community Dent Oral Epidemiol 2015; 43: 511-520.

  9. 9.

    Teusner D N, Amarasena N, Satur J, Chrisopoulos S, Brennan D S. Dental service provision by oral health therapists, dental hygienists and dental therapists in Australia: implications for workforce modelling. Community Dent Health 2016; 33: 15-22.

  10. 10.

    Dyer T A, Owens J, Robinson P G. The acceptability of care delegation in skill-mix: the salience of trust. Health Policy 2014; 117: 170-178.

  11. 11.

    Jackson G. Placement of Preformed Metal Crowns on Carious Primary Molars by Dental Hygiene/Therapy Vocational Trainees in Scotland: A Service Evaluation Assessing Patient and Parent Satisfaction. Prim Dent J 2015; 4: 46-51.

  12. 12.

    Ward P. The changing skill mix - experiences on the introduction of the dental therapist into general dental practice. Br Dent J 2006; 200: 193-197.

  13. 13.

    Ross M K, Ibbetson R, Turner S. The acceptability of dually-qualified dental hygienist-therapists by General Dental Practitioners in South East Scotland. Br Dent J 2007;DOI: 10.1038/bdj.2007.45.

  14. 14.

    Ross M K, Turner S, Ibbetson R J. The impact of teamworking on the knowledge and attitudes of final year dental students. Br Dent J 2009; 206: 163-167.

  15. 15.

    Nash D A, Friedman J W, Mathu-Muju K R et al. A review of the global literature on dental therapists. Community Dent Oral Epidemiol 2014; 42: 1-10.

  16. 16.

    Barnes E, Bullock A, Chestnutt I G, Cowpe J, Moons K, Warren W. Dental therapists in general dental practice. A literature review and case-study analysis to determine what works, why, how and in what circumstances. Eur J Dent Educ 2020; 24: 109-120.

  17. 17.

    Ross M K. Muddy water or a clear horizon? FDJ 2015; 6: 74-77.

  18. 18.

    Scottish Dental Needs Assessment Programme. Oral Health and Dental Services for Children: Needs Assessment Report. 2017. Available at (accessed July 2020).

Download references

Author information



Corresponding author

Correspondence to Stephen Turner.

Electronic supplementary material

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Turner, S., Symeonoglou, P. & Ross, M. The role of dental hygienists and therapists in paediatric oral healthcare in Scotland. Br Dent J (2020).

Download citation


Quick links