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Star Letter

The role of Professionals Complementary to Dentistry (PCDs) has changed quite radically in recent times and further changes are likely in the foreseeable future. Both hygienists and therapists now have increased clinical responsibilities, but perhaps one of the most interesting developments of late, has been the emergence of jointly qualified dental hygienist/therapists, or oral health practitioners which may be an appropriate designation for those holding a dual qualification. These skilled individuals, who have expertise in periodontal, preventive and restorative care, are equipped to undertake much of the routine dentistry for both the child and adult population, thus allowing the dentist to focus on more specialised work. Given the apparent shortage of dentists throughout the UK, these professionals are in a position to make a significant contribution to the delivery of oral healthcare, and undertake procedures that historically, have been in the domain of the dentist.

In comparison with medicine, dentistry has lacked vision in terms of patient care. Medicine has developed to the extent of now having nurse practitioners, specialists and consultants and indeed, in more remote and rural areas of the country, much of routine medical care is undertaken by individuals who have received appropriate training. Perhaps the clinical role of PCDs should be extended further to improve the service to the patient. The need for hygienists and oral health practitioners to work from a prescription is a hindrance, as is the need for a dentist to be on the premises whilst certain procedures are being done. The benefits of being able to administer inferior dental block analgesia to a patient are obvious, but the need for a dentist to be on-site is less clear. The role of the dental nurse could also be expanded significantly to allow them, again following appropriate training, to undertake more clinically involved procedures in line with nurses in medicine. Examples of these could be impression taking, placement of temporary restorations, suture removal and even administration of local analgesia.

The modernisation of dentistry throughout the UK dictates that the existing workforce takes into account the substantial contribution which can be made by PCDs in addressing the unacceptable levels of disease that exist in many parts of the country. These are exciting times in the education and career development of PCDs, and we should embrace the change and associated challenge that lies ahead for all involved in patient care!

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