Q. I've heard that a treatment plan can last for three years?  Is that correct?

A. Previously hygienists worked to a written prescription from a dentist which was valid for up to 12 months only.  Now called a treatment plan, it can be valid for up to three years.  On the day of a patient's full mouth assessment, the examining dentist will confirm the date of the next reassessment with a dentist, depending on the patient's clinical needs.  However, the hygienist will have the option of recalling the patient during this time, depending on their preventive or periodontal needs.

Q. What exactly is a treatment plan and how does it work?

A. The treatment plan is written* on the day of the patient's full mouth assessment with the dentist.  The plan could be as simple as a statement: 'that the patient has good oral health and needs routine oral care for the next three years' or a more detailed plan for complex cases which would require a shorter interval for reassessment with the referring dentist.

* this may be handwritten or transcribed onto a computer, in line with practice protocol. 

Q. What should the treatment plan include?

• Date of assessment
• Outline or full treatment plan
• Recall intervals (how often the patient should be seen by a member of the dental team)
• Date of the next full mouth reassessment by the dentist
• A referral to another member of the dental team - for hygienists this replaces 'the written prescription'.

When referring to another member of the dental team eg. dental hygienist, the dentist can delegate responsibility to that professional for setting recall intervals. 

Q. If I've got concerns about a patient, should I refer?

A. If you feel concerned or unhappy about any aspect of a patient's health, refer back to the referring dentist. 

Q. I have a nurse working with me in the surgery.  Am I responsible for his/her actions?

A. Each registrant is responsible for their own actions. However, you are responsible for any team member you lead or manage who isn't registered with the GDC eg. receptionists and practice managers.  It is essential that they are also familiar with Standards for Dental Professionals. 

Q. I have been asked to provide a type of treatment that I'm not totally comfortable with, as my basic training didn't include it.  What's the best course of action?

A. Only carry out a task or treatment if you are sure that you have been trained and are competent to do so.  If you are not, go back to the referring dentist and explain the situation, possibly suggesting a training course to enable you to extend your skills, where appropriate. 

If you intend to undertake additional training, always ensure that it is appropriate to your needs and is validated/ organised by a reputable company or organisation. Retain any certificates of attendance in your CPD records.

If you are in doubt about the validity of a course, talk to your professional indemnity insurer.

Q.  I would like to do bleaching.  Is this now permitted?

A. The GDC has recently announced that dental hygienists and hygienist-therapists are permitted to carry out tooth bleaching, subject to appropriate training.  When choosing a course please ensure that the provider is reputable and that the training has clear aims and objectives. 

BSDHT is in the process of providing courses, to register your intereste please click on the link found on the left side of this page.

Q. Should I have a nurse in the surgery with me when treating patients?

A. In case of emergency, it is essential to have access to another dental team member who is familiar with procedures to deal with dental emergencies, ie. another registered team member.

Q. Can I set up my own hygienist practice?

A. Yes, you are now permitted to set up a hygienist practice. In fact, hygienists have been allowed to set up referral practices for some time. However, a patient must have had a full mouth assessment by dentist and a written treatment plan (outline or in full) before you see them.  

If you are intending to set up in practice, make sure you take advice on business and financial planning, and that you are aware of the rules and regulations that will affect your business.  You may find it helpful to contact your local Business Link office for help and guidance.

BDHA has received many enquiries from hygienists about setting up a hygienist practice. In response to this, the Scciety has arranged appropriate speakers on this subject for the annual conference in Harrogate this year (17 & 18 November) - please see our website for more details (www.bsdht.org.uk) or request information from the office (0870 243 0752).

Q. Can I advertise to potential patients?

A. The General Dental Council no longer issues guidance on advertising.  It would be perfectly acceptable in the eyes of the GDC for a hygienist or any registrant to advertise their services and give details of the treatments that they were able to offer in a brochure. The only caveat in this situation would be that a registrant should not advertise treatments that they are not sufficiently trained or competent to carry out. In addition, it would be advisable for a hygienist to include advice to remind patients that they need a written referral form a dentist prior to treatment.

Q. Is CPD mandatory now?

A. Yes, mandatory CPD began on 1 August 2008. Further details can be found in the CPD section of this website.