Clinical Crisis/ FAQ's

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

A. Previously dental hygienists and dental hygienist-therapists 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 dental hygienist or dental hygienist-therapist 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 the GDC's 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 dental 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.

Q. Can I set up my own hygienist practice?

A. Yes, you are now permitted to set up a hygienist practice. In fact, dental 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.

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 dental hygienist/ dental hygienist-therapist 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 dental hygienist/ dental hygienist-therapist to include advice to remind patients that they need a written referral from a dentist prior to treatment.