Our inability to provide local anaesthetic without a prescription or PGD is disadvantaging patients and holding our profession back

The continued disadvantages dental hygienists and dental therapists have faced by being denied the ability to provide Prescription Only Medicines necessary for effective patient treatment is a huge problem which has long held back our profession.  But recent developments may finally mean we can take a huge leap forward and get on with our job.

Last month, we reached an important milestone in the continued development of the role of dental hygienists and therapists in the UK. We were finally given the green light by NHS England Chief Professionals Office, to pursue our long-held quest to have the ability to provide the prescription only medicines (POM), specifically local anaesthetic, topical anaesthetic and fluoride varnish, to patients without having to first get a prescription from a dentist.

Over several months, the British Society of Dental Hygiene and Therapy (BSDHT) and the British Association of Dental Therapists (BADT) have collaborated to undertake a scoping process with NHS England assessing the need for use of further mechanisms to administer or supply POMs for our profession.

BADT and BSDHT are pursuing ‘exemptions to the Medicines Act. Exemptions would mean that a list of prescription only medicines would be specified in legislation for dental therapists and dental hygienists to administer or supply.

In the future, after necessary training, this means we would be able to provide local anaesthetic and fluoride in our daily practice without a Patient Specific Directive (PSD) or Patient Group Directive (PGD), a huge leap forward for our profession.

Many of us have experienced for some time the severe limitations in our inability to supply or administer local anaesthetics and fluoride varnishes without a prescription ourselves, leading to prolonged treatment for patients and the physical and emotional impact that this has. These are not only restricting our professions’ development but also our capability to provide the most timely and effective treatment for patients.

Being given permission to finally move forward on this vital issue is fantastic news for our profession and ultimately our patients. However, this is the beginning of a long road that we need to follow with persistence and passion if we are to enforce this change.

Patient care is suffering, as is our patient/ clinician relationship

Our priority is to our patients. Our years of training, Continued Professional Development and even the way we setup our practice, is designed to give our patients the best possible treatment, outcome and experience as possible and when we can’t do this it almost feels like a failure.

This is precisely the experience many of us have had when we cannot carry out the necessary treatment due to the prescribing dentist being unavailable. We may have had to leave them in discomfort or pain with instructions to come back another day to finish their treatment.

Our patients also don’t often understand why they have not got the treatment they need, even though they were in the chair with a qualified professional. This has a heavy impact on the ongoing relationships between patient and professional, even going so far as damaging our credibility. It is often not the prescribing dentists fault either as patients may present with different needs on the day they attend for our treatment than what we initially expected. By being allowed to supply or administer certain medicines in this way it will aid the smooth running of our practice and improve the patient’s experience. The dentist will be able to go about their day without the added complications of having to leave their patient to prescribe something which we are entirely capable of providing. The patient can get the treatment they need there and then, leaving the practice happy with the patients-professional relationship firmly intact.

Personal professional development

From a professional point of view, the ability to supply or administer local anaesthetic and fluoride varnish will be a major leap forward, one which will further cement our place as an integral part of the modern Healthcare profession.

Our profession is always eager to take on more responsibility, to further ourselves and, ultimately, provide an excellent service and this is an opportunity to do just this.

Our inability to provide what is integral to being able to do our day jobs is like telling a professional racing driver to drive but having to first get written permission to touch the steering wheel. It will seriously impede their ability to do their job. That is what it often feels like for us, we have the drive but the inability to direct.

Our role is an important cog in the machine of a successful dental environment, but we need to have the ability and freedom to carry out this role. Being able to provide certain medicines will mean we will be able to treat patients there and then preventing a re-referral for a prescription, take the extra appointment burden off the dentist and patient to ensure the practice runs more smoothly.

But to go forward with our ultimate goal we need the support of our members, non-members and the wider dental profession; this is where we need your help.

Call to action

The BSDHT and BADT now need the considerable voice of our profession to ensure we drive this vital change through, to do so we need to build our case of the need for the use of exemptions across this profession.

We want to hear how the inability to supply or administer certain medicines has so far impeded your ability to do you day-to-day job. Have you had to send away a patient with incomplete treatment because you cannot get a prescription? The more voices we can get behind this cause the better.

Please email prescribing@bsdht.org.uk with your experience and the impact it had on you, your patient and your practice. Speak to your colleagues, find out if this has affected them and tell us about it. There are no guarantees we will get what we want but we have to fight hard for what we need, please help us work hard to provide evidence for the future of our wonderful profession.

This will take time and it will take resources to enable a project lead be employed in order to drive this project forwards, as it is anticipated that this will have a life-span of at least 2 years. So in order to help fund this project, the BADT and BSDHT will also be fundraising via Crowdfunding. Our members have supported this project amazingly so far, but we want wider support, as being able to supply or administer the necessary POMs without a prescription, will benefit not just us to do our job, but it will benefit all dental hygienists and dental therapists for generations to come, it will also benefit the dentists the we work with, but ultimately, and most importantly it will benefit our patients by being able to treat them in the best possible way within our scope of practice. www.justgiving.com/crowdfunding/SubscribeToprescribe

Editors Notes




01788 575050


The British Society of Dental Hygiene and Therapy (BSDHT) is a nationally recognised body that represents over 4,000 Dental Hygienists and Dental Therapists across the UK and beyond.

BSDHT maintain an on-going dialogue with the General Dental Council (GDC), the Departments of Health and all of the main groups representing dental care professionals, and attends meetings of the All Party Parliamentary Group (APPG) for Dentistry, bringing dental hygiene and therapy to the attention of government ministers and MP’s.

Visit www.bsdht.org.uk for more information.

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