Key Points
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This study suggests that a relatively small proportion of care delivered can be defined as 'complex restorative treatment'.
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There is considerable potential for delegation of care to dental hygienists and therapists.
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The findings assume that all the care currently provided is clinically necessary and appropriate.
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Further work is required on the economic aspects of employing dental hygienists and therapists in general dental practice.
Abstract
This study describes the proportion and volume of work undertaken in primary dental care that could be delegated to hygienists and therapists.
Methods Data on treatment provision, both NHS and private, over one course of treatment for 850 consecutively attending patients at 17 dental practices, selected to be representative of a range of socioeconomic, urban and rural environments, were extracted from case records.
Results The 850 patients attended on 2,433 occasions. Diagnostic examination accounted for 833 (34.2%) visits, while simple, intermediate and complex restorative interventions and other complex interventions accounted for 500 (20.5%), 361 (14.8%), 365 (15%) and 374 (15.4%) visits respectively. The total time required to provide the care was 42,800 minutes, of which 6,550 (15.3%) were devoted to diagnostic examinations, while 10,485 (24.5%), 7,935 (18.5%) and 11,790 (27.5%) were taken up with simple, intermediate and complex restorative care. Other complex interventions accounted for 6,040 (14.2%) minutes. Assuming that dental therapists are permitted to undertake simple and intermediate restorative interventions, they could provide 35.3% of care when number of visits is utilised as the outcome measure, but 43% of the clinical time taken to provide care. Delegation of diagnostic and treatment planning powers to dental therapists could potentially result in 69.5% of visits and 58.3% of clinical time being provided by therapists.
Conclusion These data imply that a considerable proportion of work in UK general dental practice could be delegated to dental hygienists and therapists.
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Evans, C., Chestnutt, I. & Chadwick, B. The potential for delegation of clinical care in general dental practice. Br Dent J 203, 695–699 (2007). https://doi.org/10.1038/bdj.2007.1111
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DOI: https://doi.org/10.1038/bdj.2007.1111
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