Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Research
  • Published:

The perceptions and attitudes of qualified dental therapists towards a diagnostic role in the provision of paediatric dental care

British Dental Journal (2022)Cite this article

A Correction to this article was published on 12 August 2022

This article has been updated

Abstract

Objectives This study explored the perceptions and attitudes of qualified UK dental therapists (DTs) to act in a diagnostic role in the dental care of paediatric patients.

Methods A mixed methods study. An electronic questionnaire was sent out to the members of associations and closed social networking groups for qualified DTs across the UK. The questionnaire explored the training, clinical experience and working practices of the participants and measured their agreements with applicable statements using Likert scale scores. Semi-structured interviews were also undertaken to explore how UK DTs perceived a diagnostic role for them and what barriers and facilitators they experienced.

Results A total of 155 questionnaire responses were returned and 11 interviews conducted. Participants were mostly women (94.8%) with a broad range of working experience, with a mean experience of 9.5 years (± 8.8 standard deviation [SD]) (range: 1-42 years). From the questionnaires, when asked to score agreement on a Likert scale from 0-5, DTs agreed that in a diagnostic role, they could increase access to dentistry for patients and a high proportion were in agreement that they had the knowledge to carry out examination (mean = 4.43 ± 0.87 SD), diagnosis (mean = 4.37 ± 0.90 SD) and care planning for paediatric patients (mean = 2.74 ± 1.32 SD). The interviews yielded three qualitative supra themes: 'working in the UK as a DT today'; 'the perceptions of dental therapists on acting in a diagnostic role in paediatric dental care'; and 'barriers and facilitators to acting in a diagnostic role' and within these, eight major themes were identified.

Conclusion Within the limitations of a small sample who were representative of the workforce demographic and educational structures, we found that DTs felt that if they were to act in a diagnostic role, it would improve access to dental services benefitting patients, dentists and the DT profession. DTs identified and explored barriers and facilitators to a diagnostic role. Change is required to overcome these barriers in order to support DTs to act in a front-line diagnostic role.

Key points

  • Dental therapists believe that if they were to operate in a diagnostic role, there would be an increase in access to dental services.

  • Dental therapists believe that there would be benefits to patients, dentists and the profession if they were to operate in a diagnostic role.

  • Dental therapists identify that there are barriers to a diagnostic role, including: the business of dentistry; the perceptions of dentists and patients, which include a lack of awareness from patients; and the dental therapists' remit.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

Change history

References

  1. Pine C M, Harris R V, Burnside G, Merrett M C W. An investigation of the relationship between untreated decayed teeth and dental sepsis in 5-year-old children. Br Dent J 2006; 200: 45-47.

  2. Scottish Dental Clinical Effectiveness Programme. Prevention and Management of Dental Caries in Children: Dental Clinical Guidance. 2018. Available at https://www.sdcep.org.uk/media/2zbkrdkg/sdcep-prevention-and-management-of-dental-caries-in-children-2nd-edition.pdf (accessed October 2019).

  3. NHS Digital. NHS Dental Statistics for England 2019-2020, Biannual Report. 2020. Available at https://digital.nhs.uk/data-and-information/publications/statistical/nhs-dental-statistics/2019-20-biannual-report# (accessed February 2020).

  4. National Institute for Health and Care Excellence. Dental checks: intervals between oral health reviews. 2004. Available at https://www.nice.org.uk/guidance/CG19 (accessed February 2020).

  5. UK Government. Hospital tooth extractions of 0 to 19 year olds. 2019. Available at https://www.gov.uk/government/publications/hospital-tooth-extractions-of-0-to-19-year-olds (accessed June 2022).

  6. NHS England. The NHS belongs to the people: A call to action.2013. Available at https://www.england.nhs.uk/wp-content/uploads/2013/07/nhs-belongs.pdf (accessed November 2020).

  7. James Lind Alliance. Oral and Dental Health: The Top Ten Priorities. 2018. Available at https://www.jla.nihr.ac.uk/priority-setting-partnerships/oral-and-dental-health/ (accessed April 2019).

  8. Gallagher J E, Lim Z, Harper P R. Workforce skill mix: modelling the potential for dental therapists in state-funded primary dental care. Int Dent J 2013; 63: 57-64.

  9. Hill H, Macey R, Brocklehurst P. A Markov model assessing the impact on primary care practice revenues and patient's health when using mid-level providers, lesson learned from the United Kingdom. J Public Health Dent 2017; 77: 334-343.

  10. Wanyonyi K L, Radford D R, Harper P R, Gallagher J E. Alternative scenarios: harnessing mid-level providers and evidence-based practice in primary dental care in England through operation research. Hum Resour Health 2015; 13: 78.

  11. Sadura Z, Hanks S, Tredwin C, McColl E. The dental therapist's role in a 'shared care' approach to optimise clinical outcomes. Br Dent J 2021; 231: 104-108.

  12. Evans C, Chestnutt I G, Chadwick B L. The potential for delegation of clinical care in general dental practice. Br Dent J 2007; 203: 695-699.

  13. Nash D A, Friedman J W, Kardos T B et al. Dental therapists: a global perspective. Int Dent J 2008; 58: 61-70.

  14. General Dental Council. Guidance on Direct Access. 2020. Available at https://www.gdc-uk.org/docs/default-source/direct-access/direct-access-guidance.pdf?sfvrsn=f45d8a83_4 (accessed February 2020).

  15. Quach J D D, Radford D R, Louca C. The viability of a diagnostic role for dental hygienists and dental therapists in the UK: a review of the literature. Med Res Archives 2020; 8: 1-9.

  16. UK Data Service. Variable and question bank. Available at https://discover.ukdataservice.ac.uk/variables (accessed April 2019).

  17. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006; 3: 77-101.

  18. Berger R. Now I see it, now I don't: researcher's position and reflexivity in qualitative research. Qual Res 2015; 15: 219-234.

  19. General Dental Council. Registration reports. 2020. Available at https://www.gdc-uk.org/about-us/what-we-do/the-registers/registration-reports (accessed August 2020).

  20. Godson J H, Williams S A, Csikar J I, Bradley S, Rowbotham J S. Dental therapy in the United Kingdom: part 2. A survey of reported working practices. Br Dent J 2009; 207: 417-423.

  21. Turner S, Ross M K, Ibbetson R J. Dental hygienists and therapists: how much professional autonomy do they have? How much do they want? Results from a UK survey. Br Dent J 2011; DOI: 10.1038/sj.bdj.2011.387.

  22. Holmes R D, Burford B, Vance G. Development and retention of the dental workforce: findings from a regional workforce survey and symposium in England. BMC Health Serv Res 2020; 20: 255.

  23. Macey R, Glenny A M, Brocklehurst P. Feasibility study: assessing the efficacy and social acceptability of using dental hygienist-therapists as front-line clinicians. Br Dent J 2016; 221: 717-721.

  24. Csikar J I, Bradley S, Williams S A, Godson J H, Rowbotham J S. Dental therapy in the United Kingdom: part 4. Teamwork-is it working for dental therapists? Br Dent J 2009; 207: 529-536.

  25. Dyer T A, Humphris G, Robinson P G. Public awareness and social acceptability of dental therapists. Br Dent J 2010; DOI: 10.1038/sj.bdj.2010.1.

  26. Turner S, Tripathee S, MacGillivray S. Direct access to DCPs: what are the potential risks and benefits? Br Dent J 2013; 215: 577-582.

  27. Ross M, Turner S. Direct access in the UK: what do dentists really think? Br Dent J 2015; 218: 641-647.

  28. General Dental Council. Scope of Practice Review: Final Report. 2020. Available at https://www.gdc-uk.org/docs/default-source/research/scope-of-practice-guidance.pdf?sfvrsn=7b3d8e58_4 (accessed July 2020).

  29. Barnes E, Bullock A, Chestnutt I G, Cowpe J, Moons K, Warren W. Dental therapists in general dental practice. A literature review and case-study analysis to determine what works, why, how and in what circumstances. Eur J Dent Educ 2020; 24: 109-120.

  30. Ross M K, Ibbetson R J, Turner S. The acceptability of dually-qualified dental hygienist-therapists to general dental practitioners in South-East Scotland. Br Dent J 2007; DOI: 10.1038/bdj.2007.45.

  31. Turner S, Symeonoglou P, Ross M K. The role of dental hygienists and therapists in paediatric oral healthcare in Scotland. Br Dent J 2020; DOI: 10.1038/s41415-020-1980-1.

  32. Shorten A, Smith J. Mixed methods research: expanding the evidence base. Evid Based Nurs 2017; 20: 74-75.

  33. Rahman M. The Advantages and Disadvantages of Using Qualitative and Quantitative Approaches and Methods in Language 'Testing and Assessment' Research: A Literature Review. J Educ Learn 2016; DOI: 10.5539/jel.v6n1p102.

Download references

Acknowledgements

The authors would like to thank the volunteer interviewees for their participation, as well as the British Society of Dental Hygiene and Therapy for their support in recruiting participants.

Author information

Authors and Affiliations

  1. Special Care Dental Therapist, Special Care Dental Services, Sussex Community NHS Foundation Trust, UK

    Joshua D. D. Quach

  2. Clinical Senior Lecturer in Dental Public Health, Queen Mary University of London, Institute of Dentistry, Centre for Dental Public Health and Primary Care, Barts and The London School of Medicine and Dentistry, London, E1 2AD, UK

    Kristina Wanyonyi-Kay

  3. Principal Lecturer, University of Portsmouth Dental Academy, Faculty of Science and Health, University of Portsmouth, Portsmouth, PO1 2QG, UK; Honorary Tutor, Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, SE1 9RT, UK

    David R. Radford

  4. Professor, Director and Head, University of Portsmouth Dental Academy, Faculty of Science and Health, University of Portsmouth, PO1 2QG, UK

    Chris Louca

Authors
  1. Joshua D. D. Quach
    View author publications

    Search author on:PubMed Google Scholar

  2. Kristina Wanyonyi-Kay
    View author publications

    Search author on:PubMed Google Scholar

  3. David R. Radford
    View author publications

    Search author on:PubMed Google Scholar

  4. Chris Louca
    View author publications

    Search author on:PubMed Google Scholar

Contributions

Joshua Quach was involved in all stages of the research process, including research design, recruitment, interviewing, analysis and writing of the research manuscript. Kristina Wanyonyi Kay acted as research and academic supervisor to Joshua Quach who supported in quantitative analysis and manuscript writing. David Radford acted as research and academic supervisor to Joshua Quach who supported in qualitative analysis and manuscript writing. Chris Louca acted as research and academic supervisor to Joshua Quach who supported in manuscript writing.

Corresponding author

Correspondence to Joshua D. D. Quach.

Ethics declarations

There was no financial support or funding for this research study. This study was conducted in accordance with the Helsinki declaration as revised in 2013.

Additional information

The original online version of this article was revised.

When initially published, there was an error in the author list. This should have read: Joshua D. D. Quach,*1 Kristina Wanyonyi-Kay,2 David R. Radford3,4 and Chris Louca5

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Quach, J., Wanyonyi-Kay, K., Radford, D. et al. The perceptions and attitudes of qualified dental therapists towards a diagnostic role in the provision of paediatric dental care. Br Dent J (2022). https://doi.org/10.1038/s41415-022-4393-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Version of record:

  • DOI: https://doi.org/10.1038/s41415-022-4393-5

This article is cited by

Search

Advanced search

Quick links