Patient information: Direct Access

Dental hygienists and their scope of practice

Dental hygienists are registered dental professionals who help patients maintain their oral health by preventing and treating periodontal disease and promoting good oral health. They carry out treatment direct to patients or under prescription from a dentist.

A dental hygienist can undertake the following if they are trained, competent and indemnified to do so:

• Provide dental hygiene care to a wide range of patients
• Obtain a detailed dental history from patients and evaluate their medical history
• Carry out a clinical examination within their competence
• Complete periodontal examination and charting and use indices to screen and monitor periodontal disease
• Diagnose and treatment plan within their competence
• Prescribe radiographs
• Take, process and interpret various film views used in general dental practiceù
• Plan the delivery of care for patients
• Give appropriate patient advice
• Provide preventive oral care to patients and liaise with dentists over the treatment of caries, periodontal disease and tooth wear
• Undertake supragingival and subgingival scaling and root surface debridement using manual and powered instruments
• Use appropriate anti-microbial therapy to manage plaque related diseases
• Adjust restored surfaces in relation to periodontal treatment
• Apply topical treatments and fissure sealants
• Give patients advice on how to stop smoking
• Take intra and extra-oral photographs
• Give infiltration and inferior dental block analgesia
• Place temporary dressings and re-cement crowns with temporary cement
• Place rubber dam
• Take impressions
• Care of implants and treatment of peri-implant tissues
• Identify anatomical features, recognise abnormalities and interpret common pathology
• Carry out oral cancer screening
• If necessary, refer patients to other healthcare professionals
• Keep full, accurate and contemporaneous patient records
• If working on prescription, vary the detail but not the direction of the prescription according to patient needs

Dental therapists and their scope of practice

Dental therapists are registered dental professionals who carry out certain items of dental treatment direct to patients or under prescription from a dentist. A dental therapist can carry out all the duties of a dental hygienist as well as undertake the following if they are trained, competent and indemnified to do so:

• Carry out direct restorations on primary and secondary teeth
• Carry out pulpotomies on primary teeth
• Extract primary teeth
• Place pre-formed crowns on primary teeth
• Identify anatomical features, recognise abnormalities and interpret common pathology

Additional skills which dental hygienists / therapists could develop include:

• Carrying out tooth whitening to the prescription of a dentist
• Administering inhalation sedation
• Removing sutures after the wound has been checked by a dentist

Both a dental hygienist and therapist, if working on prescription, can vary the detail but not the direction of the prescription according to patient needs. For example, the number of surfaces to be restored or the material to be used.

PLEASE NOTE IF YOU REQUIRE ANY OTHER TREATMENT THAN LISTED ABOVE, YOU WILL NEED TO SEE A DENTIST. SOMETIMES, DENTAL HYGIENIST/THERAPISTS MAY NOT BE ABLE TO PROVIDE TREATMENT OUTLINED ABOVE FOR VARIOUS REASONS AND MAY CHOSE TO REFER TO A DENTIST FOR YOUR BENEFIT.

Consent form to see the dental hygienist/therapist under Direct Access:
If you are thinking of seeing dental hygienist or dental therapist without seeing the dentist for an examination, this process is called Direct Access. Here are a few things you may wish to know before you see your hygienist/therapist under Direct Access.

What is Direct Access?
Direct Access is giving patients the option to see a Dental Care Professional (DCP) without having first seen a dentist. This also allows some DCPs to provide a range of services directly to patients without a prescription from a dentist which is within their scope of practice.

The role of a dental hygienist
Dental hygienists are mainly concerned with ‘preventive’ dental health and treating gum disease – showing you the correct home care and helping you to keep your teeth and gums healthy. This includes professionally removing plaque, tartar, stains and other debris (usually called a scale and polish). However, their most important role is showing you the best way to keep your teeth and gums free of plaque. They will work with your dental team to give you the care that is tailored to your needs.

In relation to gums, the hygienist can advise you on the progression of gum disease, but more advanced conditions may need to be assessed by a dentist, and the hygienist then continues treatment under the prescription of the dentist.

The role of a dental therapist
In addition to the roles of a dental hygienist, dental therapists can place fillings, extract “baby teeth”, and place preformed crowns on “baby teeth”. As long as an adult tooth does not require any treatment to the nerve of the tooth, a dental therapist can restore any part of the tooth.

However dental therapists can’t prescribe antibiotics, painkillers or any other drugs to alleviate symptoms.

Direct Access visits to a hygienist/therapist is not a substitute for full dental examinations. We recommend you visit your dentist for routine dental examinations.

Detailed information about the dental hygienist/dental therapist and their scope of practice has been outlined on the first section of this document.

You can find the same information on our website as well as a bio of all of our dental hygienist/therapists.
You can see dental hygienist/therapist of your choice for direct access (if they provide this service).