Maximising the skills and knowledge of everyone in the dental team is seen as part of the solution to the crisis in UK dentistry.
The Government’s new 10 Year Health Plan for England proposes a Neighbourhood Health Service where dental therapists provide check-ups, treatment, and referrals, while dental nurses offer individual and community oral health education, releasing dentists to focus on patients with more complex needs.
These plans build on direct access arrangements that were first introduced in 2013 (and extended to the NHS in 2022) allowing patients to see a dental hygienist or therapist for treatment without first having to consult a dentist. Direct access enables dental hygienists and therapists to work within their full scope of practice without the patient having to be seen by a dentist. Other DCPs can also consider doing more. For example, dental nurses can participate in preventative programmes while orthodontic therapists can carry out Index of Orthodontic Treatment Need (IOTN) screening.
Dentists are still the only members of the dental team with prescribing powers. However, dental hygienists and therapists can now supply or administer certain prescription-only medicines (POMs), as long as they’ve successfully completed training that meets NHS England’s criteria (or the equivalent).
But while dental practice is evolving to allow DCPs to work more independently, effective teamwork and communication are still at the heart of good patient care.
If you’re about to start your first job in dental practice, these tips should help you understand the role that your colleagues play in patient care and how you can best support them.
1. Familiarise yourself with the Scope of Practice guidance
The GDC’s Scope of Practice sets out the skills and abilities each registrant group should have, along with additional skills that you can develop after qualification. You must work within your scope of practice and also be clear about what different members of the dental team can do so that you delegate tasks appropriately.
A new version of Scope of Practice is expected later this year (2025) to better reflect the changing nature of dental practice. The GDC has said it won’t be changing the scope of practice for different dental professionals but it wants to promote more effective teamworking and enable “those who are trained, competent and indemnified to expand their personal scope of practice” safely and effectively.
2. Don’t agree to do something that poses a risk to patient safety
Even if it’s within your scope of practice, you should only undertake diagnosis or treatment if you are suitably trained, competent and indemnified. DDU members need to tell us that they are working under direct access arrangements so indemnity can be provided. You must be ready to refer patients to a dentist if their diagnosis or treatment is beyond your scope of practice or competence.
Equally, if a colleague in the dental team delegates a task, you must be clear about what they’re asking and comfortable that you have the necessary knowledge, skills and training. Get clarification if required or explain that you are unable to take on the task and why. If you are unable to talk to your colleague, seek advice from your manager or call the DDU.
3. Delegate tasks appropriately
As a dentist, don’t ask another member of the dental team to do something unless you’re confident that they are properly trained, competent, and indemnified. You shouldn’t make them feel obligated to agree to something, so frame delegation as a request rather than an order and always give your colleague the opportunity to speak up and ask questions. If you delegate a task, you are responsible for this decision and remain accountable for the patient’s care.
NHS England’s guidance on building dental teams promotes a collaborative approach and notes that “good communication [is] essential to making dental team work as effective as possible”. Meanwhile, the GDC’s Standards for the dental team says “you must treat colleagues fairly and with respect, in all situations and all forms of interaction and communication” and “value and respect” their contribution.4. Understand how direct access operates in your practice
4. Understand how direct access operates in your practice
Dental therapists and hygienists can work to their full scope of practice under direct access provided they are suitably trained and competent. The only exception is tooth whitening which still requires a prescription from a dentist. Full details of what other members of the team can do directly are set out on the GDC’s Direct Access page.
However, it’s not compulsory for DCPs to work under direct access or administer POMs under exemptions, and each practice is free to decide on the approach that works best with the skill mix in the dental team and for patients.
It's important to understand how your practice is organised so you can work collaboratively as a team and avoid interruptions to patient care.
5. Know the referral pathway within your practice
There should be a clear referral pathway so DCPs can refer patients to a dentist and dentists can refer patients to a specialist, if appropriate. It might sometimes be possible for a hygienist or therapist to refer direct to a specialist, but there can be obstacles to this, especially for NHS treatment.
If a hygienist or therapist is referring a patient for something that is outside their scope of practice, it is essential that you explain that you are referring the patient for a diagnosis and any necessary treatment.
All referrals must be clear and include all relevant information. You must also explain the referral process to the patient, get their consent and record this in their notes.
Speak to your practice owner if you are unsure how to refer a patient or have concerns that a patient hasn’t been referred when appropriate.
6. Make patients aware of what you can and can’t do
If you’re treating patients under direct access, ensure they are aware from the outset what you can and can’t do. The GDC recommends that practices provide clear information for patients on direct access eg what treatments are available, booking arrangements, and what will happen if the patient needs treatment that a DCP can’t provide. This should help manage patients’ expectations and reduce the risk of complaints.
More generally, practices should display information about the members of the dental team and their roles, and you should be prepared to answer any questions they might have.
Whatever your role in the dental team, the DDU is here for you as a student and throughout your professional career. Visit the join DDU pages to explore the benefits of membership now and beyond graduation.
This page was correct at publication on 15/07/2025. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.
by Leo Briggs BDS, MSc Deputy head of the DDU
Leo Briggs qualified from University College Hospital, London, in 1989. He has worked extensively in the community dental service, including a brief period overseas. He has also worked in general dental practice.
Leo gained a masters degree in periodontology from the Eastman in 1995 and is on the GDC specialist register for periodontics. Since 1995, he has provided specialist periodontal treatment in both the salaried dental services and private practice. He started working for the DDU in 2005.
Between 2007 and 2009 he worked part-time at the DDU and part-time as a clinical tutor at the School for Professionals Complementary to Dentistry in Portsmouth. In 2009, Leo went full time with the DDU and became deputy head in January 2016. He continues to work clinically as a specialist periodontist in a general practice on Saturdays.