The dental team varies according to the needs of the patient. For example, it may include a dental therapist or a clinical dental technician, or involve referral to and liaison with other members of the wider healthcare team - such as a medical practitioner.
All dental professionals have an ethical duty to treat all colleagues fairly and with respect, and everyone in the dental team is expected to work together in the best interest of their patients. This means effective communication and co-operation between team members is essential.
GDC registered team members assume personal responsibility in clinical governance and practice management. Failing to address this responsibility could lead to a complaint, disciplinary action or even criminal allegations, either individually or jointly with other members of the team.
These responsibilities include:
- making appropriate fee claims
- being open and honest with patients about treatment
- health and safety at work
- patient confidentiality
- maintaining adequate professional indemnity in the event of a claim for clinical negligence.
Registered dental professionals could be held responsible for the actions of anyone in the team not registered with the GDC, such as receptionists, and should therefore make sure those individuals are appropriately trained.
Team members should raise concerns if inadequate standards of care are placing patients at risk, for example if a colleague's health or performance is causing concern.
Delegating within teams
Dental professionals should work with (or at least, have easy access to) another appropriately trained member of the dental team at all times when treating patients in a dental setting, except:
- in out-of-hours emergencies
- when providing treatment as part of a public health programme
- in exceptional circumstances that could not have been foreseen.
If exceptional circumstances arise, you must assess the possible risk to the patient of continuing treatment, explain the risks to them, obtain their consent and make a note of this in their record.
There should always be at least one other person available in the working environment to deal with medical emergencies when treating patients.
Dental professionals should only delegate or refer a patient to a member of the team who is trained, competent and appropriately indemnified.
- The request to delegate should be clear and include all relevant information.
- Team members should only accept a referral or delegation if they have the knowledge and skills and believe what they are being asked to do is in the patient's best interests.
- If in doubt, discuss with the colleague concerned.
Scope of practice
Dental professionals should be aware of tasks that are outside their scope of practice or competence, and be clear about the process for referring patients, including the need for patient consent.
Under Direct Access arrangements, dental hygienists and therapists can treat patients within their scope of practice without the need for a full mouth assessment by a dentist, provided they are trained, competent and appropriately indemnified.
However, within the dental team only dentists can prescribe prescription-only medicines - including some drugs used to treat medical emergencies, local anaesthetics and fluoride varnish.
Only dentists can sign a patient group direction for a dental practice or clinic, fully report on radiographs, or prescribe/supervise tooth whitening treatment.
Dental hygienists and therapists with the necessary training can carry out the first cycle of tooth whitening, provided that a dentist:
- has assessed the suitability of the patient for the treatment, and
- is on the premises at the time of the first whitening treatment.
Team members should make sure patients have consented to treatment. This includes informing patients of:
- the members of the team providing their care
- who has overall responsibility for their treatment
- the circumstances in which information about them may be shared with others involved in their care.
For more on this topic, see our guidance to consent.
Principle six of the GDC's Standards contains relevant guidance on this topic.
This page was correct at publication on 22/04/2022. 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.