The Implications of the New GDC Standards for Dental Professionals.

This article is about the publication by the General Dental Council in 2013 of the Standards expected of those members of the dental team who are registered with the Council, on each of their Registers, and discusses the implications of the new Standards for dental professionals.

Direct access in the UK: what do dentists really think?

OBJECTIVE: To investigate dentists' views on the likely impact of direct access (DA), the clinical competence of hygienists and therapists to work autonomously and possible predictors of such views. DESIGN: Random survey of registered dentists. SETTING: UK, 2014. SUBJECTS AND METHODS: A random sample of UK-based dentists registered with the General Dental Council (GDC). A unique-access online questionnaire was developed, with a paper alternative. Email and postal reminders were sent. MAIN OUTCOME MEASURES: Measures of positive/negative views regarding the impact of DA and clinical competence of hygienists and therapists to work without a dentist's prescription. RESULTS: One hundred and fifty-nine responded (response rate: 27%), 78 (49.1%) of whom were female. No significant sources of response bias were identified. While 122 (77%) had not undergone joint training with dental hygienists or therapists at the undergraduate level, 98 (62.4%) currently worked with a hygienist and 33 (21.0%) with a therapist. Eighty-three (53.2%) disagreed with the GDC decision regarding DA for hygienists, and 94 (59.1%) felt the same regarding therapists. Concern was greatest in respect to diagnosis, treatment planning and restorations. Comments were predominantly negative and reflected concerns over patient safety, what was seen as hygienists' and therapists' inadequate training or expertise, the undermining of the dentist's role, service delivery, the reform being poorly planned, implemented or being a cost-cutting exercise. Experience of teamwork was not predictive of positive/negative views. CONCLUSIONS: Response was low, thus posing a potential threat to the study's representativeness. Many dentists had concerns and reservations about DA which were unrelated to teamwork experience. The dissemination of information on curricula and scope of practice may help allay such concerns, as may a greater emphasis on joint training at both the undergraduate level and within continuing professional development programmes.

Supporting dental registrants in difficulty.

Over the past few years there has been a significant increase in the number of dentists and dental care professionals (registrants) having conditions placed on their practice either by the General Dental Council or NHS area teams. There are a number of reasons for this including the fact that patients complain more often, colleagues are now expected to alert the authorities if poor practice is detected and the demographics of the dental profession in the UK are changing. Steps have already been taken to prevent dentists getting into difficulty, such as the development of requirements for continued professional development by the GDC and past initiatives at a local level set up to assist dentist in difficulty. The regional offices of Health Education England and equivalent organisations in Wales and Scotland assist registrants in difficulty in meeting these conditions. Little published research has been carried out into this important service which has had to develop rapidly over the past few years. There is a need to investigate the current service, the views of those dental professionals being assisted and those providing the support to inform the further development of the service. This paper provides an introduction to a planned series of research papers reporting on our investigation into the service provided by HEE teams.

Analysis of Nigerian dentists' opinion and consequences on expanded function dental auxiliaries.

OBJECTIVE: To examine Nigerian dentists' opinion on expanded function dental auxiliaries. METHODS: This cross-sectional study of Nigerian dentists attending a dental conference was conducting in 2012 using self-administered questionnaire. The data were analyzed using Statistical Package for the Social Sciences version 16.0. P < 0.05 was considered statistically significant. RESULTS: The majority of the 82 dentists that participated in this study were male, aged 31-40 years, either specialist or specializing (residents), practiced for < 10 years, teaching hospital and urban practitioners. Of the participants, 22 (26.8%) reported favorable opinion towards expanded duty dental auxiliaries. The mean scores on consequences, of expanded function dental auxiliaries ranked redundancy of dentist as highest. Males and non-specialist significantly reported expanded function dental auxiliaries would lead to redundancy of dentists. Practitioners working in other hospitals other than teaching hospital significantly reported that appropriate legislation are necessary before expansion of duties of the dental auxiliaries can be done. The dentists with favorable opinion significantly reported that expanded duty dental auxiliaries would not cause redundancy of dentist and the task are not too difficult for dental auxiliaries with necessary training but will increase service delivery and efficiency, increase job satisfaction, lead to dental auxiliary specialization with legislation. CONCLUSION: Data from this study revealed overall unfavorable opinion of Nigerian dentists on the expanded duty dental auxiliaries. However, those with favorable opinion were significantly supportive of expanded function dental auxiliaries. This information would serve as a useful tool for Nigerian oral healthcare policy formulators.

Use of restorative procedures by allied dental health professionals in Minnesota.

BACKGROUND: In 2003, the Minnesota legislature revised the Dental Practice Act to include restorative procedures in the scope of practice for registered dental assistants (RDAs) and registered dental hygienists (RDHs). The authors examined these practitioners' characteristics and made comparisons on the basis of their use of restorative function (RF) training and their practices' locations. They also examined practice type, models of implementation and perceived outcomes. METHODS: The authors mailed a survey to all RF-certified RDAs and RDHs in Minnesota (N = 387). They used descriptive statistics to summarize the data and t tests and Fisher exact tests (P <.0001) to make comparisons between groups. RESULTS: The authors received 243 surveys (63 percent). Less than one-half (38 percent) of the RF-certified practitioners performed RFs. Of these, 29 percent were RDHs and 71 percent were RDAs. These practitioners performed RFs most often by working with a dentist or when time allowed. They perceived increased access to dental care and an increase in the number of patients treated to be outcomes of performing RFs. CONCLUSIONS: The results of this survey indicated use of restorative procedures varied greatly by practitioner type. The perceptions of those who performed RFs indicated they had a positive effect on dental practice. PRACTICAL IMPLICATIONS: The addition of RF-certified personnel to the dental team has the potential to increase the number of patients seen in practice and the job satisfaction of team members.

The origins of Minnesota's mid-level dental practitioner: alignment of problem, political and policy streams.

PURPOSE: Using John Kingdon's agenda-setting model, this paper explores how Minnesota came to legislate a mid-level dental practitioner to its oral health workforce. Using a pluralist framework embracing the existence of various interests and convictions, this analysis highlights the roles of issue formation, agenda setting and politics in policymaking. METHODS: Using Kingdon's agenda-setting model as a theoretical lens, and applying case study methodology, this paper analyzes how Minnesota came to legislate a mid-level dental practitione to its oral health workforce. Data have come from scholarly research, governmental and foundation agency reports, interviews with leaders involved in the mid-level dental practitioner initiative, news articles, and Minnesota statute. RESULTS: After 2 years of contentious and challenging legislative initiatives, the problem, policy and political streams converged and aligned with the compromise passage of a bill legalizing mid-level dental practitioner practice. The Minnesota Dental Therapist Law was the first-in-the-nation licensing law to develop a new dental professional workforce model to address access to oral health care. CONCLUSION: The Minnesota mid-level dental practitioner initiative demonstrates the important convergence and alignment of the access to oral health care problem and the subsequent collaboration between political interest groups and policymakers. Through partnerships and pluralist compromise, mid-level dental practitioner champions were able to open the policy window to move this legislation to law, enhancing the oral health workforce in Minnesota.