Orthodontic therapists are perfectly entitled to work on their own if they wish without a dentist on the premises. To a large extent this is a matter of personal choice, competency and experience. 

Contact Dental Protection for more guidance on this issue.

It is particularly important that patients are not misled in any way, especially in relation to the provision of treatment and who is providing that treatment. There is no reason then not to be open and honest with a patient. Indeed most therapists are extremely proud of their position and would be horrified to be thought of as some sort of 'second class' dentist. Not only does it undermine their role in the practice but is also leads to patient misconceptions particularly when the further advice of the dentist is sought in relation to a treatment plan.

Patient misunderstandings often come from the most unusual of circumstances. It may be, for example, that the confusion occurs from how the dentist introduces you to a new patient, how your role is explained to them or even how the receptionist refers to you when talking to patients. It is wise then to discuss this within the practice and ensure that all members of the team know precisely what role you have and most importantly its limitations. 

Contact Dental Protection for guidance on the specific issue.

The GDC's Scope of Practice document indicates the skills that DCPs are expected to have (by nature of their basic training) and the additional skills that they can develop during their career. In particular, the GDC has indicated that dental hygienists and therapists may become involved in tooth whitening, provided it is to the prescription of a dentist. The GDC make no reference to the technique to be used or favours in-surgery or home bleaching.

It is important to realise however that, as this is an additional skill, a DCP would need to be able to demonstrate that they have received the appropriate training and that they are competent to carry out the task. Unfortunately the GDC does not define what it would regard as 'sufficient and appropriate' training. Indeed it leaves this decision to the DCP. That seems a little unfair particularly as the DCP's opinion in this respect may differ from the GDC's and the first time the DCP is aware of this is when it is being questioned perhaps at a conduct committee hearing.

Having said that it seems logical to assume that this training must be specifically designed with hygienists and therapists in mind (ie, it is not a course designed for dentists) and that the wider aspects of tooth whitening are considered (including the legal and ethical implications). Courses run by specific whitening companies may not necessarily comply, especially if these courses are in effect designed to promote a particular product.

If then you are at all in doubt in relation to your own personal circumstances, please feel free to contact Dental Protection 

To a large extent this relates to the business of dentistry and therefore is entirely a matter for the therapist and the practice principal. Generally speaking a well worded contract protects both parties in the event of a disagreement, and therefore it is in everybody's best interests. It is however a matter of personal choice. 

Contact Dental Protection for guidance on the specific issue.

The GDC's guidance document, Standards for the Dental Team, makes it very clear that when any clinician is treating a patient they should make sure that there is somebody else - preferably a registered team member - present in the room who is trained to deal with medical emergencies. A failure to adhere to this guidance, particularly if something goes wrong, could mean that it is difficult for Dental Protection to defend your actions. Working alongside a dental nurse makes good sense in any event as it improves patient care and makes the treatment more efficient. Contact Dental Protection for guidance on this issue.