Clear information for patients is vital. Practices which offer treatment via direct access should make sure that their practice publicity (eg, leaflets, brochures and websites) is clear about: what treatments are available via direct access; the arrangements for booking an appointment with a hygienist or therapist; and what will happen if the patient needs treatment which the hygienist or therapist cannot provide. It would also be helpful to have clear information prominently displayed in the practice about members of the team and their roles.

Click here to read our briefing document on Direct Access.

No – the GDC-approved scope of practice of CDTs remains unchanged in that full dentures are the only form of treatment that they can supply directly to the public. However, the GDC has indicated that this decision could be reviewed in the future.

Click here to read our briefing document on Direct Access.

Yes, if they are participating in structured programmes which provide dental public health interventions.

Dental nurses who wish to practise in this way should be sure that they are trained, competent and indemnified to do so.

Training can be external and accredited, or could be carried out in-house. If training is not externally accredited in some way, it should be recorded and verified by the registrant providing the training, for example by completing a log book.

If a dental nurse applies fluoride varnish to a patient as part of a structured programme, he or she should advise the patient to inform their dentist (if they have one) that they have been treated under the programme.

Click here to read our briefing document on Direct Access.

Members are reminded that they must only carry out procedures for which they have been trained and in which they are competent. The extended scope of practise does not circumvent this fundamental requirement. The GDC’s Scope of Practice document describes the additional skills that DCPs can acquire in order to extend the scope of their professional work.

Click here to read our briefing document on Direct Access.

Not if you are working the same hours and your position has not changed in terms of whether or not you own and operate a practice of your own, employ staff and/or contract with third parties for the commissioning of services to be provided by others. Our dental subscription rates are reviewed annually, and members are notified of the new subscription level at the time of their membership subscription renewal. No additional subscription increases are being made as a result of direct access.

Click here to read our briefing document on Direct Access.

The introduction of direct access does not alter the legislation that was introduced in 2012 to allow tooth whitening to be undertaken using material that releases up to 6% hydrogen peroxide. The Cosmetic Products (Safety) (Amendment) Regulations 2012 continue to determine the legality of providing tooth whitening in dental practice. They state that products may only be sold to dental practitioners and that the first cycle of use must be by dental practitioners or under their direct supervision- ie. that a dentist should be on the premises when the first treatment is carried out.

Dental hygienists and therapists would therefore need to work to a dentist’s written prescription if tooth whitening is undertaken, using products that contain or release more than 0.1% hydrogen peroxide.

Further details on tooth whitening can be found in Our position statement ‘Bleaching and Tooth Whitening by DCPs’

Click here to read our briefing document on Direct Access.

The GDC makes it clear that the following treatments remain restricted in use and still require the direct involvement of a dentist or can only be provided by a dental hygienist against a prescription from a doctor or dentist:

• Tooth whitening – the first application of tooth whitening treatment must be done by a dentist or by a dental hygienist or therapist under the direct supervision of a dentist (which means they should be on the same premises); any subsequent application can be done by a dental hygienist or therapist against a prescription from the dentist.
• Prescribe local anaesthesia – as a ‘prescription only’ medicine it can only be prescribed by a suitably qualified prescriber,usually a dentist or doctor.
• Botox – as a prescription-only medicine it can only be prescribed by a registered doctor or dentist who has completed a full assessment of the patient.

Restrictions remain on the prescription of radiographs by hygienists unless they are compliant with the core requirements of the Ionising Radiation (Medical Exposure) Regulations 2000 (IR[ME]R) and are confident to do so.

It should also be remembered that:

• All registrants must be trained, competent and indemnified for any tasks they undertake.
• All registrants must continue to work within their scope of practice regardless of these changes.
• All registrants must continue to follow the GDC’s Standards for Dental Professionals.
• Dental care professionals do not have to offer direct access and should not be made to offer it.

Click here to read our briefing document on direct access.

Direct Access means patients have been given the option to see a dental care professional (DCP) without having first seen a dentist and without a prescription from a dentist. From 1 May 2013, dental hygienists and dental therapists have been able to see patients directly. This means the requirement to carry out certain treatments under prescription from a dentist is removed.

Dental nurses and orthodontic therapists are also able to see patients directly in certain circumstances. Clinical dental technicians can see patients directly only for the provision and maintenance of full dentures, and dental technicians continue to carry out most of their work to prescription, except repairs.

Only dentists can carry out a full range of dental treatments and prescribe local anaesthesia and the full range of prescription-only medicines.

Click here to read our briefing document on Direct Access.