General dental practices with and without a dental therapist: a survey of appointment activities and patient satisfaction with their care

Abstract

Policy changes regarding the role of Dental Hygienist-Therapists (DTs) have been implemented in recent years with a view to promoting delivery of oral health-care through a more preventive-focussed, team work approach. AimsTo explore i) treatments led by dentists and DTs, and ii) patients' satisfaction with the care they received. Materials and MethodsSix case-studies of general dental practices in Wales, UK: three with and three without a DT.For each participant, a patient-satisfaction questionnaire and a staff-member-completed appointment record form were completed. We sought to recruit 150 patients seeing a dentist and 100 patients seeing a DT, per case-study practice. Results1224 patients were recruited in total (314 DT and 910 dentist appointments). Preventive work accounted for nearly half of all treatments. Dentists, in practices with a DT, undertook significantly less preventive and restorative work, and significantly more extractions and advanced treatment (p<0.005, χ²=15.352). Patient satisfaction and confidence in dentists' or DTs' ability was uniformly high (97% and 99% each group respectively). ConclusionPractices with DTs provided a more preventive-focussed approach to oral health-care delivery; dentists in these practices performed more complex work. Positive patient satisfaction and confidence in practitioners' ability suggest patient acceptability of a preventive model.

Dental therapists in general dental practice. A literature review and case‐study analysis to determine what works, why, how and in what circumstances

“…Within the UK, general dental practices typically offer a blend of NHS and private work; across the case‐study sites, the proportion of NHS treatment ranged from 46% to 100%. According to a record of appointments completed during the data collection period, overall, 83% were for NHS patients …”

“…According to a record of appointments completed during the data collection period, overall, 83% were for NHS patients. 21 The theories were refined in light of the case-study data (Column 2, Table 2). We provide a summary of each theory.…”

“…Thus DTs completing private appointments are more readily able to work to their full scope of practice. 21 In addition, DTs are reported to be underemployed, 22 with a high rate of part-time working.…”

“…However, in Wales and the rest of the UK, current National Health Service (NHS) regulations linking funding to a dentist with a performer number mean that only those seeing patients privately or working in the community dental service are able to benefit from direct access arrangements. Thus DTs completing private appointments are more readily able to work to their full scope of practice . In addition, DTs are reported to be underemployed, with a high rate of part‐time working.…”

Evaluation of Postgraduate Foundation Training for Dental Therapists: Does participation enhance career prospects?

“…(13,(42)(43)(44) Furthermore, correct utilisation of DT skills has a potential to increase access to dental care and improve oral health through delegation of up to 77% of clinical time to DTs. (13,19,45) In July 2022 the NHS announced reforms to the 2006 contract, including addressing misunderstandings around skill-mix in NHS dental services and removal of administrative barriers which prevent DTs from ful lling their full SOP. (46) However, there are professional misgivings around this reform with the British Dental Association having taken a neutral stance.…”