S Turner1, M K Ross, R J Ibbetson. 1. Edinburgh Postgraduate Dental Institute, Level 4, Lauriston Building, Lauriston Place, Edinburgh, EH3 9HA. s.turner@cpse.dundee.ac.uk
Abstract
OBJECTIVES: To investigate autonomous working among singly and dually qualified dental hygienists and therapists in UK primary care. Earlier studies and policy papers suggest that greater autonomy for these groups may be a desirable workforce planning goal. METHODS: UK-wide postal surveys of hygienists, hygienist-therapists and therapists. Respondents were asked whether they undertook 15 clinical activities on their own initiative, how comfortable they would feel undertaking such clinical activities if referral from a dentist were not required, and how they perceived dentists' reactions. RESULTS: Overall response rate was 65% (n = 150 hygienists, 183 hygienist-therapists and 152 therapists). Over 80% of hygienists and hygienist-therapists reported undertaking BPEs, history-taking, pocket charting, mucosal examinations and recall interval planning autonomously. Similarly high proportions of hygienist-therapists and therapists reported giving local analgesia and choosing restorative materials autonomously. However, fewer than 50% of all three groups said they undertook dental charting, fissure sealing, resin restorations, taking radiographs, and tooth whitening autonomously. While confidence in undertaking such activities without a dentist's referral was generally high, it was lower in respect to mucosal examinations, identifying suspicious lesions, interpreting radiographs, tooth whitening, and (except for singly qualified dental therapists) diagnosing caries. CONCLUSIONS: Results suggest high levels of experience and confidence in their ability to work autonomously across a wide range of investigative activities, treatment decision-making and treatment planning. The exceptions to this pattern are appropriate to the different clinical remit of these groups.
OBJECTIVES: To investigate autonomous working among singly and dually qualified dental hygienists and therapists in UK primary care. Earlier studies and policy papers suggest that greater autonomy for these groups may be a desirable workforce planning goal. METHODS: UK-wide postal surveys of hygienists, hygienist-therapists and therapists. Respondents were asked whether they undertook 15 clinical activities on their own initiative, how comfortable they would feel undertaking such clinical activities if referral from a dentist were not required, and how they perceived dentists' reactions. RESULTS: Overall response rate was 65% (n = 150 hygienists, 183 hygienist-therapists and 152 therapists). Over 80% of hygienists and hygienist-therapists reported undertaking BPEs, history-taking, pocket charting, mucosal examinations and recall interval planning autonomously. Similarly high proportions of hygienist-therapists and therapists reported giving local analgesia and choosing restorative materials autonomously. However, fewer than 50% of all three groups said they undertook dental charting, fissure sealing, resin restorations, taking radiographs, and tooth whitening autonomously. While confidence in undertaking such activities without a dentist's referral was generally high, it was lower in respect to mucosal examinations, identifying suspicious lesions, interpreting radiographs, tooth whitening, and (except for singly qualified dental therapists) diagnosing caries. CONCLUSIONS: Results suggest high levels of experience and confidence in their ability to work autonomously across a wide range of investigative activities, treatment decision-making and treatment planning. The exceptions to this pattern are appropriate to the different clinical remit of these groups.