Q. I am a hygienist working in a maxillofacial unit treating head and neck cancer. Can you please advise if I can take referrals from ENT surgeons to provide fluoride treatment and oral health advice? Could I ask a different dentist working in the department to countersign the letter?

Dental therapists and hygienists are only permitted to carry out treatment under the written prescription of a registered dentist. The dentist must have examined the patient and formulated a diagnosis before deriving a treatment plan for the therapist or hygienist to undertake.

Assuming that the ENT surgeons you describe are not registered dentists, they would be unable to prescribe fluoride treatment which would be considered to be the practise of dentistry. Similarly specific oral health advice can only be carried out by a therapist or hygienist on a written prescription by a registered dentist.

It would not be sufficient for a registered dentist to merely 'countersign the letter' as you suggest. That dentist should have carried out an examination of the patient and be quite comfortable in their own mind that the treatment they are asking you to do is clinically necessary and in the patient’s best interests.

In this situation it would be helpful if a registered dentist could be involved at an earlier stage during the case management.