16 November 2010

Q. I am a therapist who is currently working without a dentist on the premises due to holidays. Is it possible for me to place a temporary dressing for a patient who has lost a filling?

Dental therapists by virtue of their training, are competent not only to place direct restorations on permanent and deciduous teeth, but to place a temporary dressing within a tooth as long as the dental treatment being provided is under the prescription of a dentist.

You may be aware from the GDC’s guidance in their recent publication “Scope of Practice” (published in 2009) that the duties which can be carried out by DCPs relate to their training and competence rather than to any specific task. The GDC is quite specific that a patient should be seen by a dentist before being treated by other members of the dental team. The only exception to this is an edentulous patient who is being seen by a Clinical Dental Technician.

You do not say if the patient is currently under treatment or whether they are a new patient.

If they are a new patient then it is likely that they will not have been seen by dentist who could formulate a diagnosis leading to a prescription being written, and as a result any therapist placing a dressing in the tooth, would not be acting in accordance with the GDC’s guidance. There is a risk that a tooth from which a filling has been lost could be non-vital and that the placement of a temporary dressing in the cavity could on occasion exacerbate the patient’s condition.

However, if the patient was under treatment from a dentist at the practice and they presented with a lost filling, and as long as the dentist is comfortable for the therapist to see the patient, and the tooth in question is part of an existing treatment plan, then it would be acceptable to place a temporary dressing in the tooth if the therapist felt that was in the patient’s best interests.

Perhaps the best way of managing any patient who attends your practice who has lost a filling and who wishes something to be done about it (if it is at the front of the mouth or causing pain), and where it would be inappropriate for the therapist to treat them, would be for the practice to set in motion the arrangements which should be in place for the management of patients who require urgent treatment.

Further information for therapists is available here


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