6 July 2010

Q. What is the minimum frequency that a patient has to have a check up with a dentist in order to have hygiene treatment with a hygienist?

In the past the patient needed to see a dentist every year, but the recent General Dental Council guidance published in January 2009 entitled Scope of Practice is not as prescriptive and should be read in conjunction with Principles of Dental Team Working. Both documents can be downloaded from the General Dental Council's website or obtained in hard copy by contacting the General Dental Council directly.

In summary, the current position is that dental hygienists may not diagnose disease (or indeed, restore teeth, carry out pulp treatments, adjust surfaces that have not been previously restored or extract teeth).

Therefore, the dentist who has a strategic role in the team needs to undertake a full mouth assessment of a patient and provide the patient with either an outlined treatment plan or a full treatment plan if necessary, depending on the patient's needs.

The treatment plan could be as simple as a statement that the patient has good oral health and needs no more than routine oral care for e.g. the next three years or a detailed plan for complex treatment and reassessment in three months.

The treatment plan, whether an outline or full plan, should include:

  • Recall intervals, depending on the patient's clinical needs;
  • A date for a full mouth reassessment by a dentist; and
  • A referral if necessary.

The reassessment date is the date when a patient must return to be seen by a dentist for a full mouth examination and treatment plan. The recall interval is how often the patient should return to be seen by a member of the dental team. Therefore, you can see that dental hygienists may plan the delivery of care for patients to improve and maintain their periodontal health and provide dental hygiene care to a wide range of patients.

If you are working under a treatment plan and discover a situation which makes you think that the patient requires a diagnosis, even though there is a set recall interval or a date designated for a new examination, then you should refer the patient back as soon as possible depending on the urgency, to the dentist for diagnosis and a review of the original treatment plan.

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