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19th January 2016

Working with Extended Duties for Dental Nurses

For many years dental nurses with an ambition to play an extended role in patient care, have enrolled onto courses to develop their knowledge and skills so that they can take on extended duties.  For the practices employing these dental nurses, if they have the required vision and management skills have the opportunity to reshape their services and in doing so to better meet the needs of their patient, the team and the business.

Working within the Regulations

The GDC Scope of Practice Guidance clearly states that dental professionals should only carry out a task, or type of treatment, or make decisions about a patient’s care if they are sure that they have the necessary skills and are appropriately trained, competent and indemnified.

Skills, Training and Competence

Training resources are increasing available for dental nurses to gain additional skills. The GDC allow further duties to be performed by trained and competent dental nurses in respect of:

  • Oral health education;
  • Oral health promotion;
  • Assisting in the treatment of patients who are under conscious sedation;
  • Assisting in the treatment of patients with special needs;
  • Assisting in the treatment of orthodontic patients;
  • Intra and extra-oral photography;
  • Pouring, casting and trimming study models;
  • Shade taking;
  • Tracing cephalographs.

These additional skills can be carried out on prescription from, or under the direction of, another registrant:

  • Taking radiographs;
  • Placing rubber dam;
  • Measuring and recording plaque indices;
  • Removing sutures after the wound has been checked by a dentist;
  • Constructing occlusal registration rims and special trays;
  • Repairing the acrylic component of removable appliances;
  • Applying topical anaesthetic to the prescription of a dentist;
  • Constructing mouth guards and bleaching trays to the prescription of a dentist;
  • Constructing vacuum formed retainers to the prescription of a dentist;
  • Taking impressions to the prescription of a dentist or a CDT (where appropriate);
  • Dental nurses can apply fluoride varnish either on prescription from a dentist or direct as part.

Making Extended Duties Dental Nurses Part of your Practice Team

To incorporate extended dental nursing duties to an existing practice is far from being a simple process. In fact, to try to accomplish this with random small adjustments is bound to produce disappointing results. To make effective changes begin by developing the practice business plan, with expressed a mission statement for dental nurse development. The most obvious benefits can come from making good use of the dental nurses’ skills as an oral health promotors, in a care or implant coordinators, in this way they can provide direct and measureable benefits associated with patients’ ability to achieve and maintain good standards of oral well-being.

You may be outsourcing many of the duties on the additional skills list above. If so the cost effectiveness of appointing a trusted dental nurses with additional skills to do this may be worth considering. As too would be impression taking and fluoride varnish application as a contribution to a sustained oral health promotion programme.

Future Proof your Team’s Roles

The current status quo of dental registrant training is about to be redrafted with the introduction of the ‘Skills Escalator’ which allows students to earn as they learn. Beginning as a dental nurse dental professionals will be able to work their way up the ‘Skills Escalator’, gaining qualifications as they go, to become either a hygienist or even a dentist. Those practices that are training their dental nurses to be confident and complete to deliver extended duties are the avante Garde of a new generation of dental professionals.

Glenys Bridges – QCS Expert Dental Contributor

Topics: Dentists

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