Developing the dental team

The GDC’s Scope of Practice sets out the skills and abilities expected of each registrant group - all dental professionals should be familiar with this document.

A dental professional’s scope of practice is likely to change over the course of their career, whether because of changes in best practice and the technology of dentistry, or through their own training and development. To that end, the Scope of Practice is not intended to be an exhaustive or prescriptive list of all the tasks that someone can do, but to distinguish between the various roles in the dental team. It also describes additional skills that dental care professionals might develop after registration to increase their scope of practice.

It is helpful, for those responsible for dental professionals, to understand the Scope of Practice, as an indication of what a dental professional should and could be doing, as well as what they are not allowed to do, if it is a task or skill reserved to another profession. For example, if you manage or employ a dental nurse who is trained and able to assist in taking impressions, are they doing that? If not, is this something you could consider? How could you use the skills of the team most effectively? If a dental hygienist could undertake training to provide tooth whitening, would that be helpful to the rest of the team? A complementary mix of diverse and well-developed skills should contribute to an effective dental team.

Dental professionals must not carry out treatment if it is outside their scope of practice, or if they do not believe they are trained and competent to do it. Should they do so, this could lead to concerns being raised about their fitness to practise. It is therefore important—and, for dental professionals, a professional duty—to foster an environment where the scope of practice can be discussed and dental professionals are not pressured to perform treatments they do not feel confident providing safely.

Understanding and using the diversity of skills across the dental team should help a practice or other workplace perform more effectively. For example, some dental care professionals are able to carry out some or all of their scope of practice without the patient having to see a dentist first. This is known as direct access.

The GDC is frequently asked whether dental hygienists and dental therapists can work without assistance from another dental professional - especially under direct access, as described above.

Under the Standards for the Dental Team , all dental professionals must be appropriately supported, and work with another appropriately trained member of the dental team, when treating patients. Clinical care should generally not be provided if there is only one dentist or dental care professional on the premises when treating patients.

Employers and managers of dental professionals should also take note of the Health and Safety Executive’s guidance on lone working arrangements .

Finally, the Care Quality Commission’s series on dental mythbusters covers lone working arrangements, and may be of interest.

All dental professionals must keep their skills, knowledge and competence up to date throughout their career. To that end, the GDC requires all dental professionals on our registers to complete a certain amount of learning, training or other developmental activities relevant to their field of practice, known as continuing professional development (CPD).

Keeping up to date and engaging in development activities helps assure the GDC that dental professionals are providing services safely to the public. Through our research, we have found that patients also expect this from dental professionals. Therefore, CPD is a requirement for registration to be maintained. More information and guidance on CPD requirements are available, as well as examples of what constitutes verifiable, high quality and relevant CPD.

As employers and managers responsible for dental professionals, you will have your own expectations and interest in their professional development. We encourage you to look at how this might overlap with CPD, and how CPD goals can be linked to your own system of performance management and appraisals.

Dental professionals are asked to create a personal development plan to help identify CPD that will support them in maintaining and developing their practice. A dental professional can develop this themselves, but you might find it useful to work on this in collaboration, to assist in identifying and addressing a dental professional’s areas for professional development. An important component of personal development is reflective practice.

Dental professionals are likely to value a workplace that invests in their professional development. That investment could mean granting employees time off to undertake CPD activities or arranging for CPD activities to be taken as a team, and within a practice or other workplace setting. As long as it meets the criteria for verifiable CPD, CPD can take the form of courses and lectures, training days, workshops and e-learning activities, all of which could be performed in a workplace setting, with the support of practice managers.

We recognise that supporting dental professionals’ CPD in active ways is not always easy and may come at a time or financial cost. However, we think it is worthwhile to invest in staff, and dental professionals are likely to look for and welcome that approach in an employer, dental body corporate or other setting.

Information about CPD activities can be obtained from Health Education England, your postgraduate dental deanery outside England, or from a relevant professional membership body or society. CPD does not have to be delivered face-to-face to be considered verifiable by the GDC; online learning is also acceptable.

If you are involved, or interested in providing CPD, please see our guidance for requirements and advice on quality assurance.

Professional bodies and associations provide a wide variety of information and advice. They exist to support their members and offer extensive educational and advisory services. These range from libraries, journals and newsletters providing regular updates, to courses (in person and online) and individual advice and support, in line with their membership offer. They can also signpost professionals to other services where support might be obtained.

It is a legal requirement for all dental professionals to hold adequate indemnity cover if they are providing dental services. The responsibility for ensuring that cover is in place is that of the dental professional. As such, all dental professionals should check they have sufficient level of cover for their scope of practice—including those that may be covered under either the practice principal or employer’s indemnity cover—as this can differ. For example, some arrangements may cover a registrant for clinical negligence but not for GDC fitness to practise support.

Some professional bodies may provide indemnity insurance, and a dental professional or their employer may also have indemnity through the NHS, or membership of a dental defence organisation. Any of these will satisfy the GDC’s requirement for a dental professional to have the necessary indemnity or insurance to cover them in their work, so long as the level of cover provided is sufficient for the dental professionals’ position.

The GDC will usually investigate allegations that a dental professional is practising without adequate indemnity cover. If you provide indemnity cover for dental professionals, make sure they know when that indemnity is in place and what it covers and, if the professional relationship ends, when that cover will stop.