The Dental Therapist’s role
Under the terms of her scope of practice outlined by the General Dental Council (GDC), and through Direct Access arrangements, she can perform certain treatments directly to patients, or under a dentist’s prescription.
- Obtain a detailed dental history from patients and evaluate their medical history.
- Carry out a clinical examination within her competence.
- Complete periodontal examination charting and use indices to screen and monitor periodontal disease.
A periodontal exam accesses gum health. Our dental therapist, Hannah, can measure the pockets that surround the teeth to determine whether periodontal disease exists. Among other checks, she will look for signs of inflammation, and note the colour and texture of gums and any areas where the gum may have receded.
The good news is that mild periodontal disease, gingivitis, is reversible if patients follow professional dental advice and commit to a good, at-home oral care routine.
- Diagnose and plan treatment within their competence.
- Prescribe radiographs.
- Take, process and interpret various film views used in general dental practice.
- Plan the delivery of care for patients.
- Give appropriate patient advice.
- Provide preventative oral care to patients and liaise with dentists over the treatment of tooth decay, periodontal disease and tooth wear.
Our mouths are packed with bacteria which, along with mucus and other particles, forms plaque on the teeth. Brushing and flossing will help remove it, but if it is allowed to build-up, it can harden and form tartar which can only be removed with a professional clean, scale and polish.
The longer plaque remains on teeth, the more harmful it becomes, leading to inflammation of the gums, or gingiviltis – a condition which can be reversed with daily brushing, flossing and regular, professional cleaning. If however it is not treated, gingivitis will advance to periodontitis which can see tooth loss and the deterioration of gums, bone and supportive tissue around the teeth.
- Undertake supragingival and subgingival scaling and root surface debridement using manual and powered instruments.
This is part of the clean, scale and polish process. It involves the removal of tartar, or plaque, that occurs above the gum line (supragingval) and in the crevice between the gum margin and the neck, or root, to a tooth (subgingival).
Tartar is caused by the accumulation of minerals from saliva. It makes an ideal surface for further plaque formation and can threaten the health of the gums, ultimately leading to periodontal disease, or tooth loss. Brushing and flossing can help remove plaque, but if it has already formed it is often too hard and firmly attached to be removed with a toothbrush. The only way to remove it is with ultrasonic tools, or instruments such as a periodontal scaler.
- Use appropriate anti-microbial therapy to manage plaque-related disease.
Antimicrobial therapy uses chemicals to destroy, or slow down, the growth of bacteria that cause gum disease. The two most common forms are antiseptics and antibiotics.
- Adjust restored surfaces in relation to periodontal treatment.
- Apply topical treatments and fissure sealants.
Fissure sealants are plastic coatings which are generally placed on the chewing surfaces of children’s molar teeth. Children can find it difficult to reach back teeth when they are brushing, which means food can be left on the tooth’s surface. This can lean to the creation of bacteria and, ultimately, decay. A sealant can provide a barrier to prevent sugar and acid attack.
Fissure sealants can also be used to treat adults.
- Give advice on how to stop smoking.
Smoking is harmful to teeth, gums and dental health. It can leave yellow and brown staining on your teeth, cause bad breath and gum disease, result in tooth loss and mouth cancer.
Other problems linked to smoking and oral health include an increased build-up of plaque, or tartar; delayed healing after tooth extraction, treatment for gum disease or oral surgery, and a lower success rate for patients undergoing dental implants. The Whyte House’s Hannah Mason-Mellish can give you help and advice on giving up and explain why, when it comes to oral and all-round health, quitting smoking is one of the best things you can ever do.
- Take intra and extra-oral photographs.
Intra-oral photographs, or ‘inside the mouth’ images of teeth help dental professionals diagnose problems, their severity, and how to correct them.
Extra-oral photographs, or ‘outside the mouth’ photographs, can be used to monitor a patient’s teeth during on-going treatment, or for before and after shots of cosmetic or full-mouth restorative work.
- Give infiltration and inferior dental block analgesia.
- Place temporary dressings and re-cement crowns with temporary cement.
- Place rubber dam.
A rubber dam is a sheet of thin rubber which isolates individual or groups of teeth during treatment, protecting them from bacteria and saliva.
- Take impressions
- Care of implants and treatment of peri-implant tissues.
Peri-implant disease can affect the gum tissue around dental implants. Just as it does with natural teeth, bacteria can build up around the base of the implant, below the gum line. Over time, if the bacteria is not removed, the gum can become inflamed and the implant could deteriorate – just as a normal tooth would.
Remember, with a good oral health routine, your dental implants could last for 15 to 25 years or more.
- Carry out direct restorations on primary and secondary teeth.
The most common type of direct dental restoration is a filling. The treatment can be carried our in one visit and there is a choice of fillings depending on the type and location of the filling.
- Carry out pulpotomies on primary teeth.
A pulpotomy is performed when decay in a child’s primary tooth reaches into the pulp, or nerve, tissue. The infected nerve tissue is removed to stop further inflammation and prevent further decay. Sedative material is placed in the tooth to prevent bacteria. The tooth can be replaced with a crown to ensure the child can still chew food. The crown will hold the space for the arrival of permanent teeth.
- Extract primary teeth.
- Place pre-formed crowns on primary teeth.
See pulpotomies, above.
- Identify anatomical features, recognise abnormalities and interpret common pathology.
- Carry out oral cancer screening.
During oral cancer screening, a dental therapist will feel for irregular tissue changes and any lumps in your neck, head face and oral cavity. They will look for any sores and discoloured tissue in your mouth. They will also check for any changes which could indicate symptoms and signs of oral cancer.
- If necessary, refer patients to other healthcare professionals.
- Keep full, accurate and contemporaneous patient records.