Benefits and risks of direct access to treatment by dental care professionals: a rapid evidence review

Over 100 research dental and other health-related papers were identified as relevant for this review of direct access. The quality of the evidence regarding direct access issues to dental care practitioners was varied but as a whole of moderately good quality.
•The material was overwhelmingly related to the work of dental hygienists and dental therapists, mostly US in origin.
•There was no evidence of significant issues of patient safety resulting from the clinical activity of DCPs.
•There was strong evidence that access to dental care improved as a result of direct access arrangements, of cost benefits to patients, and of high levels of patent satisfaction.
•There was some evidence that DCPs may over-refer patients to dentists, which may ensure patient safety but lead to wasteful use of resources and a high level of ‘no shows’ on referral.
•There was evidence of ongoing training needs to strength the assessment and referral skills of DCPs in respect to patients with other health problems or risk factors, but little evidence that dentists are any less in need of such training.