The role of dental hygienists and therapists in paediatric oral healthcare in Scotland

Introduction The scope of practice of qualified dental hygienists and therapists allows them to undertake non-surgical periodontal screening, treatment and preventive care, and to diagnose and treatment plan. Therapists are also qualified to restore primary and secondary teeth, and to extract primary teeth. Both professions may see patients directly without needing a dentist's referral. In Scotland, they operate in a context of relatively poor but improving child oral health.Aim To investigate provision of dental care to children, including challenges encountered, by dental hygienists and therapists in the Scottish General Dental Service (GDS).Method An online survey of Scotland-based, GDC-registered dental hygienists and therapists in the GDS.Results Of 426 potential respondents, 194 (46%) responded, including 113 hygienists. Thirty hygienists and six therapists did not currently see child patients. Lack of referrals from dentists/specialisation by other team members, financial/contract reasons and lack of demand were the reasons given. Of those who did see children, most were therapists. Responsibility for preventive paediatric care was evenly split, with 71 (46%) citing the hygienist or therapist and 69 (45%) the dentist. Sixty-five (43%) reported barriers, most commonly relating to parents and children themselves. Time pressures, cost implications for practice and parents, and a number of practice and regulatory barriers were also mentioned.Discussion The response rate is considered to be very good. Limiting factors regarding provision of paediatric dental care include lack of referrals from GDPs and financial or contractual issues.Conclusion There appears to be considerable underuse of hygienists and therapists in respect to paediatric dental care.