This study describes the proportion and volume of work undertaken in primary dental care that could be delegated to hygienists and therapists.
Methods: Data on treatment provision, both NHS and private, over one course of treatment for 850 consecutively attending patients at 17 dental practices, selected to be representative of a range of socioeconomic, urban and rural environments, were extracted from case records.
Results: The 850 patients attended on 2,433 occasions. Diagnostic examination accounted for 833 (34.2%) visits, while simple, intermediate and complex restorative interventions and other complex interventions accounted for 500 (20.5%), 361 (14.8%), 365 (15%) and 374 (15.4%) visits respectively. The total time required to provide the care was 42,800 minutes, of which 6,550 (15.3%) were devoted to diagnostic examinations, while 10,485 (24.5%), 7,935 (18.5%) and 11,790 (27.5%) were taken up with simple, intermediate and complex restorative care. Other complex interventions accounted for 6,040 (14.2%) minutes. Assuming that dental therapists are permitted to undertake simple and intermediate restorative interventions, they could provide 35.3% of care when number of visits is utilised as the outcome measure, but 43% of the clinical time taken to provide care. Delegation of diagnostic and treatment planning powers to dental therapists could potentially result in 69.5% of visits and 58.3% of clinical time being provided by therapists.
Conclusion: These data imply that a considerable proportion of work in UK general dental practice could be delegated to dental hygienists and therapists.