Oral screening is a role for dental hygienists and therapists, study suggests - UK

A new study suggests that dental hygienists and therapists should be used to screen for dental caries and periodontal disease in a bid to improve the delivery of primary dental health care.

The findings of the report - The Efficacy of Screening for Common Dental Diseases by Hygiene-Therapists A Diagnostic Test Accuracy Study¹ - has important ramifications for service design in public-funded health systems.

And the results have been welcomed by Fiona Sandom, president of the British Association of Dental Therapists (BADT), who sees it as a major step towards a much more efficient use of the skill mix of the dental team.

Lead author, Richard Macey, research assistant at Manchester's School of Dentistry, explained: 'Researchers here at the School of Dentistry have been examining whether dental care professionals (DCPs) can screen for common oral disorders.

'The research is part of a five-year programme that is supported by a NIHR Clinician Scientist award granted to Dr Paul Brocklehurst to examine the efficacy and cost-effectiveness of role substitution in primary dental care. 

  'We now have the results of the main study which recruited 1,899 asymptomatic patients into 10 dental practices across the north west of England. Before their full check-up, patients saw a dental hygienist and therapist (H&T) and a general dental practitioner (GDP) for a screening assessment. Clinicians were asked to decide whether the patient screened positive for dental caries or periodontal disease and so required further investigation.

'The results show a comparable performance between H&Ts and GDPs and demonstrated H&Ts can screen for the two principal dental diseases.

'In particular, H&Ts were good at identifying those patients the GDP had confirmed were caries free (specificity 0.87) and at identifying periodontal disease where the dentists confirmed its presence (sensitivity 0.89).'

  The results of the study - in which 1899 patients were screened - are published in the Journal of Dental Research.

Richard Macey believes these findings, coupled with the recent GDC regulatory change permitting direct access to DCPs, opens up the potential for a 'much more comprehensive use of skill mix in the design and delivery of dental services'.  

  Welcoming the report, BADT president, Fiona Sandom, said: 'Our association find the results of this study encouraging and we view it as further evidence to support delegation within the dental team. The research confirms that dental hygienists and therapists have key parts to play in the future delivery of dental care within the UK.'

Work is now continuing to explore the cost effectiveness of using DCPs in this way, and a separate grant - awarded under the Health Services and Delivery Research scheme - is examining the technical efficiency (productivity) of team dentistry under the current contractual regulations.

  Dr Paul Brocklehurst will be presenting the results in full at the Dentistry Show (17-18 April) at NEC Birmingham and at the BDA Conference & Exhibition (7-9 May) at the Manchester Central Convention Complex.