The evolution of dental hygienists and dental therapists


‘It’s an exciting time’: Ahead of National Dental Hygienist and Dental Therapist Day, Miranda Stipes looks back at the historical evolution of these two roles.

From dental aids to dental care professionals

About a hundred years ago, dentistry was in chaos. Dentists try to establish themselves as a profession separate from medicine and work to prevent the illegal practice of medicine. The School Dental Service (SDS) is where children receive dental treatment, with “dental surgeons” providing treatment under the guidance of dentists.

Around the same time, another group of “dental auxiliaries” were dental hygienists (DH), who provided periodontal care and preventive advice to military personnel at home after the war. The Dentists Act (1921) allowed DHs to carry out “minor dental work”, but the British Dental Association (BDA) opposed the Acts because of concerns that they would “dilute” the dental profession. In 1942, the BDA successfully prevented this. However, in 1945 it was suggested that dentistry should have its own regulatory body, with provision also being made for training and supervision by the Department of Health.

In 1949, the Eastman (Eastman) DH Training School in London was established and the British Dental Hygienists Association (BDHA) was established, later renamed the British Dental Hygiene and Treatment Association (BSDHT) in 2006.

Introducing National Dental Hygienist and Dental Therapist Day

Dentistry We are pleased to announce National Dental Hygienist and Dental Therapist DayA new national day dedicated to celebrating the valuable contributions of dental hygienists and dental therapists.

In partnership with the British Association of Dental Therapists (BADT), the British Association of Dental Hygiene and Treatment (BSDHT) and the Irish Dental Hygienists' Association (IDHA), this new national day will be celebrated on 1 May. This commemorates May 1, 2013, the day direct access by dental hygienists and dental therapists went into effect.

You can find more here.

A few years later, in 1957, the General Dental Council (GDC) was formed as part of negotiations with the government, stipulating that dentists (DTh) should also receive training. The project began in New Cross, London, in 1960. At this time, DHs were allowed to work in general dental practices, but it was not until 2002 that DThs were allowed to do the same work.

It is hard to imagine that it was not until 2006 that all dental professionals became GDC registrants, and this was not completed until 2008. ”, to our dental care professionals today.

Introduction of direct access

Direct access for the private sector was launched in 2013, and for many it was unimaginable to imagine a time when we wouldn't be able to do this. This is now taken for granted, as is the right to undertake the scope of practice that we have, to work in a general practice, and that we are all registered dental professionals.

In fact, the progress that has been made over the past 100 years has been led by professionals, partly due to the needs of the governments of the day, but even more with the help of professional organizations BSDHT and the British Association of Dental Therapists.

One can look back to 2022, when direct access was introduced to the NHS in the UK, and compare it to the SDS era of about 100 years ago. SDS is underfunded and there is a shortage of dentists who want to work in the scheme. You can draw an analogy to today's NHS dental contract, where we are again professionals brought in by the government. But unlike then, when the BDA fought hard to prevent us from treating patients, there is no resistance now.

This is largely because we have limited personal interest in doing this work.One might think it provides a sense of professional fulfillment and reminds us why we got into dentistry care Professional roles. But the financial rewards are limited and certainly not comparable to those of our dental colleagues.

Scope of practice

As two different dental professional groups, we are well placed to provide NHS dental treatment to patients across our spectrum, but to achieve this requires changes in care conditions and culture, both within and outside healthcare settings.

Oral health care team members need to understand, appreciate, and respect the abilities of their colleagues. In making sense of all this, there needs to be a willingness to educate the public about who we are and what we can do. To give them the peace of mind that it's safe to sit in our chairs and that we know what we're doing is backed up by validation from all our colleagues.

Dentistry has changed and so has the population. Today, technology and the development of materials and knowledge have come so far that many restoration jobs no longer compare to what they once were. What hasn’t changed is disease prevention and oral health promotion. Today, dentistry is less reactive and more preventive in nature—more of a collaboration between clinician and patient than “something done to them.”

That's the advantage of DH and DTh – that's what we do.

It’s important to celebrate our profession and consider how far they have come in a relatively short period of time. We are the cornerstone of prevention; the future of oral health care for our patients and the public. DHs and DThs are important members of the oral health care team, providing patients with access to care and can manage some patients' oral health from cradle to grave.

'Exciting times'

Now, apart from some additional training, we are empowered to work with complete autonomy. It's an exciting time; we can pursue further professional education such as a Master's or PhD, we can work within the dental industry in education, research, or own and operate our own dental practice and be a part of our patients' lives of regular customers.

Some would like to add more skills to our scope of practice, but in my opinion this means we lose some of the essence of what it means to be a DH or DTh; prevention specialist. If the scope expands, we get into the realm of becoming a dentist, and then one can be trained to become a dentist if needed. Others want prescription rights, the same way a person can be a dentist. But these further responsibilities are not desirable across the industry and may impose additional financial burdens.

As we take on more responsibilities in the NHS, we need to make sure the environment is fair and reasonable. We are not someone's cheap labor. We are not here to be taken advantage of.

BSDHT is here for you. From your training as a student to the time the president sends you a card when you retire. It was one of the best jobs I've ever had, writing a card to someone I'd never met, a DH or DTh who had spent their lives caring for patients in the community.

This is a beautiful thing. We are a large group of dental care professionals; we are all dental professionals who care. This is something to celebrate.


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