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Direct access in the UK: what do dentists really think?

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Many dentists expressed concerns about direct access (DA) for hygienists and therapists, citing inadequate training and potential patient safety issues. Improved communication and joint training are recommended to address these reservations.

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Area of Science:

  • Dental Public Health
  • Healthcare Professional Roles
  • Professional Regulation

Background:

  • The General Dental Council (GDC) in the UK introduced Direct Access (DA), allowing dental hygienists and therapists to work autonomously.
  • This policy change aimed to improve patient access to dental care but raised questions about dentists' perceptions of professional competence and role changes.

Purpose of the Study:

  • To investigate UK dentists' views on the impact of Direct Access (DA).
  • To assess dentists' perceptions of the clinical competence of dental hygienists and therapists working autonomously.
  • To identify potential predictors influencing these views.

Main Methods:

  • A random survey of UK-registered dentists was conducted in 2014.
  • An online questionnaire, with a paper alternative, was distributed to a random sample of General Dental Council (GDC) registrants.
  • Measures focused on dentists' positive/negative views regarding DA and the autonomous practice of hygienists and therapists.

Main Results:

  • A response rate of 27% (159 dentists) was achieved, with no significant response bias identified.
  • A majority of dentists disagreed with the GDC's decision on DA for both hygienists (53.2%) and therapists (59.1%).
  • Concerns centered on diagnosis, treatment planning, restorations, patient safety, perceived inadequate training, and the dentist's role.

Conclusions:

  • The low response rate may limit the study's representativeness.
  • Dentists' reservations about DA were largely independent of their experience with teamwork.
  • Disseminating information on curricula and scope of practice, alongside increased joint training, could alleviate concerns.