Patient safety at the heart of decision over Direct Access

28 March 2013

Patient safety at the heart of decision over Direct Access

The General Dental Council is to remove its barrier to Direct Access for some dental care professionals after considering the impact on patient safety. In the past every member of the dental team had to work on the prescription of a dentist. This meant that patients had to be seen by a dentist before being treated by any other member of the dental team.

Following a detailed review of evidence and a full discussion at a Council meeting on 28 March 2013, it was agreed this should change as outlined below. Full guidance for registrants will be published before these changes come into effect on 1 May 2013.

Chair of the GDC Kevin O’Brien said:

 “This decision has been made with patient safety as an upmost priority. Registrants treating  patients direct must only do so if appropriately trained, competent and indemnified. They  should also ensure that there are adequate onward referral arrangements in place and they  must make clear to the patient the extent of their scope of practice and not work beyond it.”

It should be remembered that:

• All registrants must be trained, competent and indemnified for any tasks they undertake.

• All registrants must continue to work within their scope of practice regardless of these changes.

• All registrants must continue to follow the GDC’s Standards for Dental Professionals.

• Dental care professionals do not have to offer direct access and should not be made to offer it. 

Dental hygienists and dental therapists

Dental hygienists and dental therapists can carry out their full scope of practice without prescription and without the patient having to see a dentist first.

Dental hygienists and dental therapists must be confident that they have the skills and competences required to treat patients direct before doing so. A period of practice working to a dentist’s prescription is a good way for registrants to assess this.

Registrants who qualified since 2002 covered the full scope of practice in their training, while those who trained before 2002 may not have covered everything. However, many of these registrants will have addressed this via top-up training, CPD and experience. Those who qualified before 2002, or those who have not applied their skills recently, must review their training and experience to ensure they are competent to undertake all the duties within their scope of practice. 

Dental nurses

Dental nurses can participate in preventative programmes without the patient having to see a dentist first. 

Orthodontic therapists 

Orthodontic therapists should continue to carry out the majority of their work under the prescription of a dentist.

Orthodontic therapists can carry out Index of Orthodontic Treatment Need (IOTN) screening without the patient having to see a dentist first.

Clinical dental technicians

Clinical dental technicians should continue to see patients direct for the provision and maintenance of full dentures only and should otherwise carry out their other work on the prescription of a dentist.

However the Council stated that with the potential for further training for CDTs this decision could be reviewed.

Dental technicians

The work of a dental technician (other than repairs) should continue to be carried out on the prescription of a dentist.
Dental professionals are encouraged to get in touch with the GDC if they have any questions.


Phone: 020 7167 6000
If calling from outside the UK: +44 20 7167 6000


For media enquiries, please contact Moira Alderson on 0207 1676 191 or    

Notes to editors:

• To get all the latest news from the GDC sign up to get our monthly newsletter by email.