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Structure of the Dental Profession

The dental team is now made up of dentists and six categories of registered dental care professionals (DCPs), all of whom work together to provide oral healthcare for their patients. In hospital and clinic environments, some of the dentists may have gone on to become specialists in various fields of dentistry, while dental nurses are now able to train and become competent in various postregistration qualifications as well as ‘extended duties’. With the introduction of a new National Health Service (NHS) dental contract and with a new commissioning system imminent, there has never been a more exciting time for dental nurses to push the boundaries of their profession and become recognised as vital members of every dental team, in every dental workplace.

An overview is given below of the roles of the various registrants, and that of the dental nurse is covered in detail in Chapter 2.

The dentist

Dentists undergo 5 years of undergraduate training at a university dental school. On passing their final examinations, students are awarded the degree of Bachelor of Dental Surgery (BDS), but they cannot use the title of dentist or practise the profession until their names have been entered onto the Dentists Register. In addition, dentists who have qualified in member states of the European Union may also join the Register, although they must have an adequate level of written and spoken English. Dentists from non-European Union countries must have their skills and knowledge assessed for equivalence with that required for UK dentists before they may work here.

The Register is kept by the General Dental Council and contains the name, address and qualification(s) of every person legally entitled to practise dentistry in the United Kingdom. Such persons may describe themselves as dentist, dental surgeon or dental practitioner – there is no difference between these titles. Dentists may also use the courtesy title of Doctor but must not imply that they are anything other than dentists. Following qualification, all dentists are legally required to continue their professional education until their retirement from practice, in order to maintain and update their skills.

Registered dentists have a wide choice of opportunities within the profession.

• General practice.
• Community dental service.
• Hospital service.
• University teaching and research.
• Industrial dental service.
• The armed forces.

They may also take additional higher qualifications and become specialists in a particular branch of dentistry. Some examples of such qualifications are as follows.

• Fellowship in Dental Surgery (FDS).
• Master of Science (MSc) in a specialty.
• Membership in the Joint Dental Faculties (MJDF).
• Membership in Paediatric Dentistry (M Paed Dent).
• Membership of the Faculty of Dental Surgery (MFDS).
• Diploma in Dental Public Health (DDPH).
• Diploma in Dental Radiology (DDR).
• Diploma in General Dental Practice (DGDP).
• Diploma in Orthodontics (DOrth).

These qualifications are provided by the joint dental faculties of the Royal Colleges of Surgery.

Having obtained the relevant higher qualifications, dentists may then join the Specialist List of the Register for their particular specialty, which includes the following areas.

• Oral and maxillofacial surgery.
• Surgical dentistry.
• Dental and maxillofacial radiology.
• Dental public health.
• Oral medicine.
• Oral microbiology.
• Oral pathology.
• Orthodontics.
• Periodontics.
• Prosthodontics.
• Restorative dentistry.

The General Dental Council

The General Dental Council (GDC) is the regulatory body of the dental profession and its duties are set out in legislation. It aims to promote high standards of professional education and professional conduct among dentists and DCPs, throughout their working career. It thereby ensures that the status of the profession in the general community is upheld and that a proper code of conduct is maintained, for the protection of the public. In essence, its remit is to:

• protect patients
• regulate the dental team.

In the performance of these duties, the GDC must be satisfied that courses of study at dental schools and the qualifying examinations are adequate, and the same applies to postgraduate education and to the register-able qualifications for all the DCP categories.

It is the policy of the GDC for all dentists, after qualification, to complete a year of foundation training (previously called vocational training) before starting independent practice. Such training schemes are already in force in NHS general practice, the community and hospital services, and also on a voluntary basis in non-NHS practice. As soon as adequate resources and facilities are available, it is likely to be mandatory for all newly qualified dentists to undergo foundation training soon after qualification.

The GDC is empowered to remove or suspend from the Register any dentist or DCP who has been convicted of a criminal offence or is guilty of serious professional misconduct. It may also suspend any registrant whose fitness to practise is seriously impaired because of a physical or mental condition. These issues are discussed further in Chapters 2 and 3.

Apart from registered dentists, the only other persons permitted to undertake dental treatment are registered dental hygienists and dental therapists, and registered clinical dental technicians may provide and maintain full dentures to edentulous patients. The GDC is responsible for these dental care professionals in much the same way as for dentists. The expected level of their competences by the time of their qualification is laid out in the GDC document Preparing for Practice, while those additional duties possible after a period of suitable training and assessment are laid out in its document Scope of Practice. This has particular relevance to dental nurses, and all GDC documents can be downloaded at www.gdc-uk.org.

The dental team

Dentists’ training enables them to undertake, without assistance, all treatment necessary for patients, including construction of their dentures, crowns and bridges, provision of restorations and root fillings, extractions, etc. Except for the actual treatment performed within the mouth, much of the work which a dentist is qualified to do can be performed by other members of the dental team. For example, a chairside dental nurse provides an extra pair of hands for preparing and mixing filling and impression materials, and for helping with suction, retraction and illumination to keep the operative field clear and dry for the dentist and comfortable for the patient. A dental technician can make dentures, crowns and bridge/>

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