A practice group has been utilising its staff’s ‘mixed skills’ to provide urgent dental care to children under 12.

SpaDental, based in the west of England, strives to help children avoid future pain, discomfort and expense resulting from avoidable dental decay. It helps children to protect their teeth for life by promoting oral health awareness and regular dental examinations.

SpaDental is championing the full utilisation of ‘mixed skills’ in dentistry. This, combined with the recent NHS contract changes allowing direct access to Dental Care Professionals (DCPs), enables SpaDental to continue delivering children’s dental care despite the lack of available dentists offering NHS services, especially in the Southwest and rural settings.

The group has moved towards a model that integrates direct access therapist-led sessions. Post Brexit and Covid-19, it was clear that recruitment of GDC registered dentists was going to remain difficult for many years. So, SpaDental obtained a sponsorship licence, attracting overseas qualified dentists with GDC registration as therapists and implementing a structured vetting, training and support programme as required by the role. Now, these therapists are providing a much-needed service to young people.

Aware of the long-term benefits of early dental care, parents and guardians of young children responded in their hundreds to SpaDental’s announcement of available NHS appointments for under 12s. It asked preschools, primary schools, and GPs to help relay the message.

SpaDental said the changes to the NHS contract have proved helpful in maintaining child access and allowing therapists to work to their full Scope of Practice. However, the group acknowledges there are still frustrations as some of the additional changes needed are not yet in place. These include the updating of legislation to allow therapists to prescribe fluoride and local anaesthetic without the requirement of a dentist's prescription.

Moving forward, SpaDental believes that utilising the mixed skills of clinicians can significantly increase access. It is delighted by the uptake of children’s appointments. However, whilst dental therapists can treat adult patients via direct access arrangements, they must be able to refer patients with needs outside their scope of practice to a dentist. It is not possible, therefore, to extend our therapist-led model to all adult NHS patients as there is a limited amount of clinical time available from dentists willing to see these NHS referrals (an obstacle that also affects the age range of children we can treat under this model). SpaDental is working to increase the hours of clinical time offered by NHS dentists so therapists can refer patients with complex needs outside their scope of practice, but this is difficult due to the remuneration paid by the NHS for referrals.

SpaDental also noted that while the recent NHS contract changes have helped by encouraging mixed skills, this must be seen as the first step to saving NHS dental services for future generations.

Until there are more dentists available, SpaDental will continue to engage with the community, allocate time for younger children’s routine examinations, and encourage parents to bring them to regular appointments.

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