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How often should I see him?

Dento-legal expert Joe Ingham offers guidelines on patient’s needs, recall frequency and treatment plans

What is the minimum frequency that a patient has to have a check-up with a dentist in order to have treatment provided by a dental hygienist?
In the past, the patient needed to see a dentist every year in order to be treated by the dental hygienist. But the most recent General Dental Council guidance, published in January 2009 (entitled Scope of Practice) is not quite so prescriptive and should be read in conjunction with Principles of Dental Team Working.

Both documents can be downloaded from the GDC’s website (www.gdc-uk.org) or obtained in hard copy by contacting the GDC directly.

In its simplest form, the current position is that dental hygienists may not diagnose disease (or for that matter, restore teeth, carry out pulp treatments, adjust surfaces that have not been previously restored or extract teeth).
Consequently, the dentist, who plays a strategic role in the team, needs to undertake a full mouth assessment of a patient and provide the patient with either an outlined treatment plan or a full treatment plan if necessary, depending on the patient’s needs.

The treatment plan could be as simple as a statement that the patient has good oral health and needs no more than routine oral care for, by way of an example, the next three years, or a detailed plan for complex treatment and reassessment (for example in three months).

The reassessment date is the date when a patient must return to be seen by a dentist for a full mouth examination and a further treatment plan. The recall interval defines how often the patient should return to be seen by a member of the dental team.

Therefore, you can see that dental hygienists may plan the delivery of care for patients, to improve and maintain their periodontal health, and provide dental hygiene care to a wide range of patients.

If you are working under a treatment plan and discover a situation which makes you think that the patient requires further diagnostic input, even though there is a set recall interval or a date designated for a new examination, then you should refer the patient back as soon as possible – depending on the urgency – to the dentist for diagnosis and a review of the original treatment plan.

Treatment plans, whether an outline or a fully detailed plan, should include:
Recall intervals, depending on the patient’s clinical needs
A date for a full mouth reassessment by a dentist
A referral if necessary

Joe Ingham is a dento-legal adviser available to answer enquiries from members of Dental Protection. HE is a dental practice adviser for the two Berkshire PCTs and works as a tutor at the School of Hygiene and Therapy at The Eastman. The question has been fictionalised to ensure confidentiality.
Website: www.dentalprotection.org.uk


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