Psychology - law, ethics and professionalism Flashcards
(32 cards)
Who makes up the dental team?
Dentist
Dental hygienist
Dental therapist
Orthodontic therapist
Dental nurse
Clinical/dental technicians
Why are dental care professionals (DCP) important to dentists?
- Understand legal implications for dentist & DCP if fitness to practice is called into question
- Should understand who you work with & what they are able to undertake as part of their scope of practice
e.g. employing a DCP who is not registered or asking a DCP to underake something they are not trained/competant to do e.g. dental hygienists cannot remove hard tooth tissue!
Where can you find out about the role of the dental hygienist and dental therapist?
GDC scope of practice document
http://www.gdc-uk.org/Dentalprofessionals/Standards/Documents/Scope%20of%20Practice%20September%202013%20(3).pdf
What is indemnity?
- All DCP’s whether clinical or not should have theor own professional indemnity (insurance to protect the individual on their advice & work)
- As dentists employing DCPs you need to know if they are indemnified
What is the GDC fitness to practice?
- From april 2010
- Moniter progress throughout clinical training e.g. plagarism & behaviour outside
- Any unprofessional behaiour or serious health problems during training can affect your aboloty to register with the GDC once qualified
- Students can be suied in their own right & would almost certainly be individually named in any legal proceeding that might be brought about in respect of any treatment they provided (do not mislead patients, should bond with them = empathy & trust)
What can a Dental hygeinists & therapists do?
Allowed to undertake duties for which they are trained and competant
Which duties can a dental hygienist do?
- Provide dental hygiene care to a wide range of patients
- Plan the delivery of care for patients to improve and maintain their periodontal health
- Obtain a detailed dental history from patients and evaluate their medical history
- Complete periodontal examination and charting (indicies to screen & moniter periodontal disease)
- Provide preventative oral care to patients & liase with dentists over the treatment of caries, periodontal disease and tooth wear
- Undertake supragingival & subgingival scaling & root surface debridement using manual and powered instruments (management but can’t do invasive care)
- Use appropriate anti-microbial therapy to manage plaque and related diseases
- Adjust restored surfaces in relation to periodontal treatment
- Apply topical treatments and fissure sealants e.g. overhanging amalgam
- Giving patients advice on how to stop smoking
- Take, process & interpret various film views used in general dental practice
- Give infiltration and inferior dental block analgesia
- Place temporary dressings and re-cement corwns with temporary cement
- Take impressions
What can dental hygienists NOT do?
- Diagnose disease (but can interpret disease)
- Do not restore teeth
- Do not carry out pulp treatments
- Do not adjust unrestored surfaces
- Do not extract teeth
What additional skills may a dental hygienist have?
- Tooth whitening to the prescription of dentist (dentist must be on the premises)
- Prescribing radiographs (details currently being debated)
- Administering inhalation sedation
- Removing sutures after the wound has been checked by a dentist
What do dental therapists do?
Provide holistic patient care and are trained as a hygienist but also trained in additional therapist skills
What can dental therapists do?
- All intracoronal (class I-V) restorations in primary & permanent teeth
- Use all materials and adhesive techniques including bonded amalgams (not pre-cast and pinned placements)
- Administer local infiltration anaesthetics (LIA) & inferior alveolar nerve blocks (IDB)
- Provision of treatment under rubber dam
- Take dental radiographs
- Take alginate impressions (cannot prescribe them)
- Perform pulp therapy treatment in primary teeth
- Fit preformed metal crowns in primary teeth
- Extract primary teeth under local anaesthetic
What can dental therapists NOT do?
- Carry out initial diagnosis
- Do not take overall responsibility for planning a patient’s treatment (cannot change the direction of treatment)
- Do not undetake any of the skills described within the roles of dental technicians, clinical dental technicians or dentists
What additional duties may a dental therapist have?
- Tooth whitening to the prescription of a dentist
- Prescribing radiographs
- Administering inhalation sedation
- Removing sutures after the wound has been checked by a dentist
By which system was dental care in the UK largely delivered by?
Dental care in UK largely delivered via a system whereby patients must first be seen by a dentist in order to access dental care
Dentist = examine, diagnose & treatment plan
SEEN AS BARRIER -> introduce direct access
What is the direct access system?
Giving patients access to a dental care professional (DCP) e.g. dental hygienist without having to see a dentist first (point of access before referral to a dentist)
Practice must be compliant with legislation & codes of practice relating to direct access (GDC & FGDP)
Must advertise on website or in practice
Which DCP’s must be registered (in the expanded regestration of 2006)?
Dentists
Dental nurses
Dental technicians
Orthodontic therapists
Clinical denal technicians
Dentists act: practice of dentistry is limited to GDC registrants who may carry out treatments or duties for which they are trained and competant
Who may perform tooth whitening?
Registered dental professional (not hairdressers & beauticians etc.!)
GDC standards:
booklet of guidance 2006
Patients should first be seen by a dentist before seeing another member of the dental team
The only exception: patients who have no teeth can see a clinical dental technician (CDT) directly to have full dentures made
What must be taken by a dentist for a referral to a dental therapist/hygienist?
- Medical history & consent
- Full mouth assessment & charting including BPE
- Radiographs (reported & diagnosis)
- Treatment prescription
- Local analgesia (drug, dose & route)
- Prescriptions of Medicine (PoMs) e.g. sodium fluoride varnish, antibiotics
- Time period for review, or discharge on completeion of course of treatment
What is the bog standard max of local anaesthetic dose?
3 x 2.2 ml cartridges
Following initial assessment by a dentists for how long can a patient be seen by a dental hygienist and therapist independantly of the dentist?
Up to 3 years (only refer back to dentist if the oral health status changes significantly which warrants further assessment and planning)
Which document is especially useful for paeds?
Delivering better oral health: an ecidence based toolkit for prevention
What additional skills may a dental nurse have?
- Oral health education
- Intra-oral photography
- Shade taking
- Placing rubber dam
- Measuring and recording plaque indicies
- Pouring, casting and trimming study models
- Removing sutures after wound has been checked by a dentist
- Applying fluoride varnish as part of a programme overseen by a consultant in dental public health
- Constructing occlusal rims and special trays
- Repairing the acrylic components of removable appliances
- Tracing cephalographs
What additional skills can a nurse undertake on prescription of a dentist?
- Taking radiographs
- Taking impressions
- Constructing mouth guards and bleaching trays
- Constructing vacuum formed retainers
