ProfessionHistory of the Dental Therapist
The history of the dental therapist is surprising and begins long before 1960 when New Cross first opened its doors. In 1917 ‘Dental Dressers’ were established in some counties in England – they were the first dental therapists in the world and their duties were based on the American hygienist with the addition of ‘filling those cavities without pulpal involvement’ and ‘the extraction of ‘temporary teeth in school clinics’. There was at the time a desperate shortage of school service dental officers and the Armed Services were recruiting registered (University trained) dentists for the First World War. Until the Dental Act of 1921 apprentice trained dentists were not registered - once this came into being there were enough dentists to work in the service and the dresser’s duties were reduced to that of a hygienist, for whom there was little demand in the school services.
In 1920 New Zealand established a School Dental Service and the training of Dental Therapists began – they were called Dental Nurses. As they worked in rural communities they were the first contact point for patients with an onward referral to a dentist if necessary. This scheme continues today and has been copied by many countries in the world where there is a rural population.
Back to the UK – by 1950 there was once again a desperate shortage of dentists in the school services and children’s dental health was worsening. Following visits to New Zealand the Dentist Act of 1956 was changed to allow the training of Dental Auxiliaries – however the New Zealand scheme was not adapted in its entirety. Dental Auxiliaries would be referred patients by the Dentist – not like in New Zealand!
In 1960 the first school for training Dental Auxiliaries was opened at New Cross Hospital in south east London – using a former isolation unit which was ideal for individual surgeries. Sixty students a year followed an intense two year training course. This continued until 1983 when the school closed. They were trained to carry out restorations in primary and secondary dentition – Black Cavity Classifications Class I-V – to extract deciduous teeth – give infiltration anaesthesia – take and develop x-rays, scaling and dental health education. In fact this remit did not change until 2002. Their patient base came from local schools following school dental examinations. Parents would sign the consent form and the children would arrive from school in a coach – escorted by two students. Escort and waiting room duties were part of the second year training! Early patient management and people skills!
At this time the Dental Act would only allow Therapists to work in community dental services, hospital and the armed forces. Although able to carry out hygiene treatment they could not work under the title Dental Therapist in general practice so in order to do they had to study a further three months on a hygiene course (hygiene courses at the time varied between 9 months and a year depending on the training school) so that they could register as a Hygienist..
In 1983 New Cross was closed but that wasn’t the end of Dental Therapists. Supporters argued and battled with the government for the training to continue.. Evidence in support of dental therapists by a review group was finally examined and the first training of Dental Therapists at Barts and the London Hospital began with just 8 students. The length of the course was extended to include the extra three months so that students came out with the dual qualification.
Since then training schools have opened their doors all over the country. Many schools now offer a Degree course as well as the Diploma course. All courses give dual qualifications. For a full list of schools see Career pathway -> Dental Schools.
In 2002 after years of pressure from the British Association of Dental Therapists, the Dental Act was finally reviewed and amended and Dental Therapists were allowed to work in general practice and along with that the remit finally changed and what became known as ‘extended duties’ were added. These included the long awaited administration of ID Blocks, pulpotomies on deciduous teeth and impression taking.
August 2008 saw compulsory continuous professional development come into being with the requirement of 150 hours over a period of five years.
As the role of the Dental Therapist continues to develop there is one organisation that has worked hard all these long years pushing issues and never accepting a negative response and that is the British Association of Dental Therapists. Without them we would not be where we are today and they will continue to represent and fight for Therapists.