Skill mix and its impact on dentistry in today’s world


  Posted by: Dental Design      26th January 2021

There has been much debate surrounding the effectiveness and safety of skill mix within the dental practice. Ever since direct access was introduced, dental care professionals (DCPs) around the UK have been embracing the benefits brought to patients and practices with the opportunities this created. However, there have been some challenges to overcome, such as how to maximise skill mix in the practice while ensuring the safety of patient care and efficiency of daily practice life.

Offering her perspective will be Michaela O’Neill – a dental hygienist with nearly 30 years of experience, a Past President of the British Society of Dental Hygiene and Therapy (BSDHT) and the current Vice President of the International Federation of Dental Hygienists. She discusses what has traditionally caused unease among the dental team regarding skill mix.

“In the past, there has been a gap between what DCPs can do and what colleagues think they can do,” she says. “The GDC scope of practice helped a lot, demonstrating the skills that dental hygienists and dental therapists can have, and highlighting what they can do within their competency and with the right training”. However, this was not enough to give all clinicians confidence to utilise DCPs’ additional skills.

“Though a gap still exists, it is closing over time – more practice teams are utilising the capabilities of their DCPs. With any team, when you start working together and really come to trust your colleagues, you can better discuss how to treat patients collaboratively. You need mutual respect for each other’s skills, as well as open and honest communication. This often takes time, becoming easier as the professional relationship develops.”

While no one can predict how skill mix will be used in the future, it is interesting to consider what new opportunities may be available post-pandemic lockdown for DCPs in practices. Indeed, as Michaela goes on to explore, it may provide a chance to boost business recovery as well as patient care:

“This is a very interesting time – many clinicians are adapting and changing how they work. It’s been heart-warming to see so many team members helping their colleagues by taking on new roles and responsibilities or even giving up clinical time in order to give dental hygienists/therapists some clinical time too. People are really coming together, benefiting the profession and, ultimately, patients.

“I believe skill mix can be utilised differently today compared to how we approached it pre-pandemic. There is a huge push on prevention right now, which is definitely  one of the strengths of a dental hygienist/therapist. The fact that oral health education can be delivered virtually provides a new way for dental hygienists/therapists to utilise their skills, while overcoming some of the challenges of reduced chair time and patient footfall in the practice. We have to think creatively, now more than ever, to use our skills and deliver the care our patients need. Virtual technology is a very sensible way forward as it enables us to maintain relationships with our patients, without requiring any clinical time.” 

Offering some advice for fellow DCPs on how to encourage safe and effective skill mix in their practices, especially given the current situation, Michaela adds:

“I think DCPs need to have more confidence in their abilities and speak up. If you don’t talk about what you can do, you won’t get anywhere, so if you can offer something that will benefit patients and/or the practice, speak to the principal/owner. Be prepared to demonstrate the potential benefits of what you’re suggesting and get the conversation started. People are open to ideas – especially right now, when many of us have already implemented changes to deal with post-pandemic dentistry. Your opinion matters, so have the confidence to share it.

“I also believe that dental hygienists/therapists’ position in the practice could be made easier in future if they are able to utilise certain medications directly, without needing a prescription. Securing exemptions from the Medicines Act is one of the projects that the BSDHT and BADT continues to fight for, which would ultimately allow more flexibility in the practice and improve skill mix for simpler, faster and higher quality patient care.”

Michaela will be putting forward her side of the debate regarding skill mix at the ADI Team Congress 2021 as part of the highly anticipated Team Programme. Encouraging dental hygienists and dental therapists to attend, she adds:

“Dental implants are commonplace now in every practice and the importance of optimal oral hygiene to maintain these has been a constant drum beat within the profession. It is imperative to attend an event like this to develop and update our skills. I also believe if you are working in practice, you need to keep yourself motivated. The best way to do this is to learn more and mix with enthusiastic colleagues. It renews your passion and keeps you at the top of your game.”


ADI Team Congress 2021

“The Great Debate”

6-8 May 2021, Manchester Central


ADI members will be able to attend the ADI Team Congress for discounted rates. Join today.

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