The General Dental Council’s (GDC) Scope of Practice (GDC, 2013) has had a great impact on the role of the dental nurse. It has allowed nurses to take on more duties, which helps them to further their career and to become a great asset within the dental practice. In order to carry out these extended duties, the GDC has stipulated that further training is needed. This article discusses the additional qualifications that dental nurses can take, and the different roles that dental nurses can progress into.
Additional qualifications for a dental nurse post-registration
At present, there are five additional qualifications that dental nurses can obtain in order to further their careers. Before long, we are likely to see a sixth being added dealing with dental implants. In some practices, the principal will cover the cost of the course and the first sitting of the examination, while other practices may expect the dental nurse to self-fund the course and exam fees. Extensive information on the courses and assessment methods are given on the National Examining Board for Dental Nurses (NEBDN) website (www.nebdn.org). Therefore, only a brief outline is given in the following sections.
This course allows the dental nurse to assist as the ‘second appropriate person’ present as well as the dentist providing the sedation.
This is the second article of a two-part series that will discuss the changing role of the dental nurse and the new opportunities that these changes will bring. This article will examine how qualifications and different career options can transform dental nurses’ career progression Looking to the future: qualifications and career pathways dentist providing the sedation. Suitable for those dental nurses working in an environment routinely providing sedation, the course involves theory and practical work ,including case studies.
There is a written and oral examination at the end of the course.
This course should be suitable for almost every dental nurse engaged in clinical activity. The course allows dental nurses to take radiographs on prescription. There is both theoretical and practical training, and throughout the course the dental nurse has to take a series of radiographs. The qualification is awarded if you pass the examination at the end of the course and adequately complete the coursework.
Oral health education
This is suitable for dental nurses who are required to offer oral health advice to patients under the direction of a dentist. The course has the same elements as the dental radiography course and involves online studying combined with practical training. Case studies need to be recorded throughout the course, along with a display/exhibition, and there is a written and oral examination at the end.
This course is ideal for dental nurses who assist with orthodontic procedures. There is a record of experience, case studies, and an evidence of competence is required in clinical photographs, cephalometric tracing and casting study models. There is also a written examination.
Special care dentistry
Candidates for this course must be engaged in assisting with people whose health and social care needs may require special oral health care provision. This course is similar in assessment structure to the course in orthodontics, as there is a record of experience, case studies and evidence of competences. There is also a written examination.
Pathways available for career progression for a dental nurse
The opportunities outlined already in the enhanced skills and post-registration qualifications should allow dental nurses to progress their career, for career progression does not always mean a change from dental nursing entirely. Despite the now significant opportunities within dental nursing, some dental nurses may feel a calling to different roles, which may still utilise some of the skills acquired in their dental nurse training but involve completely different skillsets as well, outside of the ‘scope of practice’ of dental nurses as outlined by the GDC (2013).
As career progression occurs, some dental nurses may seek employment in specialist practice or a specialist department within a hospital or community setting. Others may feel a pull to the variety and challenges of working in the Armed Forces or the Prison Service or perhaps assist with occasional work in forensic dentistry, although such opportunities are likely to be rare.
For many dental nurses, there is often a natural progression that takes place once he/she has demonstrated a level of skill higher than usually expected. This results in promotion to a senior or lead nurse role, and the transition to practice manager can sometimes occur without the dental nurse realising. Challenges can be faced when the dental nurse-comepractice manager is faced with making decisions about business strategy, disciplinary procedures or financial management. For those interested in a practice manger role, there is a BTEC Level 4 Diploma in Dental Practice Management and there are resources such as the Association of Dental Administrators and Managers (ADAM) and Dental Practice Management (DPM) to offer support.
The aim of the treatment coordinator (TCO) is to remove non-clinical dentistry from the dentist. Dentists are increasingly realising that having a TCO benefits the practice, the team and the patients. Essentially, it is a desk role but at the front line—the TCO deals with the patient from the first phone call through to treatment follow-up. A dental nursing background is invaluable because many of the questions that patients will ask are about clinical treatment. A Level 3 BTEC Advanced Diploma in Dental Care Co-ordination is available that covers effective communication, marketing and sales and clinical governance for the TCO.
Dental hygiene and therapy
The Diploma in Hygiene and Therapy is now offered by most of the training schools in the UK over a two to two and a half year full-time course. A dental nurse qualification can be advantageous although some schools will accept A-level entry or equivalent. All schools expect students to have five GCSEs grade C or above, including English language, Maths and Science. Entry is very competitive and a rule of thumb is that if you have been rejected twice, there will be an automatic rejection the third time. New courses are being introduced and there is now a Foundation Degree in Oral Health Sciences that prepares individuals for a career as a dental hygienist. A BSc in Oral Health Sciences, which requires three A-levels or equivalent, is also offered and takes place over a three year period preparing individuals for a career as a dental therapist. A BSc (Hons) is also available over four years and is targeted more towards those who not only want to undertake clinical dentistry as dental therapists, but who may also wish to enter an academic environment.
To be eligible to apply for orthodontic therapy, a qualification in dental nursing, dental hygiene, dental therapy or dental technology is usually required. Many applicants also have the Certificate in Orthodontic Nursing. There is also a requirement to demonstrate a period of post-qualification experience, usually a minimum of one year. GCSEs grade C or above in English, Maths and a Science subject are also highly desirable. Training involves up to one month of core days followed by about a dozen study days. The training pathway is often just under one year and allows the successful student to carry out many of the practical aspects of orthodontics.
Some dental nurses may take an interest in the technical side of dentistry, away from the clinical environment. They may want to consider a career as a dental technician. There are many paths available, such as the Extended Diploma in Dental Technology at BTEC Level 4 offered as a three-year part-time or a two-year full-time course. There is also a Dental Technology Foundation Degree course over three years and is part-time. A BSc (Hons) Dental Technology is also offered, which can be completed over three years fulltime or five to six years part-time. Once qualified as a dental technician, subsequent specialisation can be explored in areas such as conservation, maxillofacial, orthodontics or prosthetics.
For those with a strong sales drive, limited opportunities may exist allowing employment with companies working in the dental sector. This can range from a dental supplies company to a dental product manufacturer.
Those passionate and enthusiastic about dental nursing, and who are knowledgeable about the subject area, may consider teaching as a career option. There are numerous courses available depending on the extent to which the dental nurse is involved with teaching:
- Preparing to Teach in the Lifelong Learning Sector (PTLLS)
- Certificate in Teaching in the Lifelong Learning Sector (CTLLS)
- Certificate in Further Education Teaching
- Diploma in Teaching in the Lifelong Learning Sector (DTLLS)
- Post-graduate Certificate in Dental Education (PgCert DE)
PTLLS, for example, is suitable for those supporting student dental nurses in the work place. Most of the other courses require access to groups of students, with the CTLLS course giving associate teacher status and the DTLLS course giving full teacher status. The PgCert DE is a combination of study days and online learning and is suitable for all dental team members involved in primary and secondary dental education. Upon acquiring an appropriate qualification, dental nurses may go on to teach both student and qualified dental nurses on a part-time or full-time basis.
The NEBDN has a panel of around 400 examiners who are involved with the various examinations processes. The panel of examiners is made up of registered dental nurses and dentists who have been qualified for more than four years and demonstrate an active involvement in, and commitment to, the training and qualification of dental nurses. On appointment, examiners are required to undergo a residential induction and training programme before examining. The examination takes place twice a year. Although this is unlikely to replace your clinical role as a dental nurse, it can be highly rewarding.
There are still other roles that can be explored, such as part-time work with the GDC on their Fitness to Practise Panel, involvement with an editorial board for a dental magazine or journal or even writing your own textbook for future generations of student dental nurses.
As the way in which NHS dentistry is being delivered undergoes major change, so too is the regulation of the NHS workforce. Statutory regulation for dental nurses with mandatory continuing professional development and the need for indemnity have been put in place. The role of the dental nurse has been greatly enhanced with the introduction of Scope of Practice (GDC, 2013) and there are now significant extended duty opportunities as well as a range of post-registration qualifications that allow dental nurses to further their careers and increase their levels of job satisfaction and salary. They will find that opportunities to work away from the practices with other team members will become a much greater part of their roles. Career opportunities will be significantly improved with a range of options available ranging from teaching to orthodontic therapy.