see an expert, trusted dental hygienist without seeing a dentist first

direct access

direct access

In 2013 the general dental council (GDC) removed its barrier to Direct Access for some dental care professionals after considering the impact on patient safety. Before then, every member of the dental team had to work on the prescription of a dentist. This meant that patients had to be seen by a dentist before being treated by any other member of the dental team.

This page explains what treatments are available to patients under direct access.


ental hygienists and dental therapists can carry out their full scope of practice without prescription and without the patient having to see a dentist first. The only exception to this is tooth whitening, which must still be carried out on prescription from a dentist.

A hygienist can see you to provide oral hygiene advice, remove stain, tartar, bacterial deposits, and other debris. In relation to gums, the hygienist can advise you on the progression of gum disease.

More advanced conditions need to be assessed by a dentist or periodontist. Dental Hygienists cannot diagnose or give prognosis (the likely outcome) of diseases such as decaying teeth and broken teeth or prescribe antibiotics, painkillers or any other drugs to alleviate symptoms.

Visits to hygienists are not a substitute for full dental examinations.

available treatments

Here at Cowbridge Orthodontics our highly experienced Hygienist can see you without you seeing a Dentist first. The treatments that we can offer without a prescription are:

Simple scale and polish
Stain removal
Treatment of gum disease
Oral hygiene instruction
Plaque, bleeding and periodontal indices

READ: The GDC Scope of Practice document – Dental Care Professionals

Referral to a Dentist

If the hygienist advises you to see a dentist, it is because they feel that it is in the interests of your health and outside their scope of practice.

There are circumstances when a hygienist can’t start treatment, and before they are prepared to continue, insist that a dentist assesses you. It may relate to your medical history and general health, or condition of your mouth, which gives them concern.

JW Bassett
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