Dental practitioners, are you practising dentistry within your scope of practice?
The Dental Board of Australia’s (DBA) revised scope of practice registration standard and guidelines for scope of practice came into effect as of 1 July 2020.
There are a number of dental practitioner divisions (being dentists, dental hygienists, dental prosthetists, dental therapists and oral health therapists) and each has its own scope of practice. A dentist can become a dental specialist after obtaining at least two years of experience in general dental practice and following completion of specialised education and training.
The main amendments to the standard and guidelines are with respect to:
- structured professional relationships, in that dental hygienists, dental therapists and oral health therapists are no longer required (by regulation) to have such a relationship with a dentist; and
- responsibility, in that all registered dental practitioners, no matter what division, are responsible for their provision of advice and treatment to patients, and their decision making.
When considering scope of practice, a dental practitioner must practise within the definition of dentistry which is outlined in section 2.1 of the guidelines:
“Dentistry involves assessing, preventing, diagnosing, advising on, and treating any injuries, diseases, deficiencies, deformities or lesions on or of the human teeth, mouth or jaws or associated structures. It includes restricted dental acts”.
Section 121(2) of the Health Practitioner Regulation National Law (NSW) defines a “restricted dental act” as:
“(a) performing any irreversible procedure on the human teeth or jaw or associated structures;
(b) correcting malpositions of the human teeth or jaw or associated structures;
(c) fitting or intra-orally adjusting artificial teeth or corrective or restorative dental appliances for a person;
(d) performing any irreversible procedure on, or the giving of any treatment or advice to, a person that is preparatory to or for the purpose of fitting, inserting, adjusting, fixing, constructing, repairing or renewing artificial dentures or a restorative dental appliance.”
There is no list to determine whether a specific procedure or treatment falls within the practise of dentistry. Rather, a dental practitioner’s scope of practice is dependent on their education, qualifications, training, experience and competence. A dental practitioner is expected to reflect on their individual scope of practice, and if they consider a procedure and/or treatment falls outside their individual scope of practice, refer the patient to an appropriate practitioner. To assist a dental practitioner to consider their competence and scope of practice, the DBA has created a reflective practice tool that can be downloaded from the DBA’s website.