East of England

Extended Duties for Dental Nurses

Prior to statutory registration, extended clinical duties for dental nurses were often discussed; as it was felt further career opportunities for dental nurses were required, that did not involve the dental nurse stepping away from the chairside. Since the inception of the GDC’s Scope of Practice (SoP) document in April 2009, extended duties courses are growing in number across the UK, thus providing opportunities for dental nurses to develop further knowledge and new skills in extended clinical duties. Some of the duties listed below have been available to dental nurses for sometime through the NEBDN Post certificate qualifications*.

The Scope of Practice document clearly lays out the extended duties that a dental nurse can be educated and trained to undertake, these are:

Additional skills a dental nurse could develop during their career include:

• Further skills in oral health education and oral health promotion*
• Assisting in the treatment of patients who are under conscious sedation*
• Further skills in assisting in the treatment of patients with special needs*
• Intra-oral photography
• Shade taking
• Place rubber dam
• Measuring and recording plaque indices
• Pouring , casting and trimming study models*
• Removing sutures after the wound has been checked by a dentist
• Applying fluoride varnish as part of a programme which is overseen by a consultant in dental public health or a registered specialist in dental public health
• Constructing occlusal registration rims and special trays
• Repairing the acrylic component of removable appliances
• Tracing cephalographs*

Additional skills on prescription

• Taking radiographs to the prescription of a dentist*
• Applying topical anaesthetic to the prescription of a dentist
• Constructing vacuum formed retainers to the prescription of a dentist
• Taking impressions to the prescription of a dentist or a Clinical Dental technician (CDT)

After qualification and GDC registration there are various opportunities for dental nurses to undertake Continuing Professional Development (CPD). Some choose to work towards formal qualifications, these are offered by various awarding bodies e.g. The National Examining Board for Dental Nurses (NEBDN), Faculty of General Dental Practice (FGDP), City & Guilds, University of Bedfordshire, University of Kent and various dental hospitals. The qualifications undertaken by a registered dental nurse will be determined by the career pathway they choose.

NEBDN Post Certificate Qualifications

The National Examining Board for Dental Nurses has a suite of post certificate qualifications for dental nurses. At present NEBDN offer the following:

• Oral Health Education – suitable for dental nurses who are required to offer oral health advice to patients under the direction of a dentist. The Record of Experience (RoE) consists of 3 parts. Part A, a minimum of 20 log sheets, which include the care of 10 individuals seen on at least two occasions. The student is required to target at least six of the specified patient group. Part B, two expanded case studies must be completed from the log sheets. The case studies must cover a topic from the ranges provided by NEBDN. Part C, U-using a set proforma the student is required to plan, produce and evaluate a display/exhibition. There is a 90 minute written exam and 20 minute oral exam. 
• Dental Radiography - suitable for DCPs who are required to x-ray patients under the direction of a dentist. The Record of Experience (RoE) consists of 50 log sheets of various radiographs, 3 expanded case studies and a written exercise on the taking and processing of lateral oblique radiographs. The written exam last 1 hour and consists of negatively marked MCQs. 
• Dental Sedation Nursing - suitable for dental nurses who assist in the surgery during routine conscious sedation. Candidates must be engaged in this type of work on a routine basis as completion of a RoE, which includes 25 sedation log sheets and 25 recovery log sheets as well as 2 expanded case studies. This has a 90 minute written exam and 20 minute practical oral. 
• Special Care Dental Nursing - suitable for dental nurses who assist with people whose health and social care needs may require special oral health care provision. Candidates again must be engaged in this type of work routinely as completion of a RoE is required. The RoE includes 20 log sheets and 3 expanded case studies and evidence of competence e.g. CPR and manual handling. 
• Orthodontics - suitable for dental nurses who assist in orthodontic procedures. The RoE consists of 50 log sheets, 2 expanded case studies and evidence of competence in clinical photographs, cephalometric tracing and casting study models. The written exam lasts 90 minutes.

Access to NEBDN post certificate qualifications must be made through an NEBDN accredited centre. All applicants must be registered with the GDC.

NEBDN also offer opportunities for dental nurses to become a member of their panel of examiners, in order to apply they request applicants are qualified for a minimum of 4 years and are involved in the training of dental nurses towards the National Certificate exam.

NEBDN continue to develop their suite of awards and plan to offer qualifications in Implant dental nursing, they also have plans for extended duties modules in impression taking and application of fluoride.

Further information on NEBDN post certificate qualifications and other opportunities NEBDN may have can be found on NEBDN's website .

Teaching Qualifications

Some dental nurses choose a career pathway in dental nurse education, in the past a dental nurse undertaking this role may choose to gain a qualification, however it was not deemed as necessary. However, in order to meet quality assurance set out by awarding bodies it is essential for those who choose this career pathway to embark on the qualification that supports the role they undertake.

PTTLS – Preparing to Teach in the Lifelong Learning Sector – this award covers the basics of teaching in continuing and adult education - including how to plan sessions, motivate learners and use a variety of assessment methods. Further information can be found on the City & Guilds website.

PTTLS is the first step for any dental nurse who wants to become a dental nurse tutor, however at present this qualification is adequate for those supporting student dental nurses in the work place, however a coaching or mentoring qualification would greatly benefit those undertaking this role. Work is being done by various organisations and awarding bodies to provide such a qualification.

Further study in teaching and training can be undertaken and this can be either the Certificate or Diploma in Teaching in the Life Long Learning Sector; however many DNs choose to move on to higher education (university) qualifications, such as the HE Certificate in Education. Some then go on to achieve a First Degree in Education, such as the BEd or a Masters Degree in Education MEd. The University of Bedfordshire now offers a Post Graduate Certificate in Dental Education, which can be the first part of a Masters Degree. Such qualifications are those whose main job role is that of a dental nurse tutor, as extensive evidence of work based learning in the classroom is required.

The NVQ primary qualification has also provided a route into training for DNs, with the need for NVQ assessors and internal verifiers. The qualifications to support these roles (A1 and V1 awards) are available through a number of awarding bodies and training providers.

The National Education Group is a sub-group of the BADN and its purpose is to offer support and networking opportunities for those involved in dental nurse education. Further information available from the BADN website.