Concerns for Dental Patient Safety
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- Published: Friday, 11 October 2019 07:56
- Written by Paul Felton
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Dental professionals in the UK are voicing grave concerns that overseas dental surgeons are putting patients at risk, by practising in the UK without thorough checks being carried out to assess their practical skills and competency.
Investigation by Paul Felton.
The British Association of Dental Therapists (BADT) has highlighted the fact that overseas dentists have been securing work as dental therapists without having to undergo a practical assessment of their clinical skills.
Dental surgeons from outside the European Union who wish to register as dentists with the General Dental Council (GDC), normally have to pass examinations laid down by statute, either the Overseas Registration Examination (ORE) or the Licentiate in Dental Surgery (LDS) awarded by the Royal College of Surgeons.
In the UK, dental therapists carry out a significant proportion of the routine dental work normally performed by dentists, such as adult and child fillings as well as extractions on baby (deciduous) teeth. They train to the same standards as their dentist colleagues and provide treatment in the National Health Service as well as privately, and are a vital part of the clinical dental team.
A spokesperson for the BADT, which represents a large portion of the UK’s 3,000 registered dental therapists said “Dental therapists are the only other dental registrants in the UK who are able to remove dental hard tissues and potentially cause irreversible damage to patients if not trained to an acceptable standard.”
The BADT expressed particular unease with the General Dental Council’s process for assessing overseas dental candidates wishing to register as dental therapists.
“A UK trained dental therapist will have had clinical skills assessed at multiple stages during their training and will be of a proven, agreed standard. UK dental schools are regularly inspected by the GDC to ensure standards, both educational and clinical, are maintained.”
The General Dental Council regulates dental professionals in the UK. One of its main functions is to maintain standards within the dental profession ‘for the benefit of patients.’
The GDC’s own statistics for the dentist’s overseas examination show that in January and April of 2019, 56% and 43% of dentists respectively, failed the practical ‘dental manikin exercise,’ the test where their skills at drilling and filling are assessed.
Despite this high failure rate, overseas dentists can bypass examination of their clinical dexterity and register as dental therapists without their practical skills being scrutinised.
Registration of overseas dentists as dental therapists began in 2016 and may be driven by the long wait to sit the overseas dental examination and a recruitment drive by consultancy companies targeting dentists in South Asia. So far, 51 dentists have registered in this manner. Although the numbers are currently small, a Freedom of Information request to the GDC showed that the number of dentists registering in this way has risen year on year, the biggest rise so far occurring in 2019, representing a 260% rise on 2018.
Mick Armstrong, Chair of the British Dental Association which represents 22,000 of the UK’s dentists said: “The BDA has noted with concern that overseas dentists who are required to sit the Overseas Registration Exam to work as dentists are attempting to register in dental care professional registration categories, often as hygienists or therapists. There also seems to be a specific recruitment drive to enable such registration.
He added “our concerns in this regard are both for the overseas dentists, who may be unfamiliar with the UK’s system, may lack professional support and run the risk of working outside relevant regulations and requirements, and for the patients they treat, as the competency assessment that has taken place for the purpose of registration is solely paper-based rather than clinical.”
The General Dental Council has maintained that its procedure for registering overseas dentists as dental therapists without a practical examination is ‘robust.’
The GDC declined to comment on the high failure rate of the practical examination by overseas dentists and the apparent anomaly in its regulations that allows dentists to register as dental therapists, a role they have not specifically trained for, without further examination of their manual skills.
Although overseas dentists have to sit further examinations by law in order to work in the UK as dental surgeons, the GDC can register them as dental therapists without further examination, through section 60 of the Dentists Act 1984.
The regulatory organisation is able to seek changes in the act which could make requirements for registration as therapists more stringent, but a GDC spokesman said “Whilst we are able to seek changes to the Dentists Act 1984 by virtue of section 60, this process requires significant GDC and Parliamentary time and resource. The statements provided set out the robust processes in place to ensure individuals have the requisite level of knowledge, skill and experience prior to being able to join the Registers and, until there is evidence to the contrary, there are insufficient grounds to seek changes under section 60.”
Dr Raj Rattan, Dental Director at Dental Protection, one of the UK’s oldest professional indemnity organisations said: “While Dental Protection understands the concerns raised by the registration of qualified overseas dentists as dental therapists, we believe that it is for the GDC, as the regulatory body for dental professionals in the UK, to clarify the reasons behind it.”
Images credits www.gotcredit.com and OfficialGDC
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