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Colum Durkan British Dental Journal 2012; 213: E1

Editor's summary

Evidence-based research, health policy, and desire from dentists to provide the best all-round oral healthcare for their patients are all driving the emphasis towards preventive dentistry. However, time and time again we hear that this type of dentistry may require a change in the skill-mix of the dental team. In particular, further training of dental care professionals, dental nurses very much included, may be called for so that they are able to perform extended duties and obtain additional skills with which to care for their patients under the leadership of the dentist.

So, in view of these changes, it begs the question do dental nurses actually wish to be trained in these additional skills? If so, what motivates them to seek out continuing professional development and what are their career aspirations?

The authors of this BDJ research article asked these very questions of the dental nurses based at Guys and St Thomas' Hospital Trust. Though this study only looked at a small sample, 64 nurses, at a single institution, the responses from this dental nursing workforce make interesting reading.

Indeed, the survey showed that the principal reason for entering dental nursing is the potential for career progression an engaged group of people. There was also universal interest in career progression with the entirety of the surveyed workforce having already extended or indicating a desire to extend their scope of practice – again, indicating an engaged workforce. Eighty-three percent of the respondents were already trained in an additional skill; conscious sedation being the one most frequently possessed. Radiography was the skill in which the highest proportion wished to be trained.

It would be interesting to determine if the motivation of this small sample of the nursing workforce at just one institution extends to a larger sample. If so, what a great platform that would provide for really using the whole dental team to further increase the oral health of the population in the future.

The full paper can be accessed from the BDJ website ( www.bdj.co.uk ), under 'Research' in the table of contents for Volume 213 issue 2.

Ruth Doherty

Managing Editor

Author questions and answers

1. Why did you undertake this research?

This research was undertaken as a component of a final year undergraduate project on the dental workforce. The authors have a shared interest in the dental workforce and considering the lack of research into the dental nursing profession, this was deemed to be an appropriate focus. Interest in the dental nursing profession has grown since the introduction of compulsory registration with the General Dental Council on 1 August 2008. The research was of considerable interest to the institution where the dental nurses worked as a means of assessing the experience, training needs and interests of this professional group; particularly in considering the provision of future continuing professional development.

2. What would you like to do next in this area to follow on from this work?

There is a clear need to investigate the career pathways of dental nurses working in the general dental practice setting, including their continuing professional development requirements and skills. This could be extended to dental nurses employed in the community dental services and in the armed forces, facilitating comparison between sectors of employment. There would be considerable merit in investigating the continuing professional development undertaken by dental nurses at the end of the five-year cycle so that trends in continuing professional development relative to the dental nursing role could be identified. Similar research carried out abroad, where the professional registration of dental nurses is not required, would also be of interest.

Commentary

The role of the dental nurse has become increasingly professionalised. Since July 2008, those working as a dental nurse have been required to be registered with the General Dental Council (GDC). The essential skills required on qualification are now defined by the GDC, and a range of additional skills, which a dental nurse can develop during their career, are recognised.

While past research has considered the career options and professional development of dental hygienists and dental therapists, less is known about the aspirations of dental nurses. This study surveyed, via a self-complete questionnaire, 64 dental nurses working in a large London dental hospital. Of these, 53 were trained in at least one additional skill (most commonly sedation) and those without such training reported that they would like to gain additional skills. The study provides useful information on the frequency with which this cohort of nurses had undergone additional skills training and the degree to which these had subsequently been used. There is also information on reasons for choosing a career in dental nursing and background research undertaken by nurses before applying to enter training.

However, there are a number of limitations to the study. The numbers involved are small and it is limited to one teaching institution. It is not surprising that a large proportion of nurses working in a specialist setting have additional skills and aspirations to gain further training. The degree to which such aspirations translate to dental nurses working in non-specialist settings remains to be seen and there is need for a more substantial survey including a study sample that is larger and more representative of dental nurses as a whole. That said, extrapolating from other healthcare professions, expanding the skill-set of individuals is likely to create demand and expand personal ambitions and horizons. The challenge will be to ensure that appropriate training is developed in the future. How this is facilitated and funded, and how the skills obtained are subsequently deployed in the clinic, poses a further question. Failure to consider these issues risks up-skilling a cohort of individuals who, if they cannot realise their aspirations, may subsequently be lost to the dental team.