BSDHT: The case for exemptions

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The BSDHT puts forward the case for dental therapists and hygienists exemptions

Currently, it is not possible for a dental hygienist or a dental therapist in the UK to sell, supply or administer local anaesthetics, topical anaesthetic and/or fluoride varnishes to a patient without having to first get a prescription from a dentist, or under a Patient Group Directive (PGD).

However, certain regulated health professionals such as midwives, paramedics, orthoptists and podiatrists can sell, supply and administer specified medicines without need for a prescription or PGD. This mechanism is known as exemptions.

The list of exemptions is a limited one, but if dental hygienists and dental therapists were able to supply and administer some medicines this would bring many positive benefits. For, the dental hygienists and dental therapists would be able to perform the required treatment even if the prescribing dentist was not available at all, meaning the patient would not be asked to return on another day in order to complete it. This would encourage compliance to ultimately improve their oral health.

The solution

The British Society of Dental Hygiene & Therapy (BSDHT) and British Association of Dental Therapists (BADT) are both working with NHS England who is leading a programme of work that aims to extend supply and administrations responsibilities to a number of professional groups. This includes the use of exemptions by dental therapists and dental hygienists.

The initial work includes writing a ‘case of need’ document that sets out the case for change and also the need for the sale, supply and administration of specified medicines listed in legislation. Once NHS England and the Department of Health Non-Medical Prescribing Board approve it, there will be a public consultation.

Exemptions mean that a list of POMs would be specified in legislation for dental therapists and dental hygienists to sell, administer or supply. Following the necessary training, it would enable them to sell, supply or administer local anaesthetic and fluoride toothpaste in their practice, for example, without prescription or PGD.
If exemptions for dental hygienists and dental therapists are achieved, patient care will be improved. Being able to maximise time in the practice means they get better access and better choice. The whole team will benefit from a practice that uses its time more effectively. It is believed that exemptions would be a huge step towards raising standards of oral health across the UK.

The delegation of a dentist’s responsibility in this context will allow dental hygienists and dental therapists to support them more effectively in providing a high quality, efficient and patient-focused preventive service.
Dental hygienists and dental therapists already play a valuable role in the care of patients and in supporting them with maintaining good oral health. The proposed change will enhance the work they do, to benefit the entire profession and the people they treat in a number of ways.

For more information about the BSDHT go to, call 01788 575050 or email This email address is being protected from spambots. You need JavaScript enabled to view it.