国民医疗体系人满为患 英国频现“看牙难”

Under new system, dentists must spend longer assessing each patient

In a bid to reduce waiting times, patients could see therapists, who have studied for three years, instead of dentists, who trained for five

Dentists would concentrate on more complex procedures

Dental therapists should stand in routinely for dentists and start drilling and filling patients’ teeth to tackle growing NHS waiting lists, the Government’s tooth tsar has said.

Patients are waiting weeks longer for an appointment at many surgeries piloting a new NHS system of check-ups, which could be rolled out across the country within two years.

The new check-ups require dentists to spend longer assessing each patient, and now Barry Cockcroft, the chief dental officer, has recommended that, to avoid delays, junior staff should take on some tasks traditionally carried out by dentists.

This could see therapists – who study for three years, compared with five years for dentists – drilling and filling adults’ teeth, and extracting children’s milk teeth. Dental nurses should also play a bigger role, doing procedures such as fluoride varnishes, he said. Speaking to The Mail on Sunday at the British Dental Conference in Manchester, Dr Cockcroft said: ‘A dentist is very highly trained and can carry out complex work such as crowns and bridges. Therapists can do extractions and fillings.’

Health Minister Earl Howe said patients needed to accept that dentists would do less work on their teeth in the future, and that nurses, hygienists and therapists would do more. He said: ‘Sometimes in GP practices you see a nurse and sometimes a GP. People are used to that.’

The pilot of the new dental system involves a traffic-light rating where patients are given a ‘green’, ‘amber’ or ‘red’ notice on the condition of their teeth and gums. Patients flagged as ‘red’ can be refused advanced treatment until they have improved their oral health – by cleaning their teeth more and cutting down on sugary foods.

Dentists largely welcome the scheme, which has been running for two-and-a-half years, because it focuses on preventing problems as well as treating them. But the initial check-ups take up to half an hour per patient rather than 15 minutes, meaning that waiting times for an appointment have increased.

Dr Len D’Cruz, of Woodford Dental Care in North-East London, who has been on the pilot since 2011, said: ‘It’s halved the number of patients we can see and increased waiting times which has been frustrating for the practice and patients.’

Dentist Dr Tony Kilcoyne, from Haworth, West Yorkshire, said he had no problem with therapists doing fillings but warned the move could be a ‘false economy’ as they tended to take longer. And dentist Dr Suzanne Baker, from Dewsbury, said. ‘People are going to lose the family-dentist feel patients appreciate.’

Earl Howe said no new scheme would be rolled out before 2016.

A DoH spokesman said: ‘Our pilots are exploring how we prevent people needing treatment in the first place, but will not be a blueprint for a new system.’