Dental Therapist New Graduate UK Guide

Therapist scope of practice (vs hygienist)

GDC Scope of Practice for therapists includes everything a hygienist can do PLUS:

• Direct restorations on adult and child teeth (composite, GIC, amalgam) for caries treatment
• Extraction of primary (deciduous) teeth
• Pulp therapy on primary teeth (pulpotomy with stainless steel crown / Hall crown)
• Place preformed metal crowns (SSCs) on primary teeth
• Take dental radiographs (with IRMER training)
• Apply fluoride varnish and fissure sealants (same as hygienist)
• Provide tooth whitening
• Treat patients with conscious sedation (with advanced training)
• Local anaesthesia (with training)

Cannot do: extractions of permanent teeth, endodontics on permanent teeth, fixed/removable prosthodontics, orthodontics, surgical procedures, prescribing prescription-only medicines.

Job market for therapists in 2026

Therapist demand has expanded significantly:

• NHS general practice (mixed): therapists deliver routine restorative + hygiene workload, freeing dentists for complex work. Most common role.
• NHS therapist-led practices: emerging model where therapist runs a full NHS list under dentist clinical oversight. High autonomy.
• Corporate groups (Mydentist, Bupa, Portman): structured roles, growing demand for therapists to manage UDA capacity.
• Specialist paediatric practices: therapist + paediatric dentist combo. High child-restorative volume.
• Hospital community dental services: therapist-led prevention + sealant + paediatric work.
• Private general: less common but growing — therapist private hygiene + restorative for moderate cases.

Starting employed: £32,000-£42,000 typical. Experienced: £40,000-£55,000. Self-employed/freelance therapists: £60-£120/hour rates. London/SE pays more.

Building restorative confidence — your differentiator

Your USP vs hygienists is restorative scope. Build confidence systematically:

1. First 3 months: small single-surface composites on adults. Build LA technique, isolation, prep, bonding, finishing.
2. Months 3-6: two-surface composites, simple primary tooth restorations.
3. Months 6-9: complex multi-surface composites, fissure sealants for cooperative children, fluoride varnish for high-risk.
4. Months 9-12: Hall crowns on primary molars, pulpotomies (under dentist supervision initially), confident paediatric restorative.
5. Year 2+: full restorative caseload within scope, child sedation support, specialist paediatric pathways.

Children patients — your bread and butter

Most therapists in NHS practice see 40-60% paediatric patients. The dental nurse + therapist combination is the standard team for children. Key clinical references:

• SDCEP Prevention and Management of Dental Caries in Children (3rd ed, 2025): the bible. Caries risk stratification, Hall technique, fluoride varnish schedules, fissure sealant indications.
• BSPD guidance: paediatric examination structure, behaviour management approaches, age-appropriate consent.
• IADT Guidelines 2020 Part 3: primary tooth trauma — when to extract, when to monitor, permanent successor risk.
• NICE CG19: dental recall — risk-based intervals (3-12 months) for children.

Behaviour management skills are as important as clinical skills. Tell-show-do, voice control, distraction techniques, gradual exposure. Most paediatric "failures" are behaviour management not clinical.

Notes specific to therapists

Therapist notes are scrutinised at the dentist supervisor level AND in any complaint. Areas of particular focus:

• Restoration: tooth/surface, indication, LA, isolation, material with shade, occlusion check (especially in children where occlusion changes), post-op advice. Same as dentist.
• Hall crown: pulp vitality assessment recorded (no irreversible pulpitis), parent consent including bite change, separator visit (if needed), crown size, GIC cement + lot number.
• Pulpotomy (primary): rubber dam (mandatory), exposure size, haemostasis time, MTA/bioceramic with lot number, coronal seal, post-op review schedule.
• Primary tooth extraction: indication (typically caries non-restorable, mobility, orthodontic, infection), LA, technique, socket, post-op (gauze, soft diet, watch for complications), permanent successor assessment.
• Children's consent: parental consent documented, accompanying adult named, parental responsibility verified, safeguarding consideration.

CPD and registration

GDC requires 75 hours verifiable CPD per 5-year cycle for therapists. Mandatory: medical emergencies (10h), disinfection (5h), radiography (5h if you take). Recommended subjects: paediatric behaviour management, SDCEP caries updates, Hall technique, restorative materials, sedation, IADT trauma management.

Membership: British Society of Dental Hygiene and Therapy (BSDHT) — includes journal, conferences, CPD discounts. The Association of Dental Implantology (ADI) and BSPD also offer therapist-relevant membership for specialty interest.

Where Nosht fits

Nosht supports the full therapist scope: hygiene templates (perio assessment, RSD, PmPR, SPC), restorative templates (composite, GIC), paediatric templates (Hall crown, fissure sealant, fluoride varnish, child exam), primary tooth extraction, plus all the consent prompts and IRMER prompts you need.

Therapist vs hygienist — which earns more?

Therapist typically earns 10-20% more than hygienist in employed roles (£32-42k vs £28-35k starting). Self-employed therapists can charge for restorations adding significant income. Top hygienists in private practice can match therapist income but require building a specialist niche. Therapy generally offers broader earning paths.

Can therapists do private practice?

Yes — therapists work in private general practice alongside dentists, often providing hygiene + restorative for moderate complexity cases. Some therapists run independent private hygiene/therapy clinics under direct access. Earnings can be excellent (£60-£120/hour) but require building patient base.

Do therapists need a dentist on-site?

No — therapists can work alongside dentist but don't require on-site supervision for routine scope work since 2013 Direct Access changes. Best practice is dentist accessible for consultation. Treatment plans for therapy-scope work typically agreed by dentist initially with therapist independently delivering.

Can therapists do adult extractions?

NO. GDC Scope of Practice prohibits therapists from extracting permanent teeth. Only primary (deciduous) tooth extraction is within scope. Adult extractions remain dentist-only work.

Hall technique — can therapists do this?

YES — this is core therapist scope. SDCEP recommends Hall technique as first-line for primary molar caries not requiring pulpal therapy. No LA needed, no caries removal, GIC-cemented preformed metal crown. Excellent paediatric outcomes. Therapists deliver these routinely.

What's the future for UK therapists?

Strong demand growth. NHS workforce planning identifies therapist expansion as key to delivering NHS dentistry capacity. Corporate groups are expanding therapist hiring. Therapist-led NHS practices are emerging. Increasingly, complex therapist-only career paths in paediatric, public health, and specialist support roles.