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 IR(ME)R training)
• Apply fluoride varnish and fissure sealants (same as hygienist)
• Carry out tooth whitening, only on the prescription of a dentist, with the first treatment carried out by or under the direct supervision of a dentist on the premises (the one procedure excluded from Direct Access)
• Treat patients who are under conscious sedation, and, with IACSD-recognised training, provide inhalation sedation
• Local anaesthesia (with training)

Cannot do: extractions of permanent teeth, endodontics on permanent teeth, fixed/removable prosthodontics, orthodontics, surgical procedures, prescribing prescription-only medicines (but they may supply and administer specified medicines under the 2024 exemptions).

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.

Pay varies widely with region, NHS or private mix, experience, and whether you are employed or self-employed. For NHS roles see NHS Employers (Agenda for Change pay scales); for practice-based roles, compare several practices and ask your professional association (BSDHT).

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.

Child patients — your bread and butter

Children make up a large part of many therapists' NHS caseloads. 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

DCPs need 75 verifiable hours per 5-year cycle, with at least 10 hours in every 2 consecutive years. Keep a personal development plan and make an annual CPD statement. The GDC highly recommends (but does not mandate) medical emergencies (10 hours per cycle, with at least 2 hours every year), disinfection and decontamination (5 hours) and radiography and radiation protection (5 hours if you take radiographs), plus legal and ethical issues, complaints handling, oral cancer early detection and safeguarding. See our GDC Enhanced CPD guide (linked below) for the full rules. Useful therapist 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 covers most of the therapist scope: perio (perio assessment, RSD, PMPR, perio review), restorative (filling, composite bonding), paediatric care (Hall crown, pulpotomy, simple extraction (primary teeth only), fissure sealant, fluoride varnish, child exam) and implant review, with consent and IR(ME)R prompts. The pulpotomy and simple extraction templates include a note that therapists treat primary teeth only (GDC Guidance on Scope of Practice, effective 1 November 2025, s2.5).

Sources

• GDC: Scope of Practice guidance (revised guidance in effect from 1 November 2025) (accessed 18 October 2026)
• GDC: Direct access (accessed 18 October 2026)
• GDC: CPD scheme (accessed 18 October 2026)
• The Ionising Radiation (Medical Exposure) Regulations 2017 (SI 2017/1322) (accessed 18 October 2026)
• NICE CG19: Dental checks: intervals between oral health reviews (October 2004) (accessed 18 October 2026)
• SDCEP: Prevention and Management of Dental Caries in Children (3rd edition, February 2025) (accessed 18 October 2026)
• IACSD: Standards for Conscious Sedation in the Provision of Dental Care (2015, updated March 2020) (accessed 18 October 2026)
• Day PF, et al. IADT guidelines for the management of traumatic dental injuries: 3. Injuries in the primary dentition. Dent Traumatol 2020 (accessed 18 October 2026)