Free clinical tool

GDC Scope of Practice Checker by Role

Scope of practice is the range of treatments a GDC-registered dental professional is trained, competent and indemnified to perform. This free checker covers all seven registrant titles — dentist, dental therapist, dental hygienist, dental nurse, dental technician, clinical dental technician and orthodontic therapist. Pick a role to see what it may and may not do, plus direct access, prescribing and medicines-exemption rules — using the same dataset as the Nosht in-app scope tool.

Choose a role

Select a GDC-registered dental title to see what it may and may not do.

Dental Therapist

Dental therapists combine the skills of a dental hygienist with additional restorative and paediatric capabilities. They can perform direct restorations on all teeth, extract primary teeth, and carry out pulpotomies on primary teeth. They work across both primary and permanent dentitions for restorative work.

Direct access: Yes; Full Direct Access since 2013. Can see patients without dentist referral for all procedures within scope EXCEPT tooth whitening (requires dentist prescription + first treatment supervised). Must refer to dentist when treatment needed is outside scope.
Prescribe medicines: No; Cannot prescribe medicines. However, since 26 June 2024 (Human Medicines Regulations 2012 as amended by SI 2024/729), can supply and administer specified POMs under exemptions after appropriate training (NHS England Annex A curriculum): injectable LA; periodontal gels, fluoride varnish and lidocaine spray during treatment; 2,800/5,000 ppm fluoride toothpaste and nystatin for home use. Previously required PSD or PGD for these.
Administer LA: Yes; Can administer infiltration and inferior dental block LA. Since June 2024, can do so under exemptions without requiring a dentist's prescription, PSD, or PGD, after completing appropriate training (NHS England strongly recommends its Annex A exemptions curriculum). Must be competent.
Take radiographs: Yes; Can prescribe and take radiographs within scope (IR(ME)R referrer and operator). Can justify exposures (IR(ME)R practitioner) only if adequately trained and entitled to do so. All IR(ME)R roles must be entitled by the employer.

Within title boundary (if trained, competent, indemnified)Conditional (prescription / supervision)Additional training / programmeNot a listed GDC boundary — check training and indemnityOutside title boundary

Examination & Diagnosis9 procedures

Clinical examination
Within competence. Must refer outside scope.
Within title boundary
Diagnosis of dental disease
Can identify conditions within competence. Must refer complex/unfamiliar pathology.
Within title boundary
Treatment planning
Can treatment plan within scope, especially under Direct Access.
Within title boundary
Oral cancer screening
Within title boundary
Dental charting and oral tissue assessment recording
Within title boundary
Periodontal examination and charting (BPE/6-point)
Within title boundary
Measure and record plaque indices
Within title boundary
Record medical history
Within title boundary
Assess medical history and its implications for treatment
Within scope and competence; refer outside scope (GDC Scope of Practice 2025 s2.5).
Within title boundary

Radiography5 procedures

Prescribe radiographs (IR(ME)R referrer)
Can prescribe radiographs within scope and competence (GDC Scope of Practice 2025 s2.5) — the IR(ME)R referrer role. IR(ME)R roles must be entitled by the employer.
Many assume only dentists can prescribe radiographs. Therapists, hygienists and CDTs CAN prescribe radiographs within their scope — in IR(ME)R terms they act as referrers. Justifying the exposure (IR(ME)R practitioner) is a separate role that needs adequate training and entitlement by the employer.
Within title boundary
Justify radiographic exposures (IR(ME)R practitioner)
Only if suitably qualified and trained as an IR(ME)R practitioner and entitled by the employer's IR(ME)R procedures (SDCEP Practice Support Manual).
Prescribing (referring for) a radiograph and justifying it are different IR(ME)R roles. All referrers, practitioners and operators must be entitled by the employer; practitioners and operators must be adequately trained.
With additional training
Take radiographs (intra-oral and extra-oral)
Within scope and competence (GDC Scope of Practice 2025 s2.5). Acts as IR(ME)R operator once entitled by the employer.
Dental nurses CAN take radiographs but only as an additional skill with specific training. They act as IR(ME)R operators, NOT practitioners — they cannot justify/prescribe the exposure themselves.
Within title boundary
Interpret and report on radiographs
Within competence. Must refer outside scope (e.g. complex pathology).
Within title boundary
Prepare equipment and process radiographs
Within title boundary

Prevention7 procedures

Scale and polish (prophylaxis)
Within title boundary
Fissure sealants
Within title boundary
Fluoride varnish application
Can supply and administer under exemptions since June 2024.
Dental nurses CAN apply fluoride varnish but a prescription (PSD) must ALWAYS be in place — even in public health programmes. Hygienists and therapists can now do this under exemptions without prescription (since June 2024). Orthodontic therapists can apply it on dentist prescription as an additional skill.
Within title boundary
Other fluoride treatments (rinses, gels, trays)
Within title boundary
Oral health education and advice
Within title boundary
Smoking cessation advice
Within title boundary
Apply prophylactic and antimicrobial materials
Within title boundary

Periodontics2 procedures

Subgingival scaling and root surface debridement
Within title boundary
Implant maintenance and peri-implant care
Within title boundary

Restorative6 procedures

Direct restoration — permanent teeth
Core skill. Can restore permanent teeth with direct restorations. Under Direct Access or on prescription.
Dental therapists CAN restore permanent teeth with direct restorations. This is often confused — many assume they can only work on primary teeth. Hygienists CANNOT place restorations.
Within title boundary
Direct restoration — primary teeth
Within title boundary
Place preformed crowns — primary teeth
Core skill. Can place preformed crowns on primary teeth.
Within title boundary
Indirect restorations (crowns, veneers, inlays, onlays)
Boundary: GDC Scope of Practice 2025 s2.5: dental therapists "do not undertake indirect restorative treatment".
Outside title boundary
Place temporary dressings
Hygienists CAN place temporary dressings but CANNOT place permanent restorations. There is a distinction: a temporary dressing is an interim emergency measure, not a restoration.
Within title boundary
Re-cement crowns with temporary cement
Within title boundary

Endodontics5 procedures

Pulpotomy — primary teeth
Core skill. Pulpotomies on PRIMARY teeth only.
Primary teeth only (including retained primary teeth in adults).
Within title boundary
Pulpotomy — permanent teeth
Boundary: GDC Scope of Practice 2025 s2.5: dental therapists do not undertake "procedures associated with the pulp in the adult dentition".
CRITICAL CONFUSION: Dental therapists CANNOT do pulpotomies on permanent teeth. This is one of the most commonly misunderstood scope boundaries. Despite growing evidence supporting permanent tooth pulpotomy as a minimally invasive endodontic technique, it remains outside the therapist scope. Advocacy groups (BADT) have called for this to be expanded but it has NOT been changed in the 2025 guidance.
Outside title boundary
Root canal treatment (endodontics) — permanent teeth
Boundary: GDC Scope of Practice 2025 s2.5: dental therapists do not undertake "procedures associated with the pulp in the adult dentition".
Outside title boundary
Pulp capping — primary teeth
PRIMARY teeth only, within training and competence. GDC Scope of Practice (2025) s2.5 lists direct restorations and pulpotomies on the primary dentition; the pulp boundary applies to the adult dentition.
Primary teeth only (including retained primary teeth in adults).
Within title boundary
Pulp capping — permanent (adult) teeth
Outside the dental therapist title boundary. GDC Scope of Practice (2025) s2.5: "Dental therapists do not undertake indirect restorative treatment, procedures associated with the pulp in the adult dentition or orthodontic procedures." Refer to a dentist. Whether indirect pulp capping or a lining under a deep direct restoration counts as a pulp procedure is not defined by the GDC: treat it as a grey area and check with your indemnity provider.
Boundary: GDC Scope of Practice 2025 s2.5: dental therapists do not undertake "procedures associated with the pulp in the adult dentition".
Dental therapists place direct restorations in permanent teeth, but the GDC names "procedures associated with the pulp in the adult dentition" as a boundary of the title (Scope of Practice 2025, s2.5). A pulp cap over an exposure in a permanent tooth is outside scope. Whether indirect pulp capping or a lining under a deep restoration counts as a pulp procedure is not defined by the GDC: see the disputed area on this.
Outside title boundary

Extractions3 procedures

Extraction — primary teeth
Core skill. Can extract primary teeth. Under Direct Access or on prescription.
Primary teeth only (including retained primary teeth in adults).
Within title boundary
Extraction — permanent teeth (simple)
Boundary: GDC Scope of Practice 2025 s2.5: dental therapists "do not extract permanent teeth".
Dental therapists CANNOT extract permanent teeth — this is restricted to dentists. Even simple forceps extractions of permanent teeth are outside therapist scope.
Outside title boundary
Surgical extraction (with bone removal/flap)
Applies to permanent teeth. Surgical removal of primary teeth is not separately addressed by the GDC.
Boundary: GDC Scope of Practice 2025 s2.5: dental therapists "do not extract permanent teeth".
Outside title boundary

Local Anaesthesia4 procedures

Local anaesthesia — infiltration
Core skill. Since June 2024, can supply and administer under exemptions without PSD/PGD.
Within title boundary
Local anaesthesia — inferior dental (ID) block
Core skill. Since June 2024, under exemptions.
Many assume hygienists cannot give ID blocks. They CAN — it has been within scope since 2002 for those trained after that date. The 2024 exemptions removed the need for a dentist prescription.
Within title boundary
Local anaesthesia — other regional blocks
If trained and competent in the specific technique.
Within title boundary
Apply topical anaesthetic
Within title boundary

Prescribing4 procedures

Prescribe antibiotics
Boundary: Human Medicines Regulations 2012 reg 214: only an "appropriate practitioner" (doctor, dentist or a listed independent or supplementary prescriber) may prescribe prescription-only medicines. Dental hygienists and therapists are not prescribers; the restriction comes from medicines law, not the GDC scope guidance.
Outside title boundary
Prescribe analgesics
Can supply general sale and pharmacy medicines (e.g. paracetamol, ibuprofen) under Human Medicines Regulations 2012 Sch 17 Part 4, as amended by SI 2024/729.
Boundary: Human Medicines Regulations 2012 reg 214: only an "appropriate practitioner" (doctor, dentist or a listed independent or supplementary prescriber) may prescribe prescription-only medicines. Dental hygienists and therapists are not prescribers; the restriction comes from medicines law, not the GDC scope guidance.
Outside title boundary
Prescribe or supply high-fluoride toothpaste
Supply (not prescribe) 2,800 or 5,000 ppm fluoride toothpaste directly to the patient under the 2024 exemptions, after completing appropriate training (NHS England strongly recommends its Annex A exemptions curriculum). Cannot write an FP10 or private prescription.
Therapists and hygienists can SUPPLY 2,800 and 5,000 ppm fluoride toothpaste directly to the patient (and supply and apply 22,600 ppm fluoride varnish) under the 2024 exemptions, but they CANNOT PRESCRIBE it (i.e. cannot write a prescription for a patient to collect from a pharmacy). Only dentists can prescribe.
With additional training
Supply take-home prescription-only medicines (2024 exemptions)
GDC Scope of Practice 2025 s2.5: "Supplying and administering specified ... medicines directly to patients upon completion of appropriate training." Supply only; this is not prescribing (Human Medicines Regulations 2012 Sch 17 Part 2, as amended by SI 2024/729).
With additional training

Orthodontics9 procedures

Orthodontic treatment planning
Boundary: GDC Scope of Practice 2025 s2.5: dental therapists do not undertake "orthodontic procedures".
Outside title boundary
IOTN screening (Index of Orthodontic Treatment Need)
Not a listed task or boundary in the GDC Scope of Practice 2025. Only if trained, competent and indemnified (s1.2).
Not a listed boundary
Fit, adjust and repair fixed orthodontic appliances
Boundary: GDC Scope of Practice 2025 s2.5: dental therapists do not undertake "orthodontic procedures".
Outside title boundary
Fit and adjust removable orthodontic appliances
Boundary: GDC Scope of Practice 2025 s2.5: dental therapists do not undertake "orthodontic procedures".
Outside title boundary
Orthodontic emergency care between appointments
Boundary: GDC Scope of Practice 2025 s2.5: dental therapists do not undertake "orthodontic procedures".
Outside title boundary
Interproximal reduction (IPR/stripping)
Boundary: GDC Scope of Practice 2025 s2.5: dental therapists do not undertake "orthodontic procedures".
IPR involves ENAMEL REMOVAL which is an irreversible procedure. Orthodontic therapists explicitly CANNOT perform procedures involving enamel removal. Dental therapists also cannot do IPR as it is an orthodontic procedure outside their scope. Only dentists can perform IPR.
Outside title boundary
Prepare tooth surfaces for orthodontic treatment
Boundary: GDC Scope of Practice 2025 s2.5: dental therapists do not undertake "orthodontic procedures".
Outside title boundary
Take orthodontic impressions and records
Can take impressions.
Within title boundary
Repair acrylic component of orthodontic appliances
Bench work is not a listed task. Whether it counts as an "orthodontic procedure" (GDC Scope of Practice 2025 s2.5) is not defined. Only if trained, competent and indemnified (s1.2) — check with your indemnifier.
Not a listed boundary

Prosthodontics6 procedures

Complete dentures — edentulous patients
Not a listed task. The GDC does not say whether dentures count as "indirect restorative treatment" (s2.5). Only if trained, competent and indemnified (s1.2) — check with your indemnifier.
Not a listed boundary
Partial dentures — dentate patients
Not a listed task. The GDC does not say whether dentures count as "indirect restorative treatment" (s2.5). Only if trained, competent and indemnified (s1.2) — check with your indemnifier.
Not a listed boundary
Implant-retained prostheses
Implant crowns and bridges are indirect restorations. Implant overdentures are not separately addressed.
Boundary: GDC Scope of Practice 2025 s2.5: dental therapists "do not undertake indirect restorative treatment".
Outside title boundary
Denture repairs
Not a listed task or boundary in GDC Scope of Practice 2025 s2.5. Only if trained, competent and indemnified (s1.2) — check with your indemnifier.
Not a listed boundary
Shade taking
Within title boundary
Carry out implant frame assessments (clinical)
Not a listed task or boundary in GDC Scope of Practice 2025 s2.5. Only if trained, competent and indemnified (s1.2).
Not a listed boundary

Surgical4 procedures

Place sutures
Not a listed boundary in GDC Scope of Practice 2025 s2.5 and not a listed task; the withdrawn 2013 task list gave therapists suture removal only. Only if trained, competent and indemnified (s1.2) — check with your indemnifier.
Not a listed therapist boundary in the 2025 guidance (s2.5) and not a listed task; the withdrawn 2013 list gave therapists suture REMOVAL only. Unresolved under s1.2: place sutures only if trained, competent and indemnified, otherwise hand over to a dentist.
Not a listed boundary
Remove sutures
Additional skill. Can remove sutures AFTER the wound has been checked by a dentist.
With additional training
Dental implant placement
Not a listed task or boundary in GDC Scope of Practice 2025 s2.5. Only if trained, competent and indemnified (s1.2) — check with your indemnifier.
Not a listed boundary
Periodontal surgery
Not a listed task or boundary in GDC Scope of Practice 2025 s2.5. Only if trained, competent and indemnified (s1.2) — check with your indemnifier.
Not a listed boundary

Sedation4 procedures

Inhalation sedation (nitrous oxide)
Additional skill. Can administer inhalation sedation with appropriate training.
With additional training
IV sedation
Not a listed task or boundary in GDC Scope of Practice 2025 s2.5. Only if trained, competent and indemnified (s1.2) — check with your indemnifier. Midazolam is not among the medicines the 2024 exemptions let hygienists and therapists administer (Human Medicines Regulations 2012 Sch 17 Part 3, as amended by SI 2024/729).
Not a listed boundary
Treatment under general anaesthesia
Dental therapists may TREAT patients under GA, but only: (a) for procedures within their existing scope (e.g. primary-tooth extractions, restorations, preformed crowns — NOT permanent-tooth extractions, surgical extractions, or adult endodontics/advanced radiographic interpretation); (b) under supervision within a robust clinical-governance framework; and (c) with GA-specific training and appropriate indemnity. Paediatric lists: supervision must be immediate (supervising dentist in the operating theatre or an immediately adjacent theatre). Adult special-care patients: the therapist must NEVER operate independently and must be accompanied throughout by a suitably qualified dentist/specialist/consultant. GA itself is administered by an anaesthetist — the therapist does not provide GA. This reflects GDC guidance "Dental Therapist Roles in General Anaesthetic Settings" and the BSPD/BADT/BSSCD/SAAD joint statement (GDC-supported, March 2026); it CLARIFIES existing scope rather than granting new scope.
Under supervision
Assist with treatment under conscious sedation
Not a listed task or boundary in GDC Scope of Practice 2025 s2.5. Only if trained, competent and indemnified (s1.2).
Not a listed boundary

Whitening2 procedures

Tooth whitening
Requires a written prescription from a dentist. First treatment MUST be carried out with a dentist on the premises supervising.
Tooth whitening is the ONLY procedure that hygienists and therapists CANNOT do under Direct Access. It always requires a dentist prescription AND the dentist must be on premises for the first treatment. CDTs can also do it under the same conditions.
Not for anyone under 18 (products containing or releasing 0.1–6% hydrogen peroxide), except wholly to treat or prevent disease.
On dentist prescription
Fit whitening trays / provide home whitening
Supplying trays for home whitening is tooth whitening: only under the prescription of a dentist (GDC Scope of Practice 2025 s1.6).
Not for anyone under 18 (products containing or releasing 0.1–6% hydrogen peroxide), except wholly to treat or prevent disease.
On dentist prescription

Other Clinical6 procedures

Place rubber dam
Within title boundary
Take impressions
Within title boundary
Take intra-oral and extra-oral photographs
Within title boundary
Record occlusal registrations (clinical)
Not a listed task or boundary in GDC Scope of Practice 2025 s2.5. Only if trained, competent and indemnified (s1.2).
Not a listed boundary
Construct special trays and occlusal registration rims
Not a listed task or boundary in GDC Scope of Practice 2025 s2.5. Only if trained, competent and indemnified (s1.2) — check with your indemnifier.
Not a listed boundary
Infection prevention and control procedures
Within title boundary

Laboratory3 procedures

Manufacture dentures
Not a listed task or boundary in GDC Scope of Practice 2025 s2.5. Only if trained, competent and indemnified (s1.2) — check with your indemnifier.
Not a listed boundary
Manufacture crowns and bridges
Not a listed task or boundary in GDC Scope of Practice 2025 s2.5. Only if trained, competent and indemnified (s1.2) — check with your indemnifier.
Not a listed boundary
Manufacture orthodontic appliances
Bench work is not a listed task. Whether it counts as an "orthodontic procedure" (GDC Scope of Practice 2025 s2.5) is not defined. Only if trained, competent and indemnified (s1.2) — check with your indemnifier.
Not a listed boundary

Appliances & Devices19 procedures

Sports mouthguards (custom-made)
Not a listed boundary in GDC Scope of Practice 2025 s2.5 and not a listed task. Only if trained, competent and indemnified (s1.2) — check with your indemnifier.
CDTs can provide sports mouthguards directly to patients (s2.1) — one of two CDT Direct Access provisions. For hygienists and therapists the 2025 guidance is silent (not a listed boundary in s2.2/s2.5): treat it as unresolved and check training and indemnity.
Not a listed boundary
Construct bleaching/whitening trays (lab)
Bench construction is not a listed task or boundary in GDC Scope of Practice 2025 s2.5. Only if trained, competent and indemnified (s1.2). Fitting / home whitening: see the next row.
Constructing the tray is lab work. Fitting trays for home whitening IS tooth whitening: therapists, hygienists and CDTs need a dentist's prescription; orthodontic therapists and dental technicians cannot provide it (s1.6).
Not a listed boundary
Construct vacuum-formed retainers
Unresolved. GDC Scope of Practice 2025 s2.5 says therapists do not undertake "orthodontic procedures"; whether bench construction of a retainer counts is not defined. Not a listed task (s1.2). Check with your indemnifier or BADT.
Unresolved for therapists: the withdrawn 2013 list named VFR construction as a nurse additional skill only; the 2025 guidance bars therapists from "orthodontic procedures" (s2.5) without saying whether lab construction counts (s1.2). Check training and indemnity.
Not a listed boundary
Occlusal splints / Michigan splints / stabilisation splints
Can take impressions for one on a dentist's prescription.
Boundary: GDC Scope of Practice 2025 s2.5: dental therapists "do not make or fit bite raising appliances (e.g. splints)".
Outside title boundary
Soft night guards (EVA)
Can take impressions for one on a dentist's prescription.
Boundary: GDC Scope of Practice 2025 s2.5: dental therapists "do not make or fit bite raising appliances (e.g. splints)".
Outside title boundary
Hard night guards (PMMA/acrylic)
Boundary: GDC Scope of Practice 2025 s2.5: dental therapists "do not make or fit bite raising appliances (e.g. splints)".
Outside title boundary
Anti-snoring devices / mandibular advancement devices (MADs)
Nosht treats a mandibular advancement splint as a bite-raising appliance; the GDC does not name these devices.
Boundary: GDC Scope of Practice 2025 s2.5: dental therapists "do not make or fit bite raising appliances (e.g. splints)".
CDTs CANNOT provide MADs under Direct Access. CDT Direct Access is strictly limited to (1) complete dentures for edentulous patients and (2) sports mouthguards. MADs require a dentist prescription. Some CDTs have incorrectly marketed Direct Access MAD services — this is outside their scope.
Outside title boundary
Removable orthodontic retainers — fitting and adjustment (Essix/Hawley)
Boundary: GDC Scope of Practice 2025 s2.5: dental therapists do not undertake "orthodontic procedures".
Outside title boundary
Fixed orthodontic retainers (bonded wire)
Boundary: GDC Scope of Practice 2025 s2.5: dental therapists do not undertake "orthodontic procedures".
Outside title boundary
Space maintainers
Nosht treats a space maintainer as an orthodontic appliance; the GDC does not name it. Can take impressions on prescription.
Boundary: GDC Scope of Practice 2025 s2.5: dental therapists do not undertake "orthodontic procedures".
Outside title boundary
Orthodontic aligners (Invisalign etc) — scans and records
Can take digital scans/impressions (core skill) for an aligner case on the prescription of a dentist. Cannot plan or fit aligners (orthodontic procedures, s2.5).
On dentist prescription
Orthodontic aligners — fit aligners and place/remove attachments
Boundary: GDC Scope of Practice 2025 s2.5: dental therapists do not undertake "orthodontic procedures".
IPR is DENTIST ONLY (irreversible enamel removal). Orthodontic therapists can take records and fit aligners on prescription but cannot plan treatment or do IPR (s2.7).
Outside title boundary
Denture soft liners / tissue conditioners
Not a listed task or boundary in GDC Scope of Practice 2025 s2.5. Only if trained, competent and indemnified (s1.2) — check with your indemnifier.
Not a listed boundary
Mouth props / bite blocks (clinical use)
Can use as part of clinical procedures within scope.
Within title boundary
Custom fluoride trays
Can construct and fit the tray. Since June 2024, can supply 2,800 or 5,000 ppm fluoride toothpaste under the exemptions without prescription; other high-fluoride gels are not on the exemption list. Can use under Direct Access.
Within title boundary
Obturators (surgical/definitive)
Not a listed task or boundary in GDC Scope of Practice 2025 s2.5. Only if trained, competent and indemnified (s1.2) — check with your indemnifier.
Not a listed boundary
Surgical stents / implant guides
Not a listed task or boundary in GDC Scope of Practice 2025 s2.5. Only if trained, competent and indemnified (s1.2) — check with your indemnifier.
Not a listed boundary
Digital intraoral scanning for appliance fabrication
Can take digital scans — equivalent to impression taking, which is a core skill.
Digital scanning is legally equivalent to impression taking — the same scope rules apply. There is no separate GDC guidance for digital vs conventional impressions. If you can take impressions, you can take digital scans (with appropriate training on the equipment). Dental technicians can scan with further training, under supervision in a multidisciplinary clinical team (s2.4) — not directly for the public.
Within title boundary
3D printing of dental appliances
Not a listed task or boundary in GDC Scope of Practice 2025 s2.5. Only if trained, competent and indemnified (s1.2) — check with your indemnifier.
A printed appliance is a custom-made dental device (s1.8, s2.4; MHRA). Printing should be done by, or under the supervision of, an appropriately registered and competent person; prescription and fitting stay with registrants within scope.
Not a listed boundary

Reference only — verify against the current GDC Scope of Practice guidance. This tool is not clinical or regulatory advice. Scope also depends on your individual training, competence and indemnity. Sources: GDC Scope of Practice (2025) and the Human Medicines Regulations 2012 (as amended by SI 2024/729).

Dentist vs dental therapist vs dental hygienist

The three most-confused titles compared on the procedures clinicians ask about most. A dental therapist can restore and extract teeth a hygienist cannot, while neither can carry out root canal treatment on permanent teeth or extract permanent teeth.

Procedure	Dentist	Dental Therapist	Dental Hygienist
Clinical examination	Yes	Yes	Yes
Diagnosis of dental disease	Yes	Yes	Yes
Take radiographs (intra-oral and extra-oral)	Yes	Yes	Yes
Scale and polish (prophylaxis)	Yes	Yes	Yes
Subgingival scaling and root surface debridement	Yes	Yes	Yes
Fluoride varnish application	Yes	Yes	Yes
Fissure sealants	Yes	Yes	Yes
Local anaesthesia — inferior dental (ID) block	Yes	Yes	Yes
Direct restoration — permanent teeth	Yes	Yes	No
Pulpotomy — primary teeth	Yes	Yes	Not listed
Extraction — primary teeth	Yes	Yes	No
Extraction — permanent teeth (simple)	Yes	No	No
Root canal treatment (endodontics) — permanent teeth	Yes	No	Not listed

What changed in the 2025 GDC Scope of Practice revision

The revised GDC Guidance on Scope of Practice took effect on 1 November 2025. It moved away from fixed task lists towards a competency- and role-based approach that emphasises professional judgement within existing boundaries. Crucially, the revision did not change the scope boundaries of any of the seven titles — what each may and may not do is unchanged. As before, a registrant must be trained, competent and indemnified for every task they perform.

Direct access & prescribing / exemptions (Human Medicines Regulations 2012 (as amended by SI 2024/729))

Direct access (introduced 1 May 2013) lets dental hygienists and dental therapists see patients without a dentist’s referral or prescription, for any treatment within their scope — the one exception being tooth whitening, which still needs a dentist prescription with the first treatment supervised. Dental nurses and orthodontic therapists do not have general direct access, but each has a limited route: dental nurses can take part in structured public health programmes (fluoride varnish still needs a prescription), and orthodontic therapists can carry out IOTN screening direct to patients or within a structured public health programme.

On prescribing, no dental care professional can prescribe medicines. However, since 26 June 2024 the Human Medicines (Amendments relating to Registered Dental Hygienists, Registered Dental Therapists and Registered Pharmacy Technicians) Regulations 2024 let hygienists and therapists supply and administer specified medicines under exemptions — without a Patient Specific Direction (PSD) or Patient Group Direction (PGD): injectable local anaesthetics; lidocaine/prilocaine periodontal gel, fluoride varnish, minocycline periodontal gel and lidocaine/cetrimide spray during treatment; and 2,800 or 5,000 ppm fluoride toothpaste and nystatin oral suspension for patients to take home. NHS England strongly recommends training to its Annex A exemptions curriculum before working to them. The exemptions do not allow prescribing, and do not apply to dental nurses. The GDC notes that PGDs will be phased out for dental hygienists and therapists (Direct Access guidance, updated 1 November 2025).

Role	Direct access	Medicines
Dentist	Full — all procedures within competence.	Full prescribing rights
Dental Therapist	Full scope of practice EXCEPT tooth whitening.	Exemptions: Administer injectable local anaesthetics — lidocaine 2% with adrenaline 1:80,000, articaine 4% with adrenaline 1:100,000 or 1:200,000, mepivacaine 3%, prilocaine 3% with felypressin; Supply for use during treatment — lidocaine 2.5%/prilocaine 2.5% periodontal gel, sodium fluoride varnish 22,600 ppm, minocycline 2% periodontal gel, lidocaine 15%/cetrimide 0.15% oromucosal spray; Supply to the patient for use at home — sodium fluoride 2,800 ppm and 5,000 ppm toothpaste, nystatin oral suspension
Dental Hygienist	Full scope of practice EXCEPT tooth whitening.	Exemptions: Administer injectable local anaesthetics — lidocaine 2% with adrenaline 1:80,000, articaine 4% with adrenaline 1:100,000 or 1:200,000, mepivacaine 3%, prilocaine 3% with felypressin; Supply for use during treatment — lidocaine 2.5%/prilocaine 2.5% periodontal gel, sodium fluoride varnish 22,600 ppm, minocycline 2% periodontal gel, lidocaine 15%/cetrimide 0.15% oromucosal spray; Supply to the patient for use at home — sodium fluoride 2,800 ppm and 5,000 ppm toothpaste, nystatin oral suspension
Dental Nurse	NO general Direct Access. Can participate in structured public health programmes (e.g. fluoride varnish in schools) without patient seeing a dentist first — but PSD still required for fluoride varnish.	Cannot prescribe; no exemptions
Dental Technician	Very limited patient contact — denture repairs and shade taking only.	Cannot prescribe; no exemptions
Clinical Dental Technician	LIMITED Direct Access: (1) Complete dentures for fully edentulous patients only; (2) Sports mouthguards.	Cannot prescribe; no exemptions
Orthodontic Therapist	LIMITED: IOTN screening direct to patients, or in a structured public health programme (if trained, competent and indemnified). All treatment on the prescription of an orthodontist or suitably qualified dentist, with supervision.	Cannot prescribe; no exemptions

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<p style="font:12px/1.4 sans-serif;margin:4px 0 0"><a href="https://nosht.io/tools/gdc-scope-of-practice-checker/">GDC scope of practice checker</a> by Nosht</p>

Frequently asked questions

Can a dental hygienist do fillings?

No. Placing restorations (fillings) is outside the dental hygienist scope of practice — hygienists do not restore teeth. Direct restorations on both permanent and primary teeth fall to dental therapists and dentists. A hygienist can place temporary dressings and re-cement a crown with temporary cement, but not a permanent restoration.

What can a dental therapist do?

Dental therapists combine the dental hygienist skill set with additional restorative and paediatric work. They can carry out direct restorations on both permanent and primary teeth, place preformed crowns and perform pulpotomies on primary teeth, extract primary (deciduous) teeth, scale and provide periodontal treatment, take and report radiographs, and administer local anaesthetic. They have had full direct access since 2013 (tooth whitening still requires a dentist prescription with the first treatment supervised). Endodontics on permanent teeth, extraction of permanent teeth, and indirect restorations remain outside scope.

Can a dental nurse take radiographs?

Yes, but only as an additional skill with specific training (for example the NEBDN Certificate in Dental Radiography). A dental nurse acts as the IR(ME)R operator under a prescription from an IR(ME)R practitioner — they cannot prescribe (refer for) or justify the exposure themselves, and they cannot report on or interpret radiographs for diagnosis. Preparing equipment and processing radiographs is a core dental nurse skill that needs no extra qualification.

What changed in the 2025 GDC Scope of Practice?

The revised GDC Guidance on Scope of Practice took effect on 1 November 2025. It replaced the old fixed task lists with a competency- and role-based approach that emphasises professional judgement, but it did not change the scope boundaries for any of the seven registrant titles. What each title may and may not do is unchanged; the registrant must still be trained, competent and indemnified for every task they carry out.

Sources

Notes scoped to what you actually do

Nosht’s structured templates are scoped to the work hygienists and therapists carry out — periodontal therapy, prevention, restorations and referrals — one click to copy into any practice management system. No patient identifiers in clinical notes (referral letters and leaflet sending excepted).

Nosht for hygienists & therapists The dental notes app

Related guide: GDC scope of practice for hygienists & therapists (2025) · More tools: BPE calculator