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Extending dental nurses’ duties: a national survey investigating skill-mix in Scotland’s child oral health improvement programme (Childsmile)
Open accessAbstract
BACKGROUND: Childsmile is Scotland's national child oral health improvement programme. To support the delivery of prevention in general dental practice in keeping with clinical guidelines, Childsmile sought accreditation for extended duty training for dental nurses to deliver clinical preventive care. This approach has allowed extended duty dental nurses (EDDNs) to take on roles traditionally undertaken by general dental practitioners (GDPs). While skill-mix approaches have been found to work well in general medicine, they have not been formally evaluated in dentistry. Understanding the factors which influence nurses' ability to fully deliver their extended roles is necessary to ensure nurses' potential is reached and that children receive preventive care in line with clinical guidance in a cost-effective way. This paper investigates the supplementation of GDPs' roles by EDDNs, in general dental practice across Scotland. METHODS: A cross-sectional postal survey aiming to reach all EDDNs practising in general dental practice in Scotland was undertaken. The survey measured nurses': role satisfaction, perceived utility of training, frequency, and potential behavioural mediators of, preventive delivery. Frequencies, correlations and multi-variable linear regression were used to analyse the data. RESULTS: Seventy-three percent of practices responded with 174 eligible nurses returning questionnaires. Respondents reported a very high level of role satisfaction and the majority found their training helpful in preparing them for their extended role. While a high level of preventive delivery was reported, fluoride vanish (FV) was delivered less frequently than dietary advice (DA), or oral hygiene advice (OHA). Delivering FV more frequently was associated with higher role satisfaction (p < 0.001). Those nurses who had been practising longer reported delivering FV less frequently than those more recently qualified (p < 0.001). Perceived difficulty of delivering preventive care (skills) and motivation to do so were most strongly associated with frequency of delivery (p < 0.001 for delivery of FV, DA and OHA). CONCLUSIONS: This study has provided insight into EDDNs' experiences and demonstrates that with appropriate training and support, EDDNs can supplement GDPs' roles in general dental practice in Scotland. However, some barriers to delivery were identified with delivery of FV showing scope for improvement.
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Utilising dental nurses with extended duties allows dental care professionals to take on more autonomy and responsibility within their role, possibly increasing job satisfaction.
“In addition to the financial gains, utilising dental nurses with extended duties allows dental care professionals to take on more autonomy and responsibility within their role, possibly increasing job satisfaction.”
From Implementation of a CBT-based dental anxiety management pathway for patients with learning disabilities (2024) · cites this paper as [28]
The Background says extended-duty dental nurses took on roles traditionally undertaken by dentists, and the Results record nurses describing increased responsibilities. The Discussion and Conclusions link delivering new skills to job satisfaction. The paper does not establish that the nurses gained more autonomy, so that part of the claim is unsupported. (LLM, conf=0.83)
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Cites
Making psychological theory useful for implementing evidence based practice: a consensus approach
Michie, S. (2005) · Quality and Safety in Health Care · doi:10.1136/qshc.2004.011155 · Cited by 3,440
Goyder, J., & de Vaus, D. (1987) · The Canadian Journal of Sociology · doi:10.2307/3340954 · Cited by 2,274
Substitution of doctors by nurses in primary care
Laurant, M. G. H., Reeves, D., Hermens, R., Braspenning, J., Grol, R. P. T. M., & Sibbald, B. (2005) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001271.pub2 · Cited by 961
de Vaus, D. (2013) · Routledge eBooks · doi:10.4324/9780203501054 · Cited by 797
Cook, J. V., Dickinson, H. O., & Eccles, M. (2009) · BMC Health Services Research · doi:10.1186/1472-6963-9-160 · Cited by 493
Changing the skill-mix of the health care workforce
Sibbald, B., Shen, J., & McBride, A. (2004) · Journal of Health Services Research & Policy · doi:10.1258/135581904322724112 · Cited by 335
Age, resistance to change, and job performance
Kunze, F., Boehm, S. A., & Bruch, H. (2013) · Journal of Managerial Psychology · doi:10.1108/jmp-06-2013-0194 · Cited by 165
Eccles, M., Grimshaw, J., Johnston, M., Steen, N., Pitts, N. B., Thomas, R. E., Glidewell, L., MacLennan, G., Bonetti, D. L., & Walker, A. E. (2007) · Implementation Science · doi:10.1186/1748-5908-2-26 · Cited by 151
OLDER WORKER'S ADAPTATION TO A CHANGING WORKPLACE: EMPLOYMENT ISSUES FOR THE 21st CENTURY
Yeatts, W. E. F. D. E. (1999) · Educational Gerontology · doi:10.1080/036012799267774 · Cited by 144
Gallagher, J. E., & WILSON, N. H. F. (2009) · BDJ · doi:10.1038/sj.bdj.2009.114 · Cited by 109
Skill mix changes: substitution or service development?
Richardson, G., Maynard, A., Cullum, N. A., & Kindig, D. A. (1998) · Health Policy · doi:10.1016/s0168-8510(98)00038-4 · Cited by 106
Macpherson, L. M. D., Ball, G. E., Brewster, L., Duane, B. G., Hodges, C.-L., Wright, W., Gnich, W., Rodgers, J. M., McCall, D. R., Turner, S., et al. (2010) · BDJ · doi:10.1038/sj.bdj.2010.628 · Cited by 89
Self-citationThe changing skill mix in nursing: considerations for and against different levels of nurse
Jacob, E. R., McKenna, L., & D’Amore, A. (2013) · Journal of Nursing Management · doi:10.1111/jonm.12162 · Cited by 74
Bonetti, D. L., Johnston, M., Clarkson, J., Grimshaw, J., Pitts, N. B., Eccles, M., Steen, N., Thomas, R. E., MacLennan, G., Glidewell, L., et al. (2010) · Implementation Science · doi:10.1186/1748-5908-5-25 · Cited by 58
Doyal, L. (2000) · BMJ · doi:10.1136/bmj.320.7241.1023 · Cited by 56
A national survey of dental hygienists: working patterns and job satisfaction
Gibbons, D. E., Corrigan, M. A., & Newton, T. (2001) · BDJ · doi:10.1038/sj.bdj.4800926 · Cited by 54
Turner, S., Ross, M. K., & Ibbetson, R. (2011) · BDJ · doi:10.1038/sj.bdj.2011.50 · Cited by 53
Ward, P. (2006) · BDJ · doi:10.1038/sj.bdj.4813251 · Cited by 52
THE PROFESSIONALS COMPLEMENTARY TO DENTISTRY: SYSTEMATIC REVIEW AND SYNTHESIS
Galloway, J., Gorham, J. J., Lambert, M. F., Richards, D., Russell, D., Russell, I. T., & Welshman, J. (2003) · Cited by 49
Dental therapy in the United Kingdom: part 2. A survey of reported working practices
Godson, J. H., Williams, S. A., Csikar, J. I., Bradley, S., & Rowbotham, J. S. (2009) · BDJ · doi:10.1038/sj.bdj.2009.962 · Cited by 48
Grimshaw, J., Eccles, M., Steen, N., Johnston, M., Pitts, N. B., Glidewell, L., MacLennan, G., Thomas, R. E., Bonetti, D. L., & Walker, A. E. (2011) · Implementation Science · doi:10.1186/1748-5908-6-55 · Cited by 47
The working practices and job satisfaction of dental therapists: findings of a national survey
Gibbons, D. E., Corrigan, M. A., & Newton, T. (2000) · BDJ · doi:10.1038/sj.bdj.4800793 · Cited by 41
Turner, S., Ross, M. K., & Ibbetson, R. (2011) · BDJ · doi:10.1038/sj.bdj.2011.387 · Cited by 33
The policy context for skill mix in the National Health Service in the United Kingdom
Brocklehurst, P. R., & Tickle, M. (2011) · BDJ · doi:10.1038/sj.bdj.2011.765 · Cited by 32
Envisioning an oral healthcare workforce for the future
Nash, D. A. (2012) · Community Dentistry And Oral Epidemiology · doi:10.1111/j.1600-0528.2012.00734.x · Cited by 27
Dental hygienists’ work environment: motivating, facilitating, but also trying
Candell, A., & Engström, M. (2009) · International Journal of Dental Hygiene · doi:10.1111/j.1601-5037.2009.00420.x · Cited by 26
A professional challenge: the development of skill-mix in UK primary care dentistry
Bullock, A. D., & Firmstone, V. (2011) · Health Services Management Research · doi:10.1258/hsmr.2011.011011 · Cited by 23
Nilchian, F., RODD, H. D., & Robinson, P. G. (2009) · BDJ · doi:10.1038/sj.bdj.2009.856 · Cited by 19
Carter, E., Parker, M., & Gallagher, J. E. (2012) · BDJ · doi:10.1038/sj.bdj.2012.417 · Cited by 19
Williams, D. M., Medina, J., Wright, D., Jones, K., & Gallagher, J. E. (2010) · Primary Dental Care · doi:10.1308/135576110791013884 · Cited by 18
Mackenzie, M. (2006) · Health and Social Care in the Community · doi:10.1111/j.1365-2524.2006.00640.x · Cited by 15
A national survey of dental hygienists
Evans, C., & Blinkhorn, A. S. (1982) · BDJ · doi:10.1038/sj.bdj.4804927 · Cited by 10
Determining the optimal model for role-substitution in NHS dental services in the United Kingdom
Brocklehurst, P. R., Birch, S., McDonald, R., & Tickle, M. (2013) · BMC Oral Health · doi:10.1186/1472-6831-13-46 · Cited by 10
Jones, C., & Walker, A. J. (2010) · Dental Update · doi:10.12968/denu.2010.37.8.549 · Cited by 7
Deas, L., Mattu, L., & Gnich, W. (2013) · Social Science & Medicine · doi:10.1016/j.socscimed.2013.07.001 · Cited by 7
Self-citationArpalahti, I., Järvinen, M., Suni, J., & Pienihäkkinen, K. (2011) · International Journal of Dental Hygiene · doi:10.1111/j.1601-5037.2011.00517.x · Cited by 5
Nilchian, F., RODD, H. D., & Robinson, P. G. (2009) · BDJ · doi:10.1038/sj.bdj.2009.897 · Cited by 5
A research evaluation of health support workers in a Sure Start project.
Smith, C. A., Prosser, M., & Joomun, L. (2007) · PubMed · Cited by 4
Barriers Encountered Using Skill-Mix to Deliver Caries Prevention in Dental Practices
Hatim, E., & Kendall, N. (2012) · Primary Dental Care · doi:10.1308/135576112800185287 · Cited by 2
Flagged first, then by citations
Research works printed but not linked: 9
- National Dental Inspection Programme of Scotland: Report of the 2012 Detailed National Dental Inspection Programme of Primary 1 Children and the Basic Inspection of Primary 1 and Primary 7 Children. 2012, Edinburgh: The Scottish Dental Epidemiology Coordinating Committee ISD Scotland
- NHS National Services Scotland Information Services Division: Dental Statistics - NHS Registration and Participation. Update of statistics as at 30th September 2013. 2013, Edinburgh: NHS National Services Scotland Information Services Division
- Scottish Executive: An Action Plan for Improving Oral Health and the Modernisation of NHS Dental Services in Scotland. 2005, Edinburgh: Scottish Executive Publishing
- Scottish Dental Clinical Effectiveness Programme (SDCEP): Prevention and Management of Dental Caries in Children. 2010, Dundee: SDCEP
- Scottish Intercollegiate Guidelines Network (SIGN): Prevention and Management of Dental Decay in the pre-School Child: A National Clinical Guideline. 2005, Edinburgh: SIGN
- Laurant M, Harmsen M, Faber M, Wollersheim H, Sibbald B, Grol R: Revision of Professional Roles and Quality Improvement: A Review of the Evidence. 2010, London: The Health Foundation
- General Dental Council (GDC): Scope of Practice. 2009, London: GDC
- Scottish Government: Scottish Index of Multiple Deprivation 2012. 2012, Edinburgh: National Statistics Publication
- Childsmile's Central Evaluation and Research Team: Childsmile National Headline Data. 2012, Glasgow: University of Glasgow
Cited by
Sorted by citations
Lieffers, J. R. L., Vanzan, A. G. T., de Mello, J. R., & Cammer, A. L. (2021) · Nutrients · doi:10.3390/nu13103588 · Cited by 38
Nguyen, T. M., Tonmukayakul, U., Warren, E., Cartwright, S., & Liew, D. (2019) · Health Promotion Journal of Australia · doi:10.1002/hpja.283 · Cited by 32
A dental workforce strategy to make Australian public dental services more efficient
Nguyen, T. M., Tonmukayakul, U., & Calache, H. (2019) · Human Resources for Health · doi:10.1186/s12960-019-0370-8 · Cited by 19
Modha, B. (2021) · BDJ · doi:10.1038/s41415-021-3457-2 · Cited by 19
Sandom, F., Hearnshaw, S., Grant, S., Williams, L., & Brocklehurst, P. R. (2022) · BDJ · doi:10.1038/s41415-022-4140-y · Cited by 8
Suryo, G. A., Supriyana, S., Rasipin, R., Sunarjo, L., & Fatmasari, D. (2021) · International Journal of Nursing and Health Services (IJNHS) · doi:10.35654/ijnhs.v4i2.353 · Cited by 4
Holloway, J. A., & Chestnutt, I. G. (2024) · Primary Dental Journal · doi:10.1177/20501684241232214 · Cited by 3
Opoku-Ansah, N. A., Gallagher, J. E., & Niven, V. (2025) · BDJ Open · doi:10.1038/s41405-025-00314-y · Cited by 2
Hughes, S., Davies, L., Monaghan, U., & Stennett, M. (2024) · British Dental Journal · doi:10.1038/s41415-024-7557-7 · Cited by 1
AlKatheri, N., Niven, V., Sayers, M., Holdaway, P., & Gallagher, J. E. (2025) · BDJ · doi:10.1038/s41415-024-8272-0 · Cited by 1
Human Resources for Oral Health and Dentistry: Time for Action
Gallagher, J. E. (2024) · Elsevier eBooks · doi:10.1016/b978-0-323-99967-0.00168-x · Cited by 1
Wanyonyi, K. (2015) · Research Portal (King's College London)
Becoming an oral health educator: the real story
Lloyd, L. (2016) · Dental Nursing · doi:10.12968/denn.2016.12.2.100
Professionalism by proxy: a case for the formal regulation of dental assistants in Australia
Holden, A. C. L., Jean, G., Tennant, M., & Spallek, H. (2018) · BDJ · doi:10.1038/sj.bdj.2018.759
Zhang, Y., Zhang, Y., & Wang, L. (2023) · Research Square · doi:10.21203/rs.3.rs-3367673/v1
Al Shamrany, M., Meshikhes, F., Marzouki, F., Abdrabinabi, H., Al Zaymour, L., Al Madani, A., Saleh, Z., Al Ghamdi, M. Y., Al Ghamdi, M. Y., Al Wadi, M., et al. (2022) · Austin Journal of Dentistry · doi:10.26420/austinjdent.2022.1168
den Boer, J. C. L., van der Sanden, W. J. M., Jerković‐Ćosić, K., & Bruers, J. J. M. (2025) · BMC Oral Health · doi:10.1186/s12903-025-06091-2
Yusuf, H., Tubert‐Jeannin, S., & Eaton, K. A. (2026) · Community Dental Health · doi:10.1177/0265539x261450853
Łuczak, J., Bochniak, K., Kaczmarek, W., Szabelski, M., Staniaszek, Z., Ibrahim-El-Nur, J. M., Bogdan, M., & Nitsch-Osuch, A. (2026) · Healthcare · doi:10.3390/healthcare14111501
Metadata
- Authors
- Gnich, W., Deas, L., Mackenzie, S., Burns, J., & Conway, D. I.
- Affiliations
- University of Glasgow (GB)
- NHS Lanarkshire (GB)
- NHS Ayrshire and Arran (GB)
- Corresponding author
- Gnich, Wendy
- Venue
- BMC Oral Health
- Published
- 2014-11-25
- Volume
- 14
- Issue
- 1
- Pages
- 137-137
- ISSN
- 1472-6831 (ISSN-L)
- PMC
- PMC4280710
- OpenAlex
- W2168057956
- Semantic Scholar
- d5179b3d550e794e18a531b55c46367765ce445d
- Cited by
- 19
- References
- 39
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2023: 1 · 2022: 2 · 2021: 3 · 2019: 2 · 2018: 1 · 2016: 1 · 2015: 1
- FWCI
- 0.93
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Oral Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
- Funders
- Scottish Government
- University of Glasgow
- Topics
- Health Sciences › Health Professions › General Health Professions › Nursing Roles and Practices
- Health Sciences › Health Professions › General Health Professions › Interprofessional Education and Collaboration
- Health Sciences › Dentistry › General Dentistry › Dental Health and Care Utilization
- Keywords
- skill mix, children's oral health, preventive dentistry, fluoride varnish, dietary recommendations, oral hygiene advice, role satisfaction, general dental practice, Scotland
- MeSH terms
- Adult, Cariostatic Agents, Child, Clinical Competence, Counseling, Cross-Sectional Studies, Dental Assistants, Feeding Behavior, Female, Fluorides, Topical, General Practice, Dental, Health Promotion, Humans, Job Satisfaction, Middle Aged, Motivation, Oral Health, Oral Hygiene, Scotland, Self Concept, Social Support, Staff Development, Dental Care for Children, Delegation, Professional, Young Adult
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