The Dental Council (The statutory body that regulates dentists) continues to remind dentists of their duty to examine and assess patients before assigning them to the dental hygienist for cleaning and gum treatment.

Some patients, often those new to the practice, insist that they only wish to see the hygienist. To do so, without first having had an examination and diagnosis by a dentist, is illegal and is in breach of the Dental Council guidelines and leaves both the dentist and the dental hygienist open to a charge of professional misconduct.

A dental hygienist is permitted to carry out certain dental work under the supervision of a registered dentist when the dentist has first examined the patient and indicated to the dental hygienist the course of treatment to be provided.

Healthy periodontal (gum) tissue is essential for tooth stability and well-being. It is composed of collagen fibres, and a ground substance containing cells, blood vessels and nerves.

The periodontal (gum) tissue has a number of functions. The main ones are as follows:

• Tooth support mechanism when chewing
• Tooth position maintenance
• Its cells form, maintain and repair jaw bone and tooth cementum
• Its receptors are involved in the neurological control of mastication

In order to maintain periodontal (gum) health it is very important to remove its main enemies - plaque and tartar. If the bacteria in plaque are allowed to continue to infiltrate the periodontal tissues they cause breakdown that without intervention can ultimately lead to tooth loss.

Having your teeth cleaned is therefore not just a cosmetic exercise. Legally, when a dentist examines your mouth (s)he is taking responsibility for assessing the health and consequent treatment of any disease affecting your teeth, gums or other oral soft tissue. Again, legally, the dentist is the diagnostician and, to comply with the law, a hygienist can only see a patient for treatment on the prescription of a registered dentist.

As an ongoing matter, a patient must see the dentist for examination on a periodic basis to ensure that any developing oral pathology, affecting teeth, gums or oral mucosa, is picked up at an early stage. An annual oral examination is seen as best practice.