What proportion of dental care in care homes could be met by direct access to dental therapists or dental hygienists?

Background Many care home residents require simple dental treatment which is complicated by the need for extra time to deliver dental care. The proportion of their care which could be delivered wholly by hygienists or therapists is unknown. Method 2010 Welsh dental care home survey data on clinical opinion of treatment need and special care skill level required was cross referenced with General Dental Council guidance on direct access. Results Care home residents treatment needs could be wholly addressed by a generalist dental hygienist or therapist for 22% and 27% of cases respectively. With special care experience these figures increase to 43% and 53%. Discussion A large proportion of need in care homes could be wholly provided by hygienists or therapists, especially those with special care experience. The potential efficiency gain of direct access arises from individuals who do not need to see a dentist for any aspects of their care. Direct access to hygienists/therapists for dental care of care home residents should be piloted and evaluated. Conclusion Hygienists and therapists could make a large contribution to addressing dental treatment needs of care home residents and direct access could be an efficient model of care for this setting.