Can skill mix expand preventive dental care for children?

Dental Tribune International

Wed. 3 June 2026

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LONDON, England: The National Health Service (NHS) dental access crisis in England has brought renewed attention to children’s oral health, as caries remains the leading cause of hospital admission among 5- to 9-year-olds. The government’s response has focused partly on dental training places, overseas recruitment measures and incentives for dentists. A new modelling study suggests that the workforce could also be used more efficiently and that dental therapists and extended duties dental nurses could take on a much greater role in the delivery of prevention-focused care to children.

The research modelled how different combinations of dental professionals could provide evidence-based preventive care to children across England. Using child population data, NHS dental workforce assumptions, epidemiological evidence on caries risk and preventive care guidance, the authors created six workforce scenarios ranging from dentist-only provision to maximum delegation across the wider dental team.

The modelling found that dentist-only provision was the most workforce-efficient option in theoretical terms, but would depend on substantial NHS dentist capacity being devoted to children’s preventive care. The authors therefore present skill mix as a more practical way of expanding preventive provision in a system where NHS dentist capacity is already under pressure. In the most efficient skill mix model, dentists would retain responsibility for assessment and care planning, while dental hygienists/therapists and extended duties dental nurses would deliver preventive interventions according to their scope of practice.

The authors argue that access to preventive care for children in NHS dentistry may be more realistic if access is understood as care provided by an appropriately trained dental professional, not only a dentist. In this context, they suggest that workforce redesign may be as important as recruiting additional dentists. Better integrating dental hygienists/therapists and extended duties dental nurses could allow practices to increase preventive capacity while reserving dentists’ time for diagnosis, treatment planning and more complex clinical care.

However, the paper has important limitations. The modelling assumes ideal conditions, including universal attendance by children, efficient patient flow and high levels of workforce availability. It does not demonstrate improved patient outcomes directly, nor does it address real-world barriers such as funding structures, appointment uptake, administrative complexity or whether enough dental care professionals are available to provide NHS care. Even so, the paper makes an important contribution to current debates around NHS dental reform. It highlights how a more team-based workforce model could support the future delivery of paediatric preventive care in England.

The study sits within a broader shift towards prevention-first dentistry in the NHS. Recent research on supervised toothbrushing programmes in England has similarly focused on the practical challenges of delivering preventive care at scale, as well as potential solutions.

The paper, titled “Prevention first—modelling evidence-based prevention with the dental team for children in England”, was published on 22 May 2026 in the British Dental Journal.