Clinical Dental Technicians Emily Pittard MCGDent and Carmel Vickers-Wall, an Associate Member of the College, examine the role of a CDT and how they can work efficiently and effectively within the dental team.
What are Clinical Dental Technicians?
Firstly, what actually is a Clinical Dental Technician (CDT)? Well, they are a registered dental care professional who can provide complete dentures direct to the public. They can also provide partial dentures and other dental devices on prescription from a registered dentist.
What can we do?
A CDT is able to oversee the patient’s whole denture journey. They can treatment plan (complete dentures), take the impressions, do a bite registration and then manufacture the denture from start to finish. This results in the patient receiving a high-quality denture, and changes can be made instantly rather than trying to communicate through prescriptions where information can be missed. Many times, we’ve heard “A CDT is a Dental Technician who just takes impressions”, which isn’t true. A CDT has a large scope of practice and takes on a variety of responsibilities within the dental team:
- taking impressions
- taking a detailed medical history
- carrying out clinical examinations
- taking and processing radiographs
- recognising abnormal mucosa and referring to the appropriate healthcare professionals
- giving appropriate oral health advice
Many edentulous patients won’t see a general dentist as they believe they don’t need to if they don’t have any remaining teeth. This means that they might only see a CDT if their denture breaks, or they feel they need a replacement. Therefore, it is crucial that CDTs have a full understanding of a patient’s mucosa and are able to identify any abnormalities as well as understanding medications in detail and their interactions.
Clinical Dental Technicians have an extensive knowledge of anatomy, pharmacology, cross infection and health promotion. A CDT can also further enhance their scope of practice by gaining relevant training so that they can re-cement crowns, provide anti-snoring devices, replace implant abutments and provide tooth whitening treatment on prescription.
How can we be beneficial to your dental team?
Dentistry is currently in a crisis with some patients unable to see a dentist for up to four years. CDTs can help to alleviate this strain by seeing all denture treatment; allowing dentists to focus on other treatment. Dentures are very time-consuming as they require adjustments and reviews to help the patient acclimatise; CDT’s can take over this entire journey.
They can also take impressions, see whitening patients, mouthguards and sports guards appointments and, on prescription from a dentist, they can temporarily fit crowns, bridgework and implant work. So how would this work in practice? Let’s take a look at three examples of how a CDT could help to significantly improve a workflow:
- A patient who needs an upper denture but has teeth in their lower arch. Typically, this would take a dentist up to five appointments to get the patient to final fit, and then multiple review appointments. Instead, the dentist could see them for the initial examination and then hand over all the other appointments to a CDT.
- A patient who needs a dental implant. A dentist could see the patient up to their uncover and then the CDT could take over, take the impression / scan and temporarily fit the implant crown. The patient would then see the dentist for a review a few weeks later. This requires great communication within the team and a CDT who has knowledge of implants, but it would mean that in the time frame a dentist would have seen one patient for one implant placement, they could have seen two.
- A patient who wants a denture on locators. Again, the dentist can place the implants and uncover and then hand over to the CDT who can then complete the treatment for the patient.
These are just a few examples but there are many more. As with any dental professional, to incorporate them into the team workflow will take great communication between clinicians and excellent records, but as that is something that we all intend to maintain as part of our general standards anyway, it shouldn’t take much to adapt to incorporate a CDT.
A CDT is also the only dental professional who bridges the gap between the dental practice and the laboratory. They have an intimate understanding of dental prosthesis and can help to manage patient expectations; take shades; quickly repair some things; provide teeth in a day and help to treatment plan complex cases.
What was your experience like in your first few months to a year post qualification?
Emily: I was in a lucky position to already be working in a CDT-recognising clinic, however I did find it took forever to be on the GDC register! I had previously worked and gained qualifications as a dental nurse and a dental technician and had been fortunate enough to work in a specialist practice as a Dental Technician under my extended scope of practice. So, I had been taking impressions of denture patients and implant patients and digital scans for a number of years before I qualified as a CDT. This helped me to gain confidence in my clinical skills and after qualifying I opened my own Clinic attached to my Laboratory.
Carmel: It was very daunting coming out of university from the new CDT course. Mainly because nobody else was out there who was in a similar position to me. I felt, on one hand, that some Dental Technicians I spoke to weren’t positive about the qualification I held and, on the other hand, general dentists didn’t understand what my job was!! However, I’ve met some fantastic Dental Technicians along the way who have been extremely supportive and provided me with a lot of knowledge and work experience. As I already came from a dentistry background (ex Dental Nurse) I had some good connections in the industry who helped me and I was even lucky enough to be offered a CDT job upon qualifying.
Do you feel like a CDT is a fully recognised member of the dental team by other professionals?
EP: Not at all, I have found that many dental professionals have never heard of a Clinical Dental Technician. I have, however, seen a shift for the better amongst new dentists just qualifying who seem to understand what a CDT can do and how valuable we can be to wider dental team, so it feels like we are moving in the right direction.
CVW: Sadly not yet. I think this is due to not seeing Clinical Dental Technicians in general practice. We regularly see Dental Hygienists and Dental Therapists and even Orthodontic Therapists, but as CDTs currently don’t have an NHS contract, it means we are predominantly private/independent.
How easy was it to find indemnity or relevant CPD courses?
EP: Almost impossible to find indemnity! I ended up getting indemnity that has elements of every other dental team role in the script as they didn’t have a CDT-specific one!
CVW: I agree with Emily, I couldn’t believe how few options there were for indemnity. This is the same with CPD. There are very few courses out there specifically designed for CDTs. I figured I’ll have to take courses aimed at the other members of the dental team which I could relate to within my scope of practice.
Emily Pittard is on the Board of the College’s Faculty of Clinical Dental Technology and Dental Technology.