When you book a direct access hygienist appointment, you might notice that both the time allocated and the fee are higher than a standard hygiene visit. At The Briars Dental Centre, we charge £207.40 for these appointments and schedule a full hour to ensure your hygienist can provide thorough, safe care. If you’re wondering why, you’re asking exactly the right question.
Direct access hygienist appointments represent a different approach to dental care, one that requires careful consideration and planning. Understanding what happens during these visits helps explain why they’re structured the way they are.
Since 2013, the General Dental Council has permitted dental hygienists and dental therapists to see patients without a prior referral from a dentist. This means you can book directly with a hygienist without needing to see a dentist first, offering greater flexibility and choice in how you access dental care.
However, there’s a crucial difference between direct access hygienist appointments and standard hygiene visits. When you attend a direct access hygienist appointment, your hygienist is working without any prior knowledge of your oral health status. They haven’t seen recent dental records, x-rays, or assessments of your gum condition. In practice, they’re working ‘blind’, which fundamentally changes how the appointment must be structured.
At The Briars, our experienced hygienists Meryl Colley, Amiee Mosher and Monica Robotin are all qualified to provide direct access hygienist care within their scope of practice. You can learn more about their experience and qualifications on our Meet the Team page.
The hour-long appointment window exists because your hygienist needs to complete several essential tasks that would typically have been done by a dentist in a standard referral pathway. Here’s what needs to happen during your visit.
Comprehensive Gum Health Assessment
Your hygienist must start by thoroughly assessing the current state of your gums. This involves measuring pocket depths around each tooth, checking for bleeding points, noting areas of inflammation, and identifying any immediate concerns. This detailed examination takes time because it’s the foundation for everything that follows. Without this baseline assessment, your hygienist cannot safely proceed with treatment or provide appropriate advice.
Recording and Documentation
Dental hygienists practising under direct access must work within their scope of practice and refer to a dentist when they identify areas of concern or when treatment required is outside their scope – check out the guidance we work to from The General Dental Council. This means meticulous record-keeping is essential. Your hygienist must document findings carefully, not only for your ongoing care but also to identify whether referral to a dentist or periodontist is needed.
Personalised Home Care Discussion
Once your hygienist understands your gum health status, they can provide tailored advice about your oral hygiene routine at home. For some patients, this might be a brief discussion about maintaining excellent habits. For others, it might involve demonstrating new techniques, recommending different products, or addressing specific challenges affecting your ability to clean effectively.
Professional Cleaning
Only after assessment and discussion can your hygienist proceed with the cleaning itself. The extent of cleaning needed varies enormously between patients. Someone with minimal staining and healthy gums might need a straightforward scale and polish. Someone presenting with significant tartar build-up, staining, or active gum disease will require more intensive treatment, potentially addressing different areas of the mouth with varying techniques.
The unpredictability of what your hygienist will encounter makes it impossible to allocate less time without compromising care quality. Consider two different scenarios:
A patient might arrive with relatively healthy gums, minimal bleeding on probing, low plaque scores, and light staining. The assessment reveals good home care habits with only minor adjustments needed. The cleaning proceeds smoothly, and the entire appointment might comfortably fit within 45 minutes.
Another patient might present with advanced gum disease, significant tartar deposits, heavy staining, and multiple areas of concern. The assessment takes longer because there’s more to document. The home care discussion is more detailed because substantial changes are needed. The cleaning itself is more complex and time-consuming. This patient easily requires the full hour, and in some cases, additional appointments may be needed.
Your hygienist cannot know which scenario they’re facing until they begin the assessment. Allocating a full hour ensures that regardless of what they encounter, they can provide thorough, unhurried care without having to compromise on quality or rush through important discussions.
The £207.40 fee for a direct access appointment reflects the additional complexity and responsibility these visits entail. When a hygienist works under direct access, they assume full responsibility for assessment, diagnosis within their scope, treatment planning, and referral decisions. This differs significantly from working to a dentist’s prescription, where much of the assessment and decision-making has already been completed.
The fee structure accounts for the extended appointment time, the comprehensive nature of the assessment, the clinical responsibility involved, and the need to make complex decisions about whether further referral is necessary. It also reflects the additional indemnity requirements and professional obligations that come with direct access practice.
For patients seeking flexibility and direct access to hygiene care without first seeing a dentist, this represents fair value for comprehensive, professional assessment and treatment. However, it’s worth noting that for patients who are already seeing a dentist regularly at The Briars, standard hygiene appointments with a referral from your dentist may offer better value and more continuity of care.
Direct access hygienist appointments serve an important purpose for specific situations. They’re particularly valuable if you’re new to the area and want to address gum health before registering with a dentist, if you’re between dental practices and need hygiene care, if you specifically want assessment and treatment from a hygienist without involving a dentist, or if you’re an occasional patient who wants flexibility in accessing care.
However, for patients who see a dentist regularly, standard hygiene appointments referred by your dentist often provide better continuity of care and may be more cost-effective. Your dentist can assess your overall oral health, take necessary x-rays, and provide your hygienist with crucial information that helps them tailor your appointment efficiently.
If your hygienist identifies concerns during a direct access appointment that require treatment beyond their scope of practice, they will refer you to a dentist or relevant healthcare practitioner. This means you may ultimately need to see a dentist anyway, so considering whether direct access is the most appropriate route for your circumstances makes practical sense.
When you arrive for your direct access hygienist appointment at The Briars, come prepared to discuss your oral health history, any concerns you have about your gums or teeth, your current home care routine, and any medical conditions or medications that might affect your oral health.
Your hygienist will work methodically through the assessment, taking time to explain what they’re finding and what it means for your oral health. They’ll discuss their treatment plan with you before proceeding, answer your questions, and ensure you understand what happens next. If they identify issues requiring referral to a dentist or specialist, they’ll explain why and help arrange the appropriate next steps.
The comprehensive nature of these appointments means you’ll leave with a clear understanding of your current gum health status, personalised advice tailored to your specific needs, professional cleaning appropriate to your condition, and a clear plan for ongoing care and maintenance.
Direct access hygienist care represents an important development in dental care, offering patients greater choice and flexibility in how they access hygiene services. At The Briars, our hygienists have the experience, training and qualifications to provide this care safely and effectively. They work to the highest professional standards, supported by our advanced digital technology including CBCT imaging and comprehensive diagnostic tools.
The hour-long appointment and associated fee reflect the reality of providing safe, thorough care when your hygienist must start with no prior knowledge of your oral health. Rather than viewing this as a premium price, it’s more accurate to see it as appropriate investment for comprehensive assessment and treatment that puts your safety and clinical outcomes first.
If you have questions about whether a direct access hygienist appointment is right for your circumstances, our team is happy to discuss your options and help you make an informed decision about the most appropriate pathway for your care.
To book a direct access hygienist appointment at The Briars Dental Centre, contact our team on 01635 40311 or enquire through our website. We’re here to help you achieve your dental goals with personalised, high-quality care that puts your needs first.
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