Dental Therapy: Professional Practice, Assessment and Treatment Within Scope
Scope as a legal boundary, not a preference
Dental therapy practice is defined by a scope of practice set in law and interpreted by your registering authority. Questions test whether you know where your authority ends. Core therapeutic activities typically include oral assessment and diagnosis within scope, preventive care, restorations of primary and permanent teeth, pulp therapy in primary teeth, extractions of primary teeth, and administration of local anaesthesia and nitrous oxide where endorsed. Prescribing, surgical extraction of permanent teeth, and complex endodontics usually sit outside therapy scope, and referral is the correct answer.
Structured assessment
Use a consistent sequence: history (chief complaint, medical, dental, social, cultural), extraoral and intraoral examination, periodontal and caries risk assessment, then a treatment plan negotiated with the patient. Traps include jumping to restorative treatment before completing medical history; missing that a patient's anticoagulant, bisphosphonate, or uncontrolled diabetes changes the plan; and forgetting that informed consent must precede each intervention, not just the first.
Treatment planning and referral
Plan by risk, not only by lesion. A high caries-risk patient needs prevention and behaviour change before, or alongside, restoration. Document findings, options discussed, and the patient's decision. Refer when the condition exceeds scope, when behaviour management fails, or when medical complexity requires specialist input.
Worked rule of thumb
If you cannot complete the procedure safely within your scope, with the equipment and support available, and with valid consent, the answer is refer or defer, not improvise. Example: a primary molar with pulp involvement beyond coronal therapy in a child who cannot cooperate is a referral, not a longer appointment.
Documentation and teamwork
Contemporaneous records, clear referral letters, and respectful delegation to dental assistants and hygienists are examinable professional behaviours.