From the first experimental training to the BSc degree programmes, the journey of dental hygienists and dental therapists has been one of persistence, clinical excellence, and an unwavering commitment to dental public health.
Dental hygienists: from Irene Newman to RAF dental training
The dental hygienist profession finds its roots in the early 20th century with Dr Alfred Fones, who graduated as a dentist just as the bacterial cause of dental caries was discovered. In 1907, Irene Newman - Dr Fones’ dental assistant - became the world’s first dental hygienist in Connecticut, USA. Dr Fones trained Irene to carry out oral hygiene instruction and remove hard and soft deposits from the mouth. Despite sceptics' scoffing at the idea of patients attending for regular cleaning, by 1913 the first formal classes for trainee dental hygienists began.
The UK’s adoption of the role was heavily influenced by the needs of the Armed Forces. In 1942, Sir William Kelsey Fry, a doctor and dentist, advocated for dental hygienists to treat the neglected mouths and dental sepsis among young servicemen. The first UK course was based at the Royal Air Force (RAF) Glenside in Devon. The intense 16-week course trained dental nurses to carry out scaling, polishing and oral health education.
It is worth noting that the concept of dental hygienists in the UK was not new. In 1928, University College Hospital in London had piloted the training of dental ancillaries in preventive care. However, this was abandoned due to pressure and resistance from within the dental profession, which was concerned about the encroachment of non-dentists into dental work and potential competition.
Flight Lieutenant Gerald Leatherman led the move of the dental hygienist training programme to the RAF Dental Training Establishment at Halton, Buckinghamshire, in 1945. The leadership from Sir William and Flight Lieutenant Leatherman did not go unnoticed. Sir William went on to become the first President of the British Dental Hygienist Association (BDHA), formed in 1949. Leatherman, who continued to champion the role of dental hygienists well into the 1980s, became the BDHA's second President. In the early 1990s, the BDHA, now the British Society of Dental Hygiene and Therapy (BSDHT), recognised Leatherman’s outstanding commitment to the dental hygienist profession by introducing the Dr Gerald Leatherman award. The award recognises the true dedication, professionalism and determination of dental hygienists today.
During the late 1940s and early 1950s, additional dental hygienist training schemes were introduced. However, there were still objections within the dental profession, particularly because of the proposed introduction of dental auxiliaries.
New Zealand, dental dressers, and formal dental auxiliary training
The role of dental therapists (formerly dental auxiliaries) was inspired by the dental hygienist in America, dental dressers in the UK and a New Zealand model, where dental nurses provided treatment, including diagnosis and restorative care, for children in the early 1920s. The first school opened in Wellington, New Zealand, in 1921, with schools in Auckland and Christchurch following by the 1950s.
Long before the title of “dental therapist” was adopted, the concept began with “dental dressers”. A shortage of dentists and high rates of dental caries in children in WW1 led some local authorities to experiment with dental dressers, who worked under the immediate supervision of dentists to clean, fill and extract teeth for school children. By 1923, local authorities in Derbyshire, Sheffield and Shropshire employed dental dressers. Again, this new member of the dental team met significant opposition from dentists.
In the early 1950s, a UK government team was sent to New Zealand to observe dental auxiliaries in action. The team reported that they provided a high standard of care, which ultimately led to the Dentists Act being passed in 1957, allowing dental auxiliaries to work in the UK. Their remit was similar to that of the New Zealand model, but UK dental auxiliaries were not allowed to work in general dental practices. They also needed to work to a prescription from a dentist and couldn’t diagnose, plan treatment or discharge a patient without a final inspection from a dentist.
The formalisation of the profession began in South London with the first dedicated dental school for dental auxiliaries opening at New Cross Hospital in 1959. The school admitted 60 female students each year for a 24-month course. Students were chosen from across the country with the expectation that they would return to their home town on completion of the course. After a couple of years, the government made students, parents and guardians agree to work anywhere in the UK as part of their acceptance on the course. As you can imagine, this was challenging to enforce.
Unfortunately, in 1983, New Cross closed despite recommendations for further training establishments and an expanded scope of practice. There were still calls from within the dental profession to abolish the dental therapy role altogether.
Expansion in training didn’t begin again until 1996, when Cardiff Dental Hospital started a dental therapy course for dental nurses. Charles Clifford Dental Hospital, in Sheffield, also began a combined dental hygiene and dental therapy course in the same year.
In 1999, the GDC recommended that dental therapists be permitted to work in all sectors of dentistry in the UK, including general dental practice. This was finally approved in 2002, along with the further expansion of the dental therapists' scope of practice.
The University of Manchester began the first degree course in 2000, paving the way for the BSc programmes we see today.
Dental hygiene and dental therapy: an evolution
In recent years, we have seen a transformative shift in the role of dental therapists in the UK. Once a model involving direct supervision, it has now evolved into one encompassing a high level of autonomy and clinical leadership.
In 2013, Direct Access was introduced, allowing patients to see dental hygienists and dental therapists without seeing a dentist first. Starting in 2022, NHS England implemented changes to the dental contract, specifically encouraging the use of skill-mix. These changes saw dental hygienists and dental therapists able to open an NHS course of treatment for the first time.
In 2024, the Human Medicines Regulations were amended to allow dental therapists and dental hygienists to supply and administer specific medicines under “exemptions”. In 2025, the GDC amended the Scope of Practice, shifting away from a prescribed list of duties to guidance that emphasises professional decision-making and autonomy. It now places the responsibility on the dental professional to determine if they are trained, competent and indemnified to perform a task. This creates a more flexible framework for dental therapists and dental hygienists to adopt new technologies and advanced clinical practices as they emerge.
Just this year, recent reforms have seen the introduction of funded annual appraisals, recognising that dental therapists and dental hygienists should have the same access to mentorship within the NHS as dentists. In March 2026, the GDC and major dental societies (BSDP, BADT, BSSCD, SAAD) clarified that dental therapists can play a critical role in general anaesthesia (GA) settings. Dental therapists can be supported to carry out restorative care, extractions of primary teeth and the placement of preformed crowns in GA settings. This allows consultants to oversee multiple GA lists, with theatre time being used more efficiently as part of a more patient-led, responsive service.
As we reflect on the journey from Irene Newman and the first scalings to the BSc programmes of the 21st century, it is clear that the roles of the dental hygienist and dental therapist have been defined by a relentless pursuit of professional recognition and clinical excellence. What began as a pragmatic solution to wartime dental disease and childhood dental caries has blossomed into a cornerstone of modern dentistry. For those shaping the next generation of dental hygienists and dental therapists, today is a celebration of how far the profession has come.
Sources
British Society of Dental Hygiene and Therapy (no date). The Dr Gerald Leatherman Award. [Accessed:25/03/2026].
General Dental Council (2025). Scope of Practice Guidance. [Accessed:25/03/2026].
Rhoades, L. (2024). Irene Newman: The World’s First Dental Hygienist. Dunstable, United Kingdom: Flying Ink Press.
Rowbotham, J., Godson, J., Williams, S., Csikar, J., and Bradley, S. (2009). Dental therapy in the United Kingdom: part 1. Developments in therapists’ training and role. Br Dent J 207, pp.355-359
Wheeler, M. (2018). The history of dental hygiene. BDJ Team, 5(11), pp.28-31