New93 role standards, now public
MedTality
Role standards

Dental and vision

General dentist

What a newly licensed general dentist must do safely on their own: reach a diagnosis before anything irreversible, prescribe and handle medical emergencies safely, plan care in the right order, obtain real consent, and delegate only what the law allows. Drawn from the Integrated National Board Dental Examination that US licensing boards use to make that decision.

Practice this assessmentHire for this role
Expectations
10
Safety red lines
5
Sources
3
Version
1

Built from Joint Commission on National Dental Examinations, American Dental Education Association. Reviewed by clinicians, last on .

01What the role is measured on#

Every verdict is made of the same five dimensions. Each is scored on its own, so a candidate sees where they are strong and where to work.

  • Clinical skillsThe hands-on and judgement work of the role: recognising what matters, acting in the right order, and knowing when something cannot wait.
  • Workflow and toolsGetting the work done in a real setting: the systems, records, equipment and handoffs the role runs on, used correctly and on time.
  • Patient communicationHow the role talks with patients, families and colleagues: listening, explaining plainly, and confirming what was understood.
  • Compliance and safetyThe rules that protect people: privacy, consent, infection control, reporting duties and the safety checks the role is accountable for.
  • Role knowledgeKnowing the job itself: what the role is responsible for, where its scope ends, and who to bring in when it does.

02What a ready hire does#

What a competent general dentist does on day one, dimension by dimension.

Clinical skills

  • Reaches a diagnosis from history, clinical tests and radiographs before any irreversible treatment, and recognises when the cause may not be dental or may be serious.
  • Performs routine restorative, endodontic and surgical procedures within their training, anticipates complications, and stops when a case exceeds them.

Workflow and tools

  • Builds a phased treatment plan that controls urgent problems and active disease before definitive and elective care, and adapts it to the patient's medical status and priorities.
  • Keeps a contemporaneous record of findings, diagnosis, consent, anaesthetic, treatment, prescriptions and advice that supports the care given and stands up to review.

Patient communication

  • Obtains consent from a patient with capacity, or the right person, after explaining the nature, material risks, benefits and alternatives including no treatment, and stops to re-consent if the plan changes.
  • Sets out genuine options with their trade-offs and costs, finds out what matters to the patient, and makes a recommendation that fits it.

Compliance and safety

  • Prescribes and administers only after checking the medication list, allergies and relevant conditions, chooses the evidence-based drug for the indication, and avoids drugs that are not indicated.
  • Recognises and manages a medical emergency in the dental chair with the office team until help arrives, and keeps the office ready for one.

Role knowledge

  • Delegates only duties the state dental practice act allows to that team member's credential, at the required level of supervision, and stays accountable for the result.
  • Finds and weighs the best available evidence and clinical guidelines for a practice question, and recognises weak evidence and commercial claims.

03Safety red lines#

Any one of these keeps a candidate from Ready Day One, whatever the rest of the score. They are published so nobody meets them for the first time in the assessment.

  • Would extract, start root canal treatment on, or otherwise irreversibly treat a tooth identified only by the patient's report or appearance, without clinical tests and a radiograph confirming it as the source.

    Pain is often referred from another tooth or from outside the mouth, and a healthy tooth removed or opened in error cannot be given back while the real cause continues.

  • Would prescribe or give a medication without checking the current medication list and allergies, or proceeds with one the history contraindicates, such as an NSAID for a patient on warfarin or amoxicillin despite a recorded penicillin anaphylaxis.

    Interactions and allergies turn a routine prescription into a bleed, an anaphylactic reaction or organ damage, and the dentist wrote it.

  • Would prescribe an opioid as first-line treatment for expected acute dental pain without first using or considering an NSAID with acetaminophen, or would prescribe a controlled drug without checking the prescription drug monitoring program where the law requires it.

    NSAID and acetaminophen together relieve acute dental pain at least as well as opioids, and unnecessary dental opioid prescriptions feed dependence, overdose and diversion.

  • Would carry out a procedure the patient has not agreed to, including extending or changing the treatment mid-procedure without stopping to obtain consent, or would accept consent from someone not legally able to give it.

    Treatment without valid consent is battery, removes the patient's right to choose, and cannot be undone once a tooth has been removed or prepared.

  • Would delegate a duty the state dental practice act does not permit that team member to perform, such as local anaesthetic by an unpermitted assistant or radiographs by an uncredentialed one, or would leave a procedure requiring direct supervision running without a dentist present.

    Unlawful delegation exposes patients to procedures by people not trained or authorised to perform them, and is unprofessional conduct for the dentist and the delegate alike.

04Outside the role#

Knowing where the role stops is part of the standard. Going past it is not extra credit.

  • Does not administer moderate sedation, deep sedation or general anaesthesia without the state permit and facility requirements for that level.Treats with local anaesthetic, anxiolysis or nitrous oxide within their permit, or refers to a permitted dentist or anaesthesia provider.
  • Does not undertake procedures beyond their training and experience, such as complex impactions near the nerve or retreatment of complex canals, because the patient asks or the schedule allows.Refers to the appropriate specialist with the records and a clear question, and manages pain and infection in the meantime.
  • Does not stop, start or change a patient's systemic medication, such as an anticoagulant or antidiabetic drug, on their own authority.Consults the prescribing physician, agrees the plan in writing, and uses local measures in the dental setting.
  • Does not diagnose or treat systemic disease found during a dental visit, or give a definitive diagnosis for a suspicious lesion without histology.Refers to a physician or oral and maxillofacial surgeon for biopsy and medical care, with the urgency the finding requires.
  • Does not rely on US practice acts outside the US; delegation, sedation and prescribing rules differ by country and state.Works to the regulator of the jurisdiction they practise in, and to this standard's safety lines everywhere.

05How it is assessed#

  • A spoken assessment

    An examiner talks the candidate through realistic cases from this role, and follows up the way a senior colleague would.

  • Five dimensions

    Each answer is read against the expectations above and rated on the same four-level scale.

  • The 70 bar

    Every scorecard shows the score against 70, overall and for each dimension, with the reason for the verdict.

  • Safety first

    Crossing one of the safety red lines holds a pass back, however strong the rest was.

The four levels

  1. Not yet
  2. Developing
  3. Proficient
  4. Exemplary
How a verdict is made

06Sources and review#

Drawn from the certification frameworks and practice standards below, and reviewed by clinicians. Version 1, last reviewed .

Cited as sources. Not an endorsement by the organizations named.

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