The Department has issued no guidance on the free provision of treatment by hygienists in NHS dental practices. The NHS dental system ensures that patients are entitled to all treatment that is clinically needed which the patient is willing to undergo. Which dental professional delivers the treatment is a clinical matter for the practice not the NHS. Where dental hygienists are part of the team in the practice delivering NHS care that treatment will be free where either the patient is exempt from NHS charges or the treatment itself is free. This is not affected by whether the treatment is delivered by a hygienist or any other dental professional.