'It's an exciting speciality to be a part of'

Hannah Walsh BDS Manchester BSc (hons) Biology mPaedDent RCSEng, 38, is a Specialist in Paediatric Dentistry, Blackpool Teaching Hospitals and at the Garstang Referral Practice; Honorary Secretary of the British Society of Paediatric Dentistry (BSPD); Emerging Leader, Emerging Leaders Fellowship 2023/2024 at the Royal College of Surgeons of England; and Core20PLUS5 Ambassador. Hannah lives in Lancashire with her husband and son.

How does your day usually begin?

Hannah: My alarm goes off at 5:45 am. I brush my teeth very first thing and then just before I leave the house I usually eat a simple cereal. If I run out of time whilst getting my little boy out of the door I pick up a quick piece of toast.

My son will be three this December. I'm certainly experiencing in real life now the difficulties others have expressed to me previously about how difficult it is to get their child to brush their teeth twice a day. I can certainly sympathise with the parents who come to see me.

I work across a number of locations. The closest clinic is 20 miles away and the furthest is 35. Thankfully at most it takes me about 50 minutes by car. I wish I could be more energy-efficient but it's just not practical where I work currently. The drive can be long and there are no electric charging points anywhere near where I work.

What is your typical working week?

Hannah: I work Monday, Tuesday, Thursday and Friday 8:30 am-4:30 pm. Much earlier if it's a theatre day. Saturdays I work privately 8:30 am-4 pm.

I work within two distinct teams in the NHS, the North Lancashire and Blackpool/Fylde coast teams. Each are made up of approximately eight senior dental officers, one or two dental therapists, one foundation dentist/DCT1 and one Speciality Trainee in Paediatric Dentistry. We also have two Specialists in Special Care Dentistry and each team is led by a Managerial Clinical Lead and supported by dental nurses, many of whom have additional qualifications in radiography, sedation, special care dentistry and oral health. One of my dental nurses is currently undertaking a level 4 qualification in paediatric dentistry which is great to see and amazing for our patients.

Each of my days is different. Mondays I work in sunny Blackpool in a health centre providing assessments, treatment and offering specialist support to our Senior Dental Officers. Referrals are usually children with complex medical problems, social complexities, high dental need and dental trauma. Mondays I also supervise a speciality trainee in paediatric dentistry. She is currently in her second year of training.

Tuesday is when I can take an admin day and work from home. Lots of Tuesdays are spent in trust senior leadership meetings, meeting with commissioners or with our neighbouring trusts discussing access to theatres for my ever-growing GA waiting list.

Wednesday is my day off which I like to spend away from my laptop and enjoying time with my little boy. I try and plan days out, see family and take him swimming. A day away from my laptop is incredibly important to me; having such an intense job does mean it's hard to balance work and life. Especially since having my little boy, making time for my family is more and more important to me.

Thursdays I am in North Lancashire at the Morecambe Queen Victoria Centre. The workload is very similar to that in Blackpool, seeing patients on referral and recalls of patients who are unable to have dentistry in primary care, such as those with complex medical problems or learning difficulties.

On Thursdays I also support some of our Senior Dental Officers working towards Tier 2 accreditation in paediatric dentistry. This year for the first time I have also been allocated a longitudinal foundation/DCT 1 dentist - who I hope is now loving paediatric dentistry as much as I do. Throughout the year I attend the Lancashire Paediatric Dentistry Managed Clinical Network meetings on Thursday mornings. It is great working with colleagues from around the county with a shared aim to improve paediatric dentistry in our region. I also squeeze in joint clinics with our local Consultant Orthodontist. Due to the geography of our patch, we conduct this clinic using a VR Headset, allowing us both to see our patients and discuss joint paeds/ortho management.

Friday is my general anaesthetic (GA) day. In the morning I work from Lancaster Royal Infirmary providing paediatric dentistry under GA. I also sometimes go to Blackpool Victoria Hospital when there are more complex trauma/endo cases which need to be completed in theatre. In the afternoon I'm back in Morecambe usually providing treatment under inhalation sedation. Fridays are particularly exhausting but they are incredibly rewarding, especially when you're helping children manage dentistry in other ways.

On Saturdays I work privately at the Garstang Dental Referral Practice seeing patients referred in for specialist care. I provide inhalation sedation, general and specialist level paediatric dentistry. It is lovely to provide dentistry in a quiet relaxing environment without the stresses of waiting lists.

What other roles do you hold?

Hannah: Apart from the day job I am currently the Honorary Secretary of the British Society of Paediatric Dentistry (BSPD). It is an incredibly busy role in the day-to-day running of a fantastic society. BSPD is a charity which advocates for the delivery of high-quality and accessible oral health care for children from birth to age 16 in the United Kingdom. We work to raise standards in all areas, including specialist provision in hospital, community clinics, research, teaching and general practice. We give a voice to the oral healthcare needs of children and young people. I also act as a Media Spokesperson for BSPD. Recently I was invited onto CBBC's Newsround to speak to children about key oral health messages and how to look after children's teeth. This was a really exciting opportunity, allowing me to really spread oral health messages far and wide.

For 2023/2024, I was successful in my application to become an Emerging Leader on the Emerging Leaders Fellowship with the Royal College of Surgeons of England. The programme aims to encourage women and non-binary people to become familiar with, and subsequently apply for, leadership roles within the surgical and healthcare profession. The programme has been excellent so far and has presented me with some fantastic opportunities to develop my own leadership style.

I have been recently appointed as an NHS England Core20PLUS ambassador and am also working on projects with my local commissioning team and Integrated Care Board on how to reduce oral health inequalities in my region. Core20PLUS5 is a national NHS England improvement programme set up to support the reduction of health inequalities at both national and system level. The approach defines a target population cohort and identifies ‘5' focus clinical areas requiring accelerated improvement. Core20PLUS5 for Children and Young People has named oral health as one of the 5 key areas. In particular, addressing the backlog of child under ten needing dental extractions in hospitals. My role as an ambassador entails working with local and national colleagues as well across many other fields of health and social care. It's an exciting opportunity and I'm looking forward to where the role takes me over the next 12 months.

I used to call the dental school on a weekly basis for the whole of my first year in the hope that someone had dropped out and they'd let me in.

Did you always want to be a dentist?

Hannah: From being really young I enjoyed my visits to my local GDP, Mr Murray. He was such a lovely, friendly dentist who always took an interest in my family and our lives. Once he took out my upper Cs for ortho at age 11. I weirdly found it exciting and then went on to do my secondary school work experience with the practice. Dentistry was always what I wanted to do; however, I didn't get good enough grades in my A-levels to take up my offered place in dental school. I went on to do a BSc in Biology at the University of Manchester. I used to call the dental school on a weekly basis for the whole of my first year in the hope that someone had dropped out and they'd let me in, always to be told I had to go away and get a 2:1and finish my degree before I was allowed to reapply.

Throughout my A-levels and degrees I worked as a florist part time. Especially in Manchester I worked on some very high-profile events, celebrity houses and installations in department stores. There was always a part of me that thought if dentistry wasn't for me, I could always go back to my floristry roots.

I have always enjoyed all aspects of dentistry even in dental school. In my final year I went on my paediatric outreach placement to a community dental clinic in Oldham. Oldham was a very high needs area and it was really the first time I'd experienced such a high treatment need in children. The clinical tutor who taught me did so with enthusiasm and gave me strategies in basic behaviour management. I think at that point I realised I was good with children and young people which just meant I really enjoyed treating them. Once qualified I realised that paediatric dentistry was more than just caries management and that paediatric dentistry is a number of specialities all for children and young people. The speciality itself is incredibly varied and no day is the same. I thrive on this variety and the technical skill needed in so many areas of dentistry. I was also heavily influenced by my Educational Supervisor Claire Stevens CBE during my specialist training, and all of her work for BSPD. Claire's passion for improvement in children's oral health was inspirational to see. She taught me that paediatric dentistry is not just improving the oral health of the child sat in the dental chair, but also about the work that can be done outside of the clinical sphere. As a society BSPD is amazing at bringing paediatric dentists together with the ultimate goal to champion for children's oral health and wellbeing. It's an exciting speciality to be a part of, where I can really feel that we make a difference.

How do you specialise in paediatric dentistry?

Hannah: Following BDS qualification you would be expected to complete foundation training and DCT or DCT equivalence. MJDF or MFDS are needed. Competition is strong for speciality training. In order to be successful you need a good portfolio with publications, teaching experiences, audits/quality improvement projects and presentations. You also have to demonstrate commitment to the speciality. Once in a speciality training programme you need to work towards the Tricollegiate Paediatric Dentistry Membership exam (mPaed). Completion of this exam contributes to completion of speciality training.

What do you enjoy most about your work - and what is more challenging?

Hannah: What I enjoy the most is the variety it brings. On one day I might be in clinic treating a troublesome tooth, another I'm dealing with a fresh trauma and going onto complete more complex endodontics. I get to spend time within hospitals and community clinics and I enjoy teaching and mentoring colleagues in paediatric dentistry. No matter how many children I treat, the ones where the child manages a treatment that was so unexpected still thrills me. It's that feeling of helping a child through a difficult treatment which regularly reignites my passions for dentistry.

The more challenging element is the stress. Waiting lists are at an all-time high and there's no signs of this slowing. I really hate the feeling of telling families that their child may be waiting months if not years for their treatment.

Despite the challenges, I would very much recommend specialising in paediatric dentistry to others. It is incredibly rewarding and you get to put all your technical dental skills into action. Also, there aren't many specialities you can dress up on Halloween or as Mrs Christmas and it's acceptable in a professional environment.

What time do you usually get home?

Hannah: I try and leave work for 4:45 pm in time to pick up my little boy from nursery for 5:30/6 pm. Once he's in bed however I often spend my evenings catching up with work or committing my time to BSPD work.

My husband would say my interest outside of work is work. I have to admit I'm a little too fixated on my job sometimes. But it is what I have a passion for. I otherwise love spending time with my family and I still love floristry - I am at my happiest when I'm arranging flowers. I just wish I had more time to do it. Each year I tell myself I'm going to enter an RHS flower show. Maybe this should go on my 2024 New Year's resolution list.

Every other Saturday I work in private practice. When I'm not working I take my little boy swimming, to his football class and like to spend time on days out with my family. Where we can, we like to spend lots of time in the Lake District for weekends away. The Lakes is the place where I can really switch off from my day-to-day life.

Do you have further career plans?

Hannah: At some stage, I may consider further training to become a Consultant in Paediatric Dentistry. I got to a stage in my training where I wanted some time out to develop my leadership skills within the community dental services setting. However, over the next few years I'd like to explore the possibility of further development in my career. I have no plans to move out of my area though. I am very settled here. Lancashire has a very high dental need and although our problems in paediatric dentistry and access are not unique to us, it's an area I really am committed to and in the long term I hope to be part of the oral health improvement and reduction in oral health inequalities in my area.

Interview by Kate Quinlan

If you would like to be featured in a ‘day in the life of a dental specialist' please email k.quinlan@nature.com.

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