Natalie Bradley BDS MFDS MSc MSCD RCSEd, 33, is a Consultant in Special Care Dentistry at King's College Hospital; Clinical Director at Dentaid the Dental Charity; and Chair of the British Dental Association's Young Dentist Committee.

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How does your day usually begin?

My toddler usually wakes me at 7 am but on days where I need to be up for theatres I am up at 5.30 am which can be a bit of a struggle!

I work in a few locations, as well as being able to work from home for one of my roles - so some mornings my commute is a three-second walk to the study; on others it's almost one hour and 45 minutes!

When I am working in Central London I get the train, but I drive to the district general hospital which is on the suburbs of London and also if I am doing local private domiciliary visits I will drive to those.

Breakfast is mostly on the go, yoghurt or porridge.

What is your typical working week?

I work long ten-hour days on Mondays and Tuesdays and Thursdays 9-5 clinically. Wednesdays and Fridays my hours can be flexible - working around when I have childcare - I use these for my Clinical Director role, local domiciliary work, my role within the BDA as Young Dentist Committee Chair, my role as Managed Clinical Network deputy chair and spending as much time as I can enjoying my toddler!

How did you originally get into dentistry?

I had always wanted a role in science and medicine and after being told at the age of 16 I needed a root canal treatment(!), after going to research it I thought the procedure sounded really interesting. This led to me doing work experience which confirmed for me that dentistry was the career for me.

In 2014 I graduated from Newcastle University, followed by one year of DFT in London, one year of DCT then two years as a dental officer (all in London). I also worked part time as an associate dentist in an NHS practice and emergency out of hours. I completed Fellowship with the Office of the Chief Dental Officer and 3.5 years of speciality training in London/Surrey. After completing specialist training, I was appointed within Dentaid and spent one year as a specialist in CDS before being appointed a Consultant.

Why did you decide to specialise in special care dentistry?

I chose Special Care for many reasons, but I didn't really know what Special Care was until my second year practising as a dentist! We hadn't had much exposure to the speciality as an undergraduate, but when I started working at a walk-in emergency dental department in a secondary care setting and seeing people with additional needs because they struggled to get access elsewhere, this is when I looked at Special Care. I found treating people with difficulty accessing dental care because of their complex needs really fulfilling and being able to provide all types of dental treatment a patient might need: from restorative, to endodontics, to dentures, to extractions. I wanted to specialise so that I could provide more complex care under all modalities for these patients: from local anaesthesia to sedation to general anaesthesia.

What is required to specialise in this area of dentistry?

There is a three-year full time StR training programme you need to complete to specialise. Alongside this training programme I completed an MSc but this has now been removed from the training programme. You then need to pass the Royal College Membership exam in Special Care which is a tricollegiate examination.

What do you enjoy most about your job?

I love the problem solving and teamwork needed to work out how best to manage our patients. Sometimes this can be working out how a patient with a severe learning disability who gets very anxious around medical professionals can tolerate the dental treatment they need; other times it's speaking to a patient's medical team to make sure you can safely provide care. I also love getting to know each and every patient as I learn so much from their experiences and views - it really challenges any preconceptions you might have. For example, I remember seeing a patient who had autism who was non-verbal with a learning disability who was referred to have sedation for treatment. But after listening to his carers and working out how he communicated his needs, in the end I completed all his treatment under local anaesthetic by just having a carer hold a mirror up during treatment so the patient knew what was going on.

What do you find most challenging?

I think the emotional toll of seeing patients who have suffered multiple disadvantages or traumatic events in their lives. It is hard not to take things home with you and mentally wipe your feet at the front door mat when you've just seen patients who have had diagnoses like cancer, traumatic brain injuries or patients with progressive conditions like dementia, Parkinson's or multiple sclerosis. Particularly when you see their deterioration between visits. I think what helps me is having a supportive team to talk to and it encourages me to make sure I make the most of my own life.

Do you see a wide variety of patients?

Yes, Special Care is very varied and every patient is different. We see the following groups of patients:

  • Medically complex patients

  • Patients with physical disabilities

  • Patients with learning disabilities

  • Housebound patients

  • People experiencing homelessness

  • Bariatric patients

  • Severe mental health issues

  • Severe dental phobia.

What are your interests outside work?

I like to go to music concerts (I'm a bit of a metal head) and to fitness classes. At weekends I try to relax - as much as I can with an 18-month-old - and switch off from work (although I work one Saturday a month) and spend time with family and friends.

I try to get into bed by 10 pm.

Would you recommend your career path to those starting out in dentistry?

I would highly recommend Special Care. Even though it is the newest dental speciality, the need for our services is growing with patients becoming more complex and access issues worsening. You really get to make a big impact on the lives of your patients and they might teach you something too!

Do you have any special plans for this year?

I'm hoping to grow our Special Care spoke hospital site so that patients can be seen more locally to where they live instead of travelling into central London for their care and strengthen the links between our hospital and community clinics.

We have lots of exciting plans in the pipeline for Dentaid this year with providing more clinics with more mobile dental units to serve communities in the UK who struggle to access dental care.

Interview by Kate Quinlan

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