Laura Cox1 recounts her journey into a dental hygiene and therapy career.
The dental nursing years
I didn't know when I chose my ‘A’ Levels that I’d end up working in dentistry. As a result I haphazardly picked subjects that I was vaguely interested in and thought may be useful in the growing technological age of 2001. Therefore, my journey into dentistry was somewhat ‘round the houses’ and an enlightening experience to say the least. Reflectively, the person I thought I was half my life ago is certainly not the person I actually turned out to be. So, the subjects I chose to study were English, psychology and information technology: certainly not the pure sciences the universities ask for. I got my place nonetheless, and the ‘A’ Levels I perceived to be useless turned out to be fairly useful given the academic writing required for study, the behaviour change aspects and understanding of patients, and of course getting to grips with the often mind-boggling dental software.
Aged 19 I tentatively applied in writing for two trainee dental nurse positions I saw in the local paper; searching online for a job was still beyond me at this point! The reason for applying at the time was because I had undergone a lot of dental treatment as a child and teenager, and as a result was quite phobic. In my mind, working in a dental practice would surely help ‘cure’ my phobia and educate me to look after my teeth better! I was interviewed for one of these positions and was offered the job on a part-time, maternity cover basis. Within a year this was full time and permanent. Luckily, I started my dental career in a very small, independently owned, supportive practice. The NHS pace of life was a true testament to what I saw as a ‘sink or swim’ opportunity and luckily I thrived.
Having gained my National Certificate in Dental Nursing from the National Examination Board for Dental Nurses (NEBDN), my employer was keen to also get me qualified in dental radiography alongside some other nurses in the practice. I was always very grateful for the investment in career progression the practice made in dental nurses. A few years down the line I decided that I needed a new challenge and my employer allowed me to undertake the oral health education course. This led to me having oral health sessions for individual patients and families. I knew before enrolling onto this course that I was testing the water for future endeavours. Consequently, this additional role sparked my interest further and pushed me into applying for university.
As my ‘A’ Levels were not sufficient for UCAS application I instead applied for the Dental Development course at the University of Portsmouth Dental Academy. At the time the interview process involved a ten minute presentation on a subject of my choice; I chose to speak about my two volunteer trips with Bridge2Aid, something I am passionate about. My dentist colleague at the time made the suggestion of avoiding PowerPoint presentations and to instead ‘speak from the heart’ and take my personal photo albums in. The passion and enthusiasm that seven years of dental nursing and two volunteer trips provided me with must have shone through as I was offered a place on my first attempt at applying and interviewing. It is always in my mind that I have been extremely fortunate in gaining my place as I am very aware of how competitive this process can be.
Fortunately, undertaking the Dental Development course for six months prior to starting my degree in Dental Hygiene and Dental Therapy at university helped prepare me for full time student life and also provided me with lifelong friendship and great house share options! It cannot be stressed enough how useful and helpful this development course is for dental nurses wishing to pursue university education, and I always recommend this route to my nursing colleagues who also don't have the correct ‘A’ Levels.
Although being a student is good fun, there is a lot to consider such as finances, living arrangements, home commitments, and the sheer amount of work required. The university hours necessary seemed to outweigh that of other courses, but if anything it made the time fly by. There was a good, healthy mix of clinical time and classroom time. The course is enjoyable and the subjects were kept interesting by the lecturers. The University of Portsmouth Dental Academy is renowned for being friendly and supportive and I consider myself lucky and privileged to have studied there. The support offered was second to none and they are very good at recognising each student's strengths and weaknesses to help them thrive and succeed. One of the highlights of the course for me was dental practice in the wider community, where we got to experience dentistry in different environments and use our skills to help disadvantaged people such as the homeless or individuals in substance misuse rehabilitation. Another thing I really enjoyed was the research project which really allowed us to sink our teeth into a subject of our choice. For me this was acupressure and acupuncture, something I would really like to train formally in.
Dental Therapists Foundation Training
Prior to graduating in Dental Hygiene and Dental Therapy I gained a position on the dental therapist foundation training scheme with the Wessex and Thames Valley (Oxford) Deanery. This meant I had some peace of mind making the transition from university into working life. Interviewing for this position was quite tough and involved competency questions. Performance on the day determined the allocation of a place and the practice assignment. The scheme is an invaluable opportunity to start a dental career in a supportive environment. Personally, this position helped me consolidate my skills, gain experience in treating a range of patients, develop time management skills and undertake further academic projects, something I really enjoy!
Currently, postgraduate training is compulsory for dentists who want an NHS performer number, but is not compulsory for therapists. However, I consider this option to be of great value as it really prepares new graduates for working life, offers a supportive pair of eyes and hands when required, allows you to network with graduates from other establishments and undertake projects such as audits. Additionally, it gives a guaranteed opportunity for undertaking therapy work and prevents deskilling. During university I only ever did pulpotomies on plastic teeth and extractions were largely performed on unconscious children at the hospital. Needless to say my confidence in these treatments was fairly low on graduating and I am very lucky that the first few times I was faced with these in general practice (and on conscious children…) I had one of my trainers with me to offer guidance, support, and feedback. Within a few months, certain treatments stopped bringing me out in a hot sweat and I looked forward to the sometimes difficult paediatric patients. As the scheme is part time it allowed time for me to seek other opportunities in private practices to add breadth to my clinical experience. It is my belief that my postgraduate training year and experiences are what helped me secure my current position.
Working for the Ministry of Defence
Halfway through my postgraduate year a job opportunity arose close to my home town for a dental therapist with the Ministry of Defence (MOD). This is not something I had previously considered but when I saw the position I knew it was a great career prospect. Despite having lived in a military area for most of my life, my contact with individuals in the Armed Forces was comparatively minimal. It hadn't really occurred to me that civilians could work with the Army.
The quality of my working life is incredibly important to me. I spend more time at work than doing any other activity in my life, so I was immediately drawn to a career within the civil service. My benefits include:
Continuing Professional Development at Regional Training days
Time allowance for administrative tasks and duties
Weekly staff meetings
A supportive and diverse working environment
Employment rather than self-employment
Continuity on a day-to-day basis
Guaranteed salary at the end of the month
Paid annual leave
Paid bank holidays (plus a few extra for the military and civil service!).
I love coming to work in the morning knowing that I can provide high quality dental care to my patients without the financial and time pressures that can sometimes interfere in other working environments. It is fantastic to have autonomy over length of time required for hygiene and therapy appointments, which means that I am in more in control of my diary and able to carry out the best possible care for the service personnel I come into contact with. Having this flexibility allows me to treat my patients effectively, efficiently, and at a pace that suits them. I am also encouraged to use my broader skills, such as conducting audits and attending professional development opportunities. I am also able to use my knowledge and creative skills to plan and update the oral health education notice board alongside a colleague, which is tailored to patient needs and runs concurrently with national health awareness campaigns.
One of the most enjoyable aspects of working as a civilian in the MOD is learning all about the military way of life and getting to know a range of patients. It astounds me how committed the men and women who form our armed forces are; it is not to be underestimated how much effort goes into sustaining the work and lifestyle joining the Army entails. I never know who is going to walk through my surgery door and I love the diversity in people, personalities and experiences that my day brings me.
It has been an enjoyable experience to work with people in the Armed Forces as well as fellow civil servant employees and agency staff. I have met so many wonderful people from all walks of life and enjoy coming to work with colleagues who have a shared passion for their roles. I am also fortunate to be able to work on the same days as other hygienists, which is invaluable for peer review and feedback, as well as working on strategies to improve delivery of care. These activities will prove to be even more valuable in the future, with the implementation of enhanced CPD in August.
The dental centre I work in is the busiest in the MOD with ten dental chairs; creating an invaluable opportunity to support dentists, fellow dental care professionals (DCPs), and the profession as a whole. There are huge benefits of working in this way, allowing each member of the dental team to focus on their individual area of expertise. The team regularly meets, both formally (during weekly meeting) and informally (by going out to the ‘cookhouse’ for lunch once a week). These activities instil the importance and benefits of working together as a team, which is a hallmark of MOD life.
In the immediate future I would like to undertake the NEBDN witness training so I can assist the trainee dental nurses at work and sign off their activities during training. My appetite for learning and knowledge is always growing so I am keen to expand my skills and role to beyond the surgery. My ultimate goal – given enough time, experience and training – is to become a clinical tutor and lecturer.
On reflection my professional life has been a whirlwind and I have been constantly surprised and fascinated at the amazing opportunities I have encountered. Some things have been a stroke of good luck, but a lot of hard work has gone into getting here today. Dentistry is continually evolving and changing and I am excited that I am a DCP during a period of such exciting change.
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Cox, L. ‘My professional life has been a whirlwind’. BDJ Team 5, 18092 (2018). https://doi.org/10.1038/bdjteam.2018.92