A spotlight is shone on the important contribution of dental nurses, hygienists and therapists in paediatric dentistry at the British Society of Paediatric Dentistry's (BSPD's) conference, reports Caroline Holland.

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Teacher, helper, ally, mother - these are among the qualities ascribed to dental nurses (DNs) who work on undergraduate clinics where their role is to care for patients and support students. Patients are unaware, however, of the critical role that DNs have on the clinic in relation to student learning.

Dr Emma Robinson, a Clinical Fellow in Oral Surgery at the University of Newcastle's School of Dental Sciences, suggested it was time for a reappraisal of the role of hospital dental nurses who support and nurture novice dentists.

A speaker at the annual study day of the Teachers' Branch of the BSPD, Dr Robinson shared the research she has undertaken as part of her PhD looking at the experiences of undergraduates and the role of dental nurses.

The latter is an under-researched area, she said, and one she was motivated to undertake because of her own experience as an undergraduate. During her undergraduate training she noted there was little opportunity to work on a 1-2-1 basis with a qualified dental nurse. It was only when she qualified and started working professionally with experienced dental nurses that she realised what a powerful asset they are. Today's undergraduates are more fortunate.

As part of her research, Dr Robinson asked students on oral surgery clinics at Newcastle Dental School to describe how they were helped by the dental nurses who supported them. All the undergraduates said the dental nurse was essential, for a variety of reasons.

For many undergraduates undertaking clinical work for the first time, the clinic is a high stakes environment, Dr Robinson said, and the young dentist in training may find that for the first time in their life they do not automatically excel at what they are doing. In this environment, they value the dental nurses who might reassure them, encourage them to take a moment away from the patient or tell them it's okay to not be okay.

There is a suggestion that the role of the dental nurse on undergraduate clinics should be formalised, she said. ‘They deserve more recognition in relation to the part they play in undergraduate clinical education. I believe there should be more in the curriculum about the role of the dental nurses in supporting clinical skills development. In addition, the benefit of building strong working relationships with dental nurses at an undergraduate level should be emphasised as it is an essential skill set that can be transferred to the working environment. It's essential for patient safety that everyone in the team works together.'

In the same session, Professor Paula Waterhouse, Professor in Paediatric Dentistry, also based at the University of Newcastle, gave a fascinating presentation called ‘Decolonising the curriculum: a marathon or a sprint?'

She tracked the slow development of an inclusive curriculum beginning in the 1990s, only achieving momentum in the UK following the death of George Floyd and the subsequent Black Lives Matter movement.

A video made by Newcastle's dental students challenged the teaching staff to make immediate and necessary changes. Professor Waterhouse said: ‘It was a real awakening. It brought me to tears'.

The students were requesting change, namely that the curriculum should be decolonised, more Black students should be recruited, and the environment should be actively anti-racist. She provided an overview of the steps that had been taken, adding: ‘Decolonising the curriculum is not just about toppling statues and changing the reading list'.

The teaching staff organised for a survey to be carried out and found that some immediate changes were required: the religious needs of students were not being universally met, there was not enough diversity among both students and staff and there was too much emphasis on a drinking culture in new students' social life.

It was only when she qualified and started working professionally with experienced dental nurses that she realised what a powerful asset they are. Today's undergraduates are more fortunate.

Professor Waterhouse said staff set about making changes swiftly, assisted by the school's Equality, Diversity and Inclusion (EDI) student reps, broadening out religious and cultural celebrations to reflect more faiths and cultures. Teaching materials are also being revised to increase inclusivity around clinical norms, diagnosis and more international data. For instance, healthy gums are not always pink and cephalometric values should not be standardised around Caucasian ethnicity.

In order to be truly diverse, she added, the dental school should be mindful of social class as well as ethnicity. Research had shown that only 13% of boys from poor white backgrounds were gaining a place at university.

What she had learned, she said, was to constantly remind herself of her own privileges and never to stereotype a person, we are all individuals. Her view was that making the dental school more diverse and inclusive was both a sprint and a marathon, in addition to the immediate changes, a long-term shift in cultural competency was in motion.

Since 2019, DCPs have been able to join BSPD as full members and they are now represented on the Society's Executive Committee by Leigh-Ann Randell.1 Their important contribution in paediatric dental settings is reflected in their contribution to the annual conference.

Dental therapist Olivia Blodwell, who has just finished her academic foundation training at Newcastle, was shortlisted for the final of the Research Prize and delivered her presentation in the main hall on the first day of the conference. It was entitled: Food for thought: Dental student perceptions for delivering dietary advice. She interviewed 11 student dentists. Her survey found that students are aware of current resources but experienced a variety of challenges in delivering information, including the absence of culturally competent advice.

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Olivia Blodwell

Her interviewees had insightful ideas on how resources could be modernised using digital technology to be more accessible to families. Unfortunately, Olivia struggled to recruit students from the hygiene and therapy programme; she highlighted that future research should focus on gaining the views of this important group.

There were three contenders in the annual DCP poster prize competition:

  • Joanne Ellis, Sheffield Teaching Hospital Charles Clifford Dental Hospital

  • Laura Shuter, Alder Hey Foundation Trust, Liverpool

  • Jenny Owen, University of Leeds School of Dentistry.

The winner was Jo Ellis, a research dental nurse, who submitted a poster on: Provider perspectives of integrating a communication tool within routine dental care. Joanne sought the views of dental professionals on an intervention designed to improve child-dentist communication called ‘Message to dentist' (MTD). As part of a pilot scheme the MTD proforma was sent out to all new patients and asked them to share their concerns or needs around their dental treatment. The evaluation found that staff considered the MTD to be very helpful for reducing anxiety. The MTD has been in use at Charles Clifford Dental Hospital in Sheffield since January 2020.

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Jo Ellis

Jo commented: ‘I was thrilled and honoured to have won the DCP poster prize. Presenting is something that is way out of my comfort zone, but the “message to dentist” communication aid is an asset to both patients and staff, so it was great to be a part of it. In paediatric dentistry it is so important to build up that trust and communication between staff and patient from their first appointment, so from a staff perspective, “MTD” provides the information on how the patient feels - ie their history, just as the referral letter from a GDP provides the dental history.

‘I was very happy to represent the team in the DCP category and had amazing support and encouragement from my colleagues which I'd like to thank them for; it was brilliant meeting the other candidates in the DCP category and seeing the great work going on by DCPs around the country caring about children's oral health.'

Next year's BSPD conference will be held in Newcastle-upon-Tyne on 14-15 September 2023. For more information visit https://www.bspd.co.uk/Professionals/Annual-Conference.