'No A-levels, no problem'

In 2013 Lauren Chipman doubted her academic abilities and wasn't sure which road to take. Ten years later, she has just completed her second year of the BSc (Hons) Dental Hygiene degree at the University of Portsmouth. Her Instagram feed inspired this article.

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Interview

What were your career plans when you were still at school?

Lauren: During school I was very sporty. I enjoyed gymnastics, netball, football and swimming and completed my lifeguard qualification. I consider myself to be a great communicator - I am very chatty and I am caring and look out for others. I looked into becoming a paramedic but I didn't feel I would be able to get into university as I'm not the academic type.

In year 11 I went to local colleges to look at travel and tourism to become an air hostess. I enjoy travelling and socialising.

I finished secondary school with grade Cs in science and maths after two retakes for both, and I didn't pass English. The secondary school I was at gave me the option to continue onto A-levels while re-sitting GCSE English.

Once I completed the exam in January 2014 and passed my English GCSE I decided to leave as A-levels were not for me. I struggled with the topics I had chosen and felt that due to my inadequate GCSEs I wouldn't be suitable for university.

You did a nursery apprenticeship from 2014-2016. How did you find working with young children?

As I left sixth form halfway through the academic year my only option was to wait until September to rejoin a college or find an apprenticeship. At the age of 16 I was already working Saturdays at a hair salon and at a local pub waitressing four times a week. I have always had the work ethic and people skills so began an apprenticeship in Childcare and young people level 2 and 3. Due to my GCSE grade Cs the college I enrolled with offered level 2 functional skills to complete alongside my apprenticeship.

Experience in this field has allowed me to feel empathy and excel in working with children and young people. The working environment for me was very busy, always on the go, having responsibilities to look after children. I worked with a great team of girls who I am still in contact with seven years later. I have been asked to attend the nurseries they work in to hold an oral health morning, teaching under 5s the importance of looking after their teeth.

I felt overjoyed and excited but also apprehensive as I knew the hard work was about to start. This gave me the opportunity to reach my goal in a career I am passionate about.

The University of Portsmouth offers a paediatric module in level 5, providing the opportunity to participate in the Brush UP programme in Portsmouth to visit local schools talking and interacting with children, promoting oral health. I feel without the childcare education I completed I wouldn't be as confident with children in the clinical setting while delivering and assisting with treatment.

Why did you decide to move to a dental nursing apprenticeship in 2016?

I enjoyed working with children but my close friend at the time was completing their apprenticeship in dental nursing and I was invited to shadow at the practice. Once I had a feel for the workflow and what the job entailed, I accepted a position starting at the practice in February 2016 and joined a college in April 2016 to begin my Level 3 dental nursing course.

As applicants must have grade C/4 in Maths and English or functional skills I was able to apply. The course promotes the importance of motivation and work ethic, good communication skills and a willingness to learn.

There are many options after dental nursing: training in dental radiography, oral health promotion or dental practice management.

On completing my dental nursing qualification, I joined Central England Specialist Referral Centre in July 2018 based in south Birmingham with a great team and gained lots of experience with lots of support and I still work there six years on.

What did you like about dental nursing?

As the dentist is not the ideal place to be for many people, as I'm a sociable person I feel I can put patients at ease, helping them and creating a positive patient journey. One of the primary roles of dental nursing is to provide chairside support and deliver a high level of patient care and a clean clinical environment. A good key skill to have as a person is being your friendly self while showing empathy and sympathy as patients may be nervous but show this in many ways. It's helpful if dental nurses are reassuring and confident with a calm manner.

Lauren on clinic with fellow dental hygiene students: (left to right) Rosie, Ikhlas, Lauren, Karolina, Summer, Leila

I enjoy socialising with other members of staff working as a team, helping each other to ensure the day runs smoothly and being comfortable around clinicians is key as you are working alongside them 9-10 hours a day.

How did you find the dental nursing qualification?

The dental nursing apprenticeship consists of both hands-on learning while working and the academic side completed at college or online. During my time at Birmingham Metropolitan College I had lots of support from the assessing team and my college tutor.

I feel like I had to work twice as hard as everyone else to achieve the qualifications as retaining information is hard for me and I learn better while completing the action or hands-on training, so the apprenticeships I have completed were my best options.

I always have the mindset of 'I'm not the best at exams due to past experience' so my expectation of passing first time is low. The only exams I have passed first time were my driving practical and sporting exams.

My dental nursing exams were multiple choice, computer-based and we completed one exam every term. Again, I didn't pass any first time - only one or two marks off - my tutor at college would wait outside the door and say 'Go again' as she believed I would pass eventually. Alongside the exams we had many modules to complete, some being assessed in practice and handwritten modules which I was able to complete in practice or in my spare time, meeting the deadlines set.

Throughout school I struggled with reading and academic lessons. I found them 'boring', thought that they didn't make sense and I couldn't remember content from books or lessons. When I started university I was introduced to student support. This is a one-to-one appointment you can book with an academic teacher supporting assignments or any queries. In the first year I felt I wasn't achieving the same grades as everyone else. My feedback comments for improvements would be 'academic writing skills including sentence structure and linking points together'; 'To obtain higher marks, essays need to flow better'.

I was then tested for dyslexia and recently diagnosed with visual stress. I now have extra time in exams, more student support, and also wear glasses with purple and blue tint for reading, especially in exams.

Did passing your dental nursing qualification inspire you to undertake further qualifications?

Yes, I took advantages of opportunities at the dental practice where I work aimed at enhancing my skill set and enabling me to reach my full potential as a dental nurse.

I visited St George's Hospital in London to complete a hands-on venipuncture and cannulation course in July 2019. This has been a skill I have much enjoyed having learned more about PRGF and PRF in practice, assisting oral surgery, periodontal surgery and implant placements. I gained more confidence being a part of the patient journey, more interaction and enhanced patient communication.

At Central England Specialist Referral Centre, we offer sedation options to help alleviate anxiety in nervous patients undergoing treatment. In September 2019, I had the opportunity to undergo training in dental intravenous conscious sedation, which involved eight hours of face-to-face instruction and the completion of ten assisted cases in a clinical setting.

The same month, I enrolled in a Dental Radiography level 4 course that took place in the evenings. This course required me to attend a college located in Birmingham city centre for one night a week over a period of six months.

In-house opportunities were also offered working alongside the principal dentist - I was able to complete many other extra skills sets such as clinical photography, suture removals, intra oral 3D scanning and impression taking. Working alongside Sabrina the dental hygienist, I witnessed firsthand the improvement in patients' oral hygiene over their appointments, as well as their increased comfort level. This aspect of my work greatly interested me.

My employer supplies high end up-to-date technology and equipment so I felt the courses encouraged me to be a part of the patients' treatment, getting to know patients more personally and having extra responsibilities.

Despite all of this training, at the time I felt that becoming a dental hygienist was out of reach.

Was the Dental Development Programme at the University of Portsmouth your stepping stone to higher education?

During the COVID lockdown I applied for the Dental Development Programme (DDP). This programme is for dental nurses who have the experience and qualifications but may not have the correct GCSEs or A levels to apply for undergraduate study.

DDP is listed as an online short course, one day a week, to progress onto Dental Hygiene or Dental Hygiene and Therapy, with only limited spaces. As well as the anatomy and physiology in the DDP there are also learning skills and evidence-based practice.

I felt shocked to successfully gain a place on this course and was very positive throughout.

Did completing this course help you to gain a place on the BSc Dental Hygiene degree course?

Yes for sure! There are lots of routes into higher education such as access courses but for the DDP you are only interviewed once to get onto the course and if all modules are passed you are guaranteed a place onto the full time BSc. Even though it's a self-funded course it is definitely worth the money. My other option would be to complete an access course which may be cheaper but this would not guarantee me a place on the BSc.

I feel the DDP should be set up in other universities to help people like me!

How did it feel to gain a place on the degree course?

I felt overjoyed and excited but also apprehensive as I knew the hard work was about to start. This gave me the opportunity to reach my goal in a career I am passionate about. Gaining any place at university for dental hygiene is such an achievement as there are only a limited number of universities offering the course in the UK. Many courses are three years but four years at the University of Edinburgh or a two-year diploma of higher education.

Did you leave dental nursing to become a full-time student?

No, I continued to work part time as I felt the course in first year involved minimal face to face interaction which meant the commute was less frequent and I was able to remain in Birmingham to work. In second year the timetable was busier for the first four months so I remained in Portsmouth one or two weeks at a time and became self-employed and started with an agency working around the area. I use Airbnb rather than student accommodation, pre-booking my weeks in advance, as student accommodation is very expensive.

I am very excited to be able to treat patients who are in need and work alongside dentists to help successfully deliver treatments which can be life changing for patients.

The first two years of the course have gone really quickly. Sometimes they have been tough but with the support I have around me and the drive it is important to keep going. Having the experience as a dental nurse really helped; the existing understanding of what a dental hygiene appointment entails and being familiar with patient communication is important.

What have you enjoyed?

I have enjoyed exploring a new city and calling it a second home for the last two years, meeting new friends and interacting with patients in the clinic, making it feel 'real'. Being part of a patient journey at university means I have learnt lots of new skills and being part of a cohort having the support from peers and tutors has been a positive experience.

I am very excited to be able to treat patients who are in need and work alongside dentists to help successfully deliver treatments which can be life changing for patients.

Have you made close friends on the course?

Yes, everyone is close in our year, we help each other and offer reassurance to one another.

I was lucky to have completed the DDP as students I met online are also now on the degree course and it was great to meet them in person on our first day after six months online.

I have made friendships for life with Summer and Karolina. Not a day goes by where we don't talk to each other and support each other through revision and assignments. I feel without having a close bond I would not have enjoyed the experience as it could have felt lonely, but again the cohort is also very supportive.

Are you looking forward to graduating in 2024?

Of course! Time is going quickly. I will miss student life and being at university but I am excited to go back into practice full time and begin my next chapter. With the new skills I have gained over the last three years I'm looking forward to implementing this into practice as well as educating and motivating patients.

Where do you hope to work as a dental hygienist?

Once I qualify I will be remaining in the West Midlands but if the job is right I will consider moving or commuting as dental hygiene is in great demand. I feel modern practice with prevention techniques would be ideal. I have been exploring the options to work at Birmingham Dental Hospital or Birmingham Children's Hospital in the future, working on the cancer ward to help with oral care throughout patients' treatment.

What do you like to do in your spare time?

When I'm not working or studying I love to spend time with family, friends and my boyfriend Luke. We have a Miniature Dachshund, Lola, who is ten months old. Most weekends we explore the Shropshire hills with Lola and have planned a visit in August to the Lake District with our friends and their dog.

We have a number of holiday plans this summer in fact, including an amazing week in September to explore New York and Las Vegas, before I head back to Portsmouth to tackle third year.

After two years at uni are you good at writing essays now?!

I wouldn't say good but I feel I have learnt many techniques from others! Having access to student support and peer opinions are key. We all bring different strengths and academic writing is not mine.

What would you say to other school leavers who are thinking of working in dentistry but who don't have a great academic record?

I would say, if you know dentistry is your goal, complete research on the course content and contact universities directly to ask. Dental nurses who are lacking the academic side of completing A-levels: don't give up. There are many routes into dentistry; some are more time consuming than others but explore all extra courses offered and access courses available. Again, check the universities to ensure your chosen access course is recognised.

Interview by Kate Quinlan

Editor's note: Since Lauren completed her DDP, the entry requirements have changed. For the full details, please visit https://go.nature.com/3NSHvvi.