BDJ Team meets Alison Edisbury, 40, a dental hygienist and therapist turned academic from Wigan, to find out all about her career history and interest in oral health behaviour change.

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Interview

What were your career ambitions while still at school?

Alison: Whilst at school I didn't really get much career advice. I was never an A* student, but I always loved learning so I knew that I wanted to pursue higher education and wanted to work in a health-focused career. As a B/C student I knew that I would be able to enrol on the nursing degree and so I focused on a career in nursing, taking Health and Social Care whilst at college.

What led you to dentistry?

Whilst in my second year at college I had applied to the nursing degree and been accepted but wouldn't start that course until approximately 18 months after I finished my A levels. So, I started looking for a job that would bridge the gap between college and university and would give me some experience of working in a healthcare setting. There was a practice local to me that was looking for a full-time trainee dental nurse, so I applied and was successful.

I was offered the role of trainee dental nurse in 2002 and at that time you didn't have to be registered as a dental nurse with the GDC or enrolled on a formal training course - so initially it was just a great way to get some experience before going to university.

When I did eventually start the nursing degree, I realised how much I'd actually enjoyed working as a dental nurse and felt that I was much more suited to working in dental practice, so after nine months I made the decision to leave the nursing degree and go back to dental nursing. Luckily the practice I'd been working at previously welcomed me back, and from there I enrolled onto the dental nurse course.

Why did you decide to become a dental hygienist and therapist and what route did you take?

I never knew what a dental hygienist was before I started working as a dental nurse, let alone what a dental therapist was. But the practice I worked at had a brilliant hygienist who really inspired me to pursue a career in dental hygiene - I admired the way she was able to build rapport with patients, to help them gain control of their oral health and how they appreciated the treatment and advice she offered them.

I decided to apply for the dental hygiene and therapy courses at the University of Liverpool and the University of Sheffield in 2005. At that time the courses were diplomas rather than degrees and the entry requirements were two A-levels or a dental nurse qualification. I was aware that places were limited on these courses as demand was high, and that I might have to apply a few times before being successful. I was offered interviews for both universities, but they were on the same day, so I chose to attend the University of Liverpool interview, and was very lucky to be offered a place.

Where did you work after graduating?

I graduated in January 2009 with a diploma in dental hygiene and therapy. The hygienist I had worked with as a dental nurse was due to go on maternity leave in February 2009, and I was very lucky that the practice approached me and asked if I would like to cover her maternity leave. One of the associates had also bought his own practice whilst I'd been studying so I was offered a position there too - I still work at this practice all these years later! After the hygienist returned from maternity leave, she cut down her hours which meant that I was offered a part time permanent position, and at this point I then started working at another local practice doing hygiene and therapy.

After a few years working as a hygienist and therapist in general practice, I realised that I much preferred the perio side of the role, and eventually stopped doing therapy, instead focusing on developing my skills in periodontal treatment.

When did you decide to undertake further studies?

After a few years of working, I started to get the itch to do a formal course again. I knew I wanted to study further but at that point wasn't really sure what I wanted to do. As my original qualification was a combined diploma in dental hygiene and therapy, I decided to do the BSc Dental Studies for Dental Care Professionals at UCLan to ‘top-up' my qualification to a degree, as I felt that would open up more opportunities for me. I did this in the evenings and weekends, alongside working full time as a dental hygienist, and graduated in 2019.

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Things were then put on hold due to the pandemic and I settled back into practice life, but soon after, that itch to learn returned, and so in 2022 I was part of the first cohort to gain a Postgraduate Diploma in Periodontics for Dental Hygienists, which is an accredited course run by Dr Reena Wadia at her Harley Street Perio School.

Have you always been eager to learn?

Yes, I've always loved learning. As a child, I always had my head in a book, and whilst I was never an A* student, my love for learning motivated me to continue. As I've progressed through my academic career, narrowing down my focus to specific areas, my grades have risen and I was proud to gain a First Class Honours Degree at UCLan.

How did you decide on the focus for your PhD?

Whilst I was studying for the Postgraduate Diploma in Periodontics, I started looking for a master's course - I was interested in studying behaviour change or public health. It was whilst I was researching courses that I came across a proposed PhD project at the University of Manchester entitled ‘Oral Health Behaviour Change and Technology-Aided Interventions' which I thought sounded really interesting and could potentially combine my interest in both behaviour change and public health, whilst also learning how to do research. I did some reading on the topic, what doing a PhD involved, the university and the supervisors and decided to go for it!

I've always found psychology and behaviour change fascinating - why people behave in certain ways, why some take on board advice to improve their health and others don't, for example. Supporting patients in behaviour change is such an integral part of the work we do as dental professionals, and I really wanted to learn more about it and how we can improve this aspect of the treatment we provide.

My research is all about understanding dental professionals' behaviours, understanding what matters to patients and finding solutions that maximise the professional's time and efficiency when it comes to oral health behaviour change for periodontal patients.

I am learning a lot about behaviour change and how best we can support periodontal patients, and I am taking this away and implementing the theory into my own clinical practice.

As behaviour change can be a long, complex undertaking, previous research has indicated that technology could bridge the gap between what dental professionals do in surgery and what the patients do at home. By understanding the challenges dental professionals face, we can hopefully identify areas where we can support the patient beyond the dental surgery, in a way that is acceptable to both the dental professional and the patient.

Have your studies affected your clinical practice so far?

I am learning a lot about behaviour change and how best we can support periodontal patients, and I am taking this away and implementing the theory into my own clinical practice. It has certainly made me think differently about the way I approach behaviour change conversations with patients, and how to support them.

Do you think the subject of your studies is particularly important in light of the current crisis in relation to NHS dentistry and access to dentistry?

I do. As dental professionals, we only have a limited time with patients. Most of my periodontal patients see me every three months - that's only four days out of every 365 that I have to discuss behaviour change and support them as best I can. The other 361 days, it's all on them. In that time, life happens, and for some, optimum oral hygiene behaviours start to slip, which can make it a challenge to maintain periodontal stability - technology could potentially prevent this from happening.

In the context of the current crisis, I think technology could definitely be an avenue to explore - some of the things we do in surgery such as preventive advice, oral hygiene instruction and supporting behaviour change take time, which is often not a luxury that we have with patients, and could actually be done away from the dental surgery, maximising dental professionals' time. We know that prevention is key, and I think if we could approach this in a different way, it may decrease the burden on NHS dentistry.

When do you hope to complete your PhD?

The plan is to complete the PhD by October 2025.

Do you have any further plans you would like to share, post-graduation?

I'm not quite sure yet - I'm open to exploring different options but I am interested in education and implementation science… but who knows?!

Is your working week extremely busy?

Yes! I have to be really organised. The last thing I do on Friday afternoon is make a list of tasks that I need to do the following week, and then I get my planner and add the tasks around meetings, workshops, and my clinical week. I make sure to break down big tasks into smaller ones, and not overwhelm myself with too much to do.

How do you like to unwind?

I like the simple things - reading, cooking, pottering in the garden, spending time with family and friends, walking the dog, listening to live music. Just things that I can really switch off and enjoy.

Any exciting plans for this year?

This year is all about recruitment and data collection! I am currently recruiting dental professionals to take part in my research, so if there are any dentists, dental hygienists or dental therapists working in UK general dental practice reading this who wouldn't mind completing a ten-minute online survey, the link to more information and the consent form is: https://www.qualtrics.manchester.ac.uk/jfe/form/SV_0D0cnWrQzghnLH8 or please email me: alison.edisbury@postgrad.manchester.ac.uk for more information on the research.

I appreciate that academia isn't for everyone. That's what's so great about dentistry - there are so many options to expand your career.

Last year I was lucky enough to attend the European IADR conference in Rhodes, as well as the BSP conference in Birmingham, and the BSDHT conference in Bournemouth as part of my PhD work, so hopefully I'll be able to present some of my work later this year at some conferences.

Do you think more DCPs should consider an academic career pathway like yours and/or get involved with research?

I would encourage any DCP who wanted to continue their academic career to just go for it. I've always loved learning, so for me I love being a student, and really having the time to deep dive into certain topics - but I appreciate that academia isn't for everyone. That's what's so great about dentistry - there are so many options to expand your career.

With regards to research, I definitely think more DCPs should get involved, whether that's working in research or taking part in research. If we want to see developments within dentistry, we have to be a part of that - sharing our experiences and ideas, to better shape dentistry and see the change we want.

Interview by Kate Quinlan