From Trainee Dental Nurse to Qualified Hygienist

DNN-photo-k-aMy journey started in 2006. Like many other 19-year-olds, I was unsure of which career path to take, so I had handed my CV into local businesses for reception work whilst I figured things out! During my interview for a position as a receptionist in a dental practice, I was asked why I wanted to be a dental nurse. 'A dental nurse - what's that?' I asked. Feeling slightly confused and bemused, I decided to accept the position. 

As we all know, the first few weeks (and maybe months) can be a blur - until things click and you complete your first treatment without aspirating half of someone's tongue up.

After the buzz of qualifying in 2008, I completely caught the dental nursing ‘bug’. I wanted to know more and more about dentistry whilst furthering myself and opening up career opportunities. This led me to consider a career path in hygiene, and I decided I could work towards this whilst still enjoying dental nursing. I left my first practice in 2010 and enrolled on the online Oral Health Education (OHE) course whilst taking up a position as Senior Dental Nurse in a newly established NHS practice. 

Unfortunately, internal changes at the practice meant I could not continue to pursue the OHE course. Desperate to continue with the course but not wanting to settle in just any practice, I joined a dental agency. After a fantastic three months I was offered a part-time position at a great practice in Bath. Four months later I said goodbye to the agency altogether as I was offered a full-time position. 

I soon completed the OHE course and this was followed by courses in fluoride application, impression-taking, dental acupuncture and radiography, mixed in with some interesting periodontal updates, oral diseases seminars and forensic lectures. My dentist was so supportive that not only did he invest a lot of surgery/personal time in assisting me with records of experience for my clinical courses, but he also allowed me to leave early every week so I could complete my Biology A-level! 

As the qualifications started racking up, I decided to apply for the hygiene course, and my application to study at Bristol University was accepted. The course there is currently purely focused on hygiene and runs full-time over 21 months. Between leaving practice and becoming a student, I applied to become (and was accepted as) an Examiner for the NEBDN, having previously worked as a helper. 

The first few days of university consisted of the eight of us awkwardly opening doors for each other, traipsing around hilly Bristol to fill out forms, and receiving jabs from the occupational health team. Up until the Christmas break, phantom heads are used for practice and a huge amount of anatomy and physiology is covered; everything from polymorphonuclear leukocytes to tongue formation in-utero. Throughout the course I was amazed at the amount of 'ologies' we had to familiarise ourselves with: they included physiology, histology, pharmacology, radiology, pathology, microbiology, embryology and epidemiology. 

During the first term, students are invited to visit the morgue at the University to further their learning. Cross-sections of heads allow for a better understanding of regional anatomy. In January, after what feels like a lifetime, real-life patients are treated - appointments last for one or two hours. Every aspect of the appointment is overseen by a tutor. Thorough medical histories are taken, and a huge emphasis is placed on aetiology of periodontal disease and personalised oral hygiene instruction (OHI). Once plaque scores (Turesky) are at a suitably low level, supra-gingival calculus has been removed and a full mouth pocket chart (FMPC) has been recorded, non-surgical periodontal therapy can take place, often with local anaesthetic. Patients generally receive root surface debridement (RSD) over two 2-hour visits, preferably within the same week. However, this is patient- and disease-dependent. The patient is reviewed after three months, when an FMPC, Turesky and any necessary OHI is given. The referring practitioner is then consulted as to whether the patient will either return to practice or receive another course of treatment, possibly with antibiotics (depending on the review results). 

Between treating patients and attending lectures there is heavy involvement with the local community in terms of oral health promotion (OHP). Each week, one pair of students visits a care home, nursery, mainstream or special needs school and gives tailored advice to the patient group. OHP can be incredibly rewarding and eye-opening as well as confidence-building. 

A research project is also undertaken in the first term of Year Two. I chose 'Intra-venous drug use and oral health' and visited a drugs rehabilitation facility to get personal experience from a recovering user. During the following term, rotations take place; several weeks are spent outside of the hygiene department in areas such as oral medicine, orthodontics, general/specialist practice, community and in the intensive care unit at the local hospital. 

There are continual assessments throughout the course, ranging from e-assessments, practicals, essays, multiple choice, MMIs and vivas. The final exams consist of eight essays (on pretty much any of the subjects studied!), and then a patient presentation followed by a viva in relation to the patient.

I qualified in June this year and work full-time in a mix of private and NHS practices. My prior experience of dental nursing gave me a great starting point for studying hygiene and for understanding patient care, communication, infection control, dental anatomy, chartings and instruments. I am currently undertaking a teaching course with a view to teaching dental nurses and hopefully sharing some of my passion for dentistry. 

Katy Amber RDN RDH

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