Sarah Hill, dental hygienist and the FGDP National Board’s DCP Representative, talks to Kate Quinlan about her journey into dentistry, the effects of the pandemic on her work and her new role with the FGDP.
Sarah qualified as a dental hygienist from the University of Bristol, with distinction, in 2012, and also holds a BSc (Hons) in Biomedical Sciences from the University of Southampton and a Postgraduate Diploma in Clinical Education from the University of Plymouth.
Sarah works as a hygienist in a Mixed (NHS/Private) General and Orthodontic practice in Halesowen; delivers oral health presentations on behalf of TePe; is an assessor for the National Examining Board for Dental Nurses (NEBDN); is an active member of the British Society of Dental Hygienists and Therapists (BSDHT); and is married with two daughters.
What were your career plans when you were still at school?
It was actually to study medicine to become a doctor. Unfortunately, I didn't achieve the A level grades that I needed to so I went through clearing to study biology at the University of Southampton. During the first year, I changed to biomedical sciences as the modules are exactly the same, but basically, biomedical sciences didn't include the study of plants.
I enjoyed biomedical sciences and thought that it would give me a good grounding if I wanted to apply for medicine again.
What were your next steps once you graduated?
I ended up with a 2:2 so I didn't apply for medicine, and I was a bit unsure as to what to do at the time. Then I got through to an interview with an agency to become a sales representative with GlaxoSmithKline (GSK) in London. I wasn't successful the first time around, but then for some reason, I got a phone call a couple of days later saying they would like to take me on. So I moved to London with a few days' notice.
It was a really good experience, but then I had the opportunity to apply to dental hygiene at Bristol University and was accepted.
So, we decided to buy a house in Bristol and my husband commuted to Portsmouth while he was training to be a nuclear engineer in the Royal Navy.
So you didn't have any dental experience before applying to study dental hygiene?
Well, this will tell you a bit about me really. Basically, you could say I was born into dentistry. Both my parents are dentists - which I don't tend to tell too many people - but they own the practice that I am working in today.
I promised that I would never have anything to do with dentistry, because I wanted to stand on my own two feet. Obviously, my parents used to come home and talk about dentistry all the time and I saw the less glamorous side of it. And I said, no, I'm not going to get involved in it. But I was a receptionist for a long time and really enjoyed it, and still do now, and I did a bit of chairside before dental nurse registration came in if I needed to help out. But I didn't actually work as a dental nurse before studying to become a dental hygienist. So I was a bit of a wild card in my group at university.
Why did you decide at that point that you'd like to be a hygienist?
I think it was the clinical aspect. When I was working as a sales rep for GSK, I found it quite lonely. It involved a lot of driving and I missed being with people and wanted to use my science and apply it clinically. I'd always wanted to do a clinical job, from the beginning - be with patients, interact with them and make decisions. One of my dental hygienists when I was younger, who used to work at this practice, always seemed to love her job as well. So I just wanted to see if I could get in, and I did.
Can you outline your career history since graduating?
As soon as I graduated my husband was then posted down to Plymouth. So we decided to move to married quarters in Plymouth. I followed him to support his career.
I applied for jobs and worked in Newton Abbot, Totnes and Tavistock in mixed private and NHS practices, which was really good experience. I also commuted to the family practice in the Midlands once a month to carry out hygiene work.
I then saw an advert for a lecturer in community based dentistry at Plymouth University. So I applied for it and they actually wanted a dual hygienist and therapist, which I wasn't. But I was given the role as a job share with my colleague and now friend. It was a huge undertaking in terms of clinical supervising and looking at community based projects with the students. Again, it was really great experience.
Our first child was born in 2016, so I took a little break, and then we decided to relocate back to the West Midlands.
In 2017 I took on the role with TePe UK as part of their extended clinical team, going to conferences, being on the stand and talking about the products. I also joined the educational team, going to universities and delivering presentations based around TePe products and providing oral hygiene instruction.
Since then I have had another child and had another break, and then I came back to work and within about eight weeks the pandemic started.
Towards the end of 2020 I became an NEBDN assessor as part of Learn Direct. Then in December, I got the DCP Observer role with the FGDP.
How have you been affected generally by the pandemic over the last year?
I think it's been unsettling for everybody. At the start of the pandemic, as I mentioned, I had just returned from maternity leave into my clinical job. My husband had just left the Navy after ten years and was about to start a new job, and nursery closed for the children as well.
At the practice we stopped seeing patients on 23 March 2020. I remember it very well - I can't believe it's almost a year - and we reopened on 8 June. Since then we have been seeing patients and everyone has done an amazing job of pulling together and working as a team.
I think this period has affected everybody mentally. I see that with my patients, when they walk through the door. I will ask them how they are and I can see it in their faces... I often have patients who just cry as it's a bit of a release and sometimes we are the only people they have seen for weeks and months. I think that's quite sad really but I'm glad we can be there for them.
My dental nurse and I have taken a lead role in looking after our colleagues' wellbeing. We've made pamper packs, treat boxes and held a virtual cocktail party at Christmas.
In the early days of the pandemic there was a lack of communication for dental practice staff, and that was really awful, because I think it stirred up a lot of anxiety in everybody. Things were going quite wild on social media groups, causing quite a frenzy. So my dental nurse and I thought we would take charge of that and try and communicate well with colleagues and with patients.
Was the role of DCP Board Observer something you were nominated for, or something you applied for?
It's something I applied for. I saw an email that came into my inbox from the FGDP(UK), advertising for a new DCP Board Observer to replace Janet Goodwin, who sadly died last year. I applied for it and didn't think I'd get it in the slightest. I sent across my CV and I got a Skype interview. I was amazed to be offered the position.
What does the role involve?
There are four meetings a year and of course everything has been virtual so far. As I'm a Board Observer I can't vote, and I'm an associate member of the FGDP, not a full member. Essentially, I observe board meetings and have to wait to be asked to speak. I think you can raise an issue, but generally you're there to observe, raise any concerns or questions at any point, and be a voice for DCPs.
I spoke to Ian Mills, the Dean of the FGDP, in February, to talk about the role, and then we had our first board meeting last Friday which was really interesting.
It is early days but I did have a meeting with the British Association of Dental Nurses (BADN) because they're keen to collaborate. I'm just trying to keep my ear to the ground, really, with all sorts of organisations. I've spoken by email to some of them; I hope to make lots of connections, be supportive and be DCPs' voice on the FGDP board.
Are there any issues you are hoping to champion where DCPs are concerned?
One of the key things is considering all members of the dental team, including dental hygienists, dental therapists, dental nurses, dental technicians, clinical dental technicians, orthodontic therapists and so on. It's very easy for me to think of the dental hygienist's perspective. I'm very keen to make sure that we include all DCPs.
I think there are a lot of issues to consider, such as scope of practice of the dental team and ensuring that all members of the dental team understand everyone else's scope of practice. Looking at pay scales - that is always something that crops up.
There is FGDP's move to the College of Dentistry later this year and so we will be looking at that transition and what it means for DCPs. I will be talking to BADN members later this spring about what that transition is going to look like.
We'll be looking at what DCPs would like to see in terms of career progression. It is planned that the College of Dentistry will be a really good platform for career progression for members of the dental team. There will be a lot of focus on the structure of the College of Dentistry and whether it will be more inclusive of members of the dental team.
Another key issue is of course equality and diversity. Also, NHS employment benefits for dental teams: a really hot topic at the moment.
One thing the pandemic highlighted is that in mixed or NHS practices, ie, if the dentist has an NHS contract, the dentist or dentists will receive all the NHS benefits, but the rest of the dental team don't receive any. Yet when the pandemic started, everyone who worked in an NHS practice or had an NHS contract was called on to be redeployed.
There are numerous other issues to explore such as exemptions and prescribing for dental hygienists and therapists; mentorships and career pathways; oral health inequalities and NHS contracts.
Overall, I am passionate about educating the dental team, learning from each other, and inspiring and supporting those dental professionals who are still in training or about to qualify or graduate, as they embark on their careers in dentistry.
What are your thoughts on how dentistry will ever recover from the effects of the pandemic? Do you think NHS dentistry will 'catch up' with all the patients who have missed appointments?
Very, very good question. I think the picture is extremely varied across mixed and NHS practices around the country. I feel like I can only really talk about my own perspective. I have heard some horror stories of, you know, patients having to pay private fees in other places. In this practice, I think the team have managed very well with seeing patients through teamwork, but it hasn't been easy. The oral health and wellbeing of our patients has been at the forefront of this.
We stopped face-to-face treatment on 23 March 2020, and began again on 8 June. In between that time, we had a triage system; dental nurses and the dentist triaged and spoke to patients and sent out information in the post to try and reassure them during that very unsettling time when we couldn't see them. We began to see patients again on 8 June and some practices haven't and as I said, since we've been seeing patients again, sometimes that has been the only contact patients have had with other people for weeks or months. It's had a huge impact on all of the dental team, and of course we have all had to cope with the PPE and the extra cleaning in between patients and so on.
Three of our dental nurses have become COVID-19 vaccinators, which is brilliant. Looking forward, we've got the vaccine, we've got the lateral flow tests that are in place, we've got the PPE and we've been fit tested: we're in a much better place.
I think at this practice, if we sing our own praises, we've cracked it. We're even seeing a lot of new patients that we wouldn't normally have seen, because a lot of the practices around here are still closed. A lot of these patients are worried about their oral health.
In answer to your question: I don't know if NHS dentistry will ever catch up. There were oral health inequalities before the pandemic and the gap has now got even larger.
What do you like to do outside of work and to relax?
I love baking, that is one of my favourite things to do - a little bit controversial, being a hygienist. Spending time with the family, photography, singing, musicals, playing the piano. I love spas, when they're allowed.
What do you look forward to doing when the lockdown restrictions are relaxed and eventually removed?
I would say I am most looking forward to enjoying watching my children play together with their friends outside, in the warm sunshine, and having a picnic.
I'm really looking forward to seeing my friends, not just on Zoom; hugging my best friend, but also enjoying time with my family and my Mum's roasts, because they're the best thing in the world.
Anything else to add?
I'd just like to say thank you to you for giving me the time to talk about my passion for dental hygiene. It hasn't been a particularly easy path to get to where I am now but with determination and the support of family and friends, I've managed it.
I'm extremely glad to work as part of my very supportive dental team in my clinical job but also feel that my dental colleagues have become unified during the pandemic and really supported each other. My only hope is that this continues and that I can do a good job of being a voice for DCPs across the country.
This article was abridged from the full interview, which was originally published in BDJ Team on 19 March 2021 and is available at https://www.nature.com/articles/s41407-021-0550-y.