Dentistry’s forgotten patients

I’ve been in my current role for three years. I am responsible for co-ordinating a variety of oral health improvement programmes within NHS Lanarkshire. Most of these initiatives have been results of the Action Plan for Improving Oral Health and Modernising NHS Dental Services in Scotland which was published by the Scottish Executive. I’m also a committee member of the National Oral Health Promoting Group, in which I have recently taken on the role of key communicator. As part of this, I compile weekly bulletins on oral health news, pieces of research, other published literature and send out nationally to the members of the group. On a good day, I’m up about 7.00am. I don’t know if I’m a morning person – I can function pretty well and will wake up quite quickly – but whether you’ll get a smile is another matter!

Work begins anytime between 8.15am and 9.30am. I have two email accounts and they are always full. I try not to put too many appointments in my diary each day, normally it’s two. I would never get on with the rest of the work if I attended more.


The Scottish government asked NHS Boards to develop and deliver oral health preventive programmes for adults in most need, such as homeless people and prisoners. The homeless population is one of the most vulnerable, powerless and disadvantaged of our society and undoubtedly experience extreme social exclusion and deprivation. Many homeless people will have high levels of oral and dental disease.

Results from the Scottish prisons dental health survey suggest that, on average, the Scottish prison population have more decayed, but fewer filled, teeth and fewer natural teeth than the general Scottish population. Severe tooth decay was found to be four times more likely in the male prison population, and 14 times higher in female prisons in comparison to the general population. In our local prison, we are currently piloting a whole settings approach to improve oral health for staff, prisoners and families.

Engaging with some individuals in these populations is challenging, as is the partnership working required to deliver the initiatives. It’s always a struggle to get some clients and staff to consider oral health a priority. Health is often not a priority, especially when homeless. So, encouraging good dental hygiene and dental access can be challenging. Initiatives are always developed in partnership, whether that’s with, for example, NHS staff, education bodies, housing departments and social workers. I suppose they start with me (because it’s my remit) but I like to draft in as much support as I can. The best example is with our homeless programme. Without input of partners who are working directly with homeless people, I wouldn’t have had any idea how to design an oral health improvement initiative for homeless people. Good working relationships are so important to the success of any initiatives.

Currently, the National Dental Inspection Programme of Scotland is showing that the oral health of our children is improving year on year – so we are beginning to see a real positive picture. We still see a linear relationship between deprivation and oral health, but aspects of Childsmile target our most deprived families.

My organisational skills are great – just don’t look at my desk – but aspects of my role are difficult. There are times you need to use every skill you have and then there are times where programmes start falling into place or you get great feedback on something and it‘s all worth it. It can be very rewarding.

I originally wanted to work in physiotherapy but changed my mind when I completed a health promotion module as part of my BSc Hons. I then went onto complete an MSc in Health Promotion. I have worked in a few topics but longest in this post of SHPO (Oral Health). I remember when I got my first NHS post. I was so proud.

Last year, I fulfilled a childhood dream and bought a horse, Leo. He takes up much more time than my poor partner Joseph. After work I go to the stables so I’m normally home before 8pm. I spend a couple of hours a day at the stables which is relaxing. On Saturdays – rain or shine – a few of us hack in and around Mugdock Park in Glasgow; through the forest, round the reservoir, through the park. It’s lovely, I lose hours. Sundays, I like to chill out with Joseph.
I’ve started the second book of Cormac McCarthy’s The Border Trilogy. Lights out at 11pm.
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