Dr Ranj – dentistry ‘chronically under-resourced and neglected’

Dr RanjWe speak to BAFTA award-winning TV presenter and NHS consultant paediatrician, Dr Ranj, about his lockdown experience, balancing his TV and hospital work – and why the UK needs a dental health intervention.

How was your lockdown?

I never really know how to answer that question. Technically speaking, we’re still in it!

Obviously, it’s hugely important that the country went into lockdown to control coronavirus. However, for me, this was a very welcomed pause. It slowed everything down and gave me a chance to stop and reflect. Prior to that, I felt like I was always running around trying to get everything done.

Lockdown gave me a chance to slow down a little and get things done that I’d been putting off for a really long time. I got to finish off projects that I’d put on hold as well as simple things like clearing out cupboards. I ended up donating half of my wardrobe to charity! Doing all of those little things was really therapeutic for me.

I got to continue working, because I work in the hospital and do a bit of TV work as well. I helped to launch a podcast with some friends and I wrote a couple of books. So I still had other things to do, but I had time to spend with myself too. Mentally, that was really beneficial for me – at the start anyway!

Unfortunately, as lockdown got longer and longer – much like everybody else – I started to get frustrated. I am a very social and tactile person and I rely on social contact. So I need to see people face to face and I need to socialise. I miss hugs!

Another thing I’m really into is physical activity. When I stop moving, it affects my mental health quite quickly. So I tried home workouts, which lasted a couple of weeks. Then I tried going for jogs, but I hate running. I ended up doing hardly any exercise at all, which really started to get me down. But now that gyms are starting to reopen, I feel like I’m getting back on track.

What was it like working on the frontline?

I work in paediatrics, specifically emergency paediatrics, and one thing we’ve learnt is that COVID-19 isn’t predominantly a condition found in children. Children have been relatively under affected by it, which is a good thing. So our workload didn’t go up significantly.

However, we did end up changing the way we worked. We saw older patients and were redeployed to adult areas to help them out as they bore the brunt of the pandemic. I got to do more clinical work which was really important to me.

What else did you get up to?

TV and media work quietened down, understandably, but I still did bits here and there as I went along. A lot of the work I did was around coronavirus information and education. For example, I wrote a special episode of Get Well Soon on coronavirus. It was the very first one I had written by myself. We created, wrote and filmed it all in lockdown.

It was a massive learning curve but I’m hugely proud of it as I think it’s one of the best episodes we’ve ever done. It shot to the top of BBC Iplayer as soon as it came out which, for me, that was a really proud moment.

I did a bit of work in the theatre industry just before lockdown and my heart breaks for them seeing what has happened to that world. I’ve been relatively lucky, but lockdown has been tough for so many others in other lines of work.

Why have you got involved with the new BSPD videos?

Even as a doctor, I see a fair share of dental stuff in children’s A&E. Often people don’t know where to present, often they have multiple problems and happen to have a dental issue when I’m looking into their mouth. It’s part and parcel of the job.

I have huge respect for my dental colleagues. Whenever I’m faced with a dental problem in A&E, I’m reminded why having the expertise of my dental colleagues is so important. The best outcomes always happen when we work together. I don’t purport to be a dentist; I have a tiny bit of knowledge but I know when to refer for an expert opinion. And when we work well together, the patients get the best care – that’s the important thing.

One in eight children under the age of three have dental caries. And dental extractions are one of the most common reasons for children under the age of five being admitted to hospital under general anaesthetic. These are shocking statistics and I hadn’t quite appreciated it until I looked into it a bit more closely. So when I was asked to get involved, I thought how better to use whatever platform I have to do something really helpful for the public.

Dental work has been forgotten in terms of public health messaging. I feel like all of the stuff we had around looking after your teeth when I was a kid has kind of gone. People don’t have the same awareness or realise how important it is to look after your teeth from an early age. That needs to change.

Why is it so important to improve children’s oral health?

There have been increasing discussions around sugar of late and the dental field has received a bit of attention from that. However, I think public health dental messages have been chronically under-resourced and neglected. Dental health seems to have been forgotten and become a luxury rather than a necessity. It’s almost become an afterthought for many people.

It’s probably more important now than ever given that children’s diets have changed. Many have a much higher sugar content in their diets and their teeth are affected because of it. I think it’s something we could all do with reminding of. We have campaigned for things around immunisation, for example – it’s on social media and it’s in the press.

But why is nobody talking similarly about dental health? It’s so easy to look after your teeth and prevent them from getting to a stage where you need intervention. Why are we not having public health campaigns for that? It doesn’t make sense to me, as it’s hugely important.

For instance, many parents I talk to don’t know about Dental Check by One. This campaign has been around for some time now but they still haven’t heard about it and they don’t understand the value of it. There hasn’t been enough noise – and there needs to be.

What more could be done between doctors and dentists?

I don’t think we can achieve any of this without a range of healthcare professionals getting involved. Doctors and dentists have a shared responsibility and I think we should work better together. I think as doctors we need to embed it into our routines more; into our child health reviews and checks that we do. We need more health visitors to talk to parents about it too. I think that’s one of the reasons it’s fallen off the radar – because we don’t have as many health visitors as we need.

I also don’t think it’s just a doctor and dentist thing – it should also be a school thing. It’s got to be embedded everywhere. We all have shared responsibility and as part of this, central government needs to play its part too. Everyone’s got teeth!

In your early years, the health of your mouth reflects your health but also has an impact on your general health. When you’re a child it can affect your speech and your ability to feed. Not to mention that your smile is so important! For socialisation, for your mental and emotional development – smiles are hugely important. It’s one of the first things you do as a baby!

We’ve got to look after our smiles. They change the way we view ourselves, our confidence, our ability to interact. So we should pay them a bit more attention.

What’s it like balancing your hospital and TV work?

I’ve been very lucky with my varied career. I love my job. I love both my NHS work and media work. Balancing them can be tricky, but I always try to do them both to the best of my ability. They complement each other.

The passion I take to the media comes from my clinical work. That’s where I started and that’s why I still do what I do.

The great thing about working in media is getting public health messages out there. I work with lots of people with lots of different skills and when we come together as a team, I take that learning back to the NHS.

I may have spent a day filming these videos, but they could prevent many patients presenting with dental issues.

What is the Dental Check by One campaign?

The BSPD’s Dental Check by One campaign encourages all parents and guardians to take their children to see a dentist as soon as their first teeth come through, and before their first birthday.

Dr Ranj is helping to reinvigorate the campaign with a selection of new videos on the BSPD Kidsvids page.

Although not all dental practices are seeing their patients for routine appointments now, the charity says the time is right to promote to parents and carers the concept of a dental check by the age of one.

Parents can then speak to their dental practice and take advice by phone or online until face-to-face appointments resume.

The videos can be found at www.bspd.co.uk/Kidsvids.

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