‘Dental nurses need recognition’ – the difference between NHS and private work

Dental nurses and private versus NHS workClaire Frisby talks about her 25 years in dental nursing and how her private work compared to that in the NHS.

Please tell us about yourself and your journey into dentistry

I never knew what I wanted to do for a living, I just knew I didn’t want to sit at a desk all day typing. I wanted something practical to do.

After trying several jobs (that I didn’t last in) someone I knew found an advert for a ‘dental nurse’ to start straight away. I went for the interview and got the job and started the next day. All it took for me was that first extraction and I knew this was for me.

Cutting a long story short, this was an NHS practice. There was no room in this practice to grow, they were not prepared to move me up the ladder, I was impatient and looked for another job (I was there around nine months). As a result, I found a new job in a private practice.

Private experience

I thought I knew everything about dental nursing, I knew the last practice inside out and being very naive I thought it would be the same. I was very very wrong – I didn’t know anything. The NHS nursing was quick and fast paced this was a completely different ball game and I didn’t know anything.

The dentist was asking me questions and I hated the fact that I didn’t know any of the answers. I had to learn and fast! I listened and watched.

They enrolled me on the dental nursing course. I worked my way up, getting as much knowledge and experience from everyone in the practice. We were quite advanced and were one of the first surgeries to have an implant surgeon/periodontist (this was mid 90s).

I started learning about implants and loved anything surgical. I still wanted to be more a part of the team ‘not just the nurse’ as you were then.

They encouraged me to progress. I went on to become a dental health educator, started having patients booked in with me under prescription, mainly children and denture patients for OHI (oral hygiene instruction).

After this, I did my radiography course and started having patients prescribed to me for full mouth PAs, OPG etc. I quickly became lead dental nurse and was teaching the trainee dental nurses. Additionally, I moved up to practice manager of both the practices they owned.

I had accomplished everything I could in this practice. Eventually, I ended up working with a specialist implant surgeon, specialist orthodontist and a specialist periodontist in another up to date practice.

Progressive practice

As we grew busier the jobs became more complex, more paperwork, more background work. I had to choose which specialist I wanted to stay with as I did not have enough time to do everything for all of them. I chose implants. From here, I went onto CT scanning courses and sedation courses.

I then moved on after eight years or so and went onto another practice. Luckily for me, it was another progressive practice.

I still wanted more and I trained in phlebotomy, clinical photography, impression taking and plasma training. They prescribed me patients for CTS impressions, suture removals and clinical photos. I helped out with facial aesthetics and vitamin drip therapy.

As everything is evolving at a fast pace in dentistry, I started getting into the marketing and social media side and decided this was my next move. I became social media lead for the practice.

Lockdown came and some were furloughed and some worked in the UDC hub. I was furloughed and decided to make use of my time, learning more about social media and marketing, doing courses, and writing articles for dental magazines.

I’m still social media lead for the practices. I have also started as an associate assessor with NCFE university.

Do you think there’s a difference between being an NHS dental nurse and being a private dental nurse? If so, what are they?

For me, there is a big difference but it depends on where you work too. I cannot say for dental nurses who work in hospital as I have never worked in one. But in general practice, the NHS is more fast paced than private, and the equipment, materials and appointment times different.

Private dentistry is more intense. I know NHS dental nurses that wouldn’t swap to work in private dentistry.

But then I also know private dental nurses who wouldn’t go back to NHS dental nursing. I think it depends on the individual. I believe an NHS dental nurse’s role has changed over the last few years.

The main difference between NHS and private dentistry (in practice, not hospital) is time, materials and procedures. NHS is much faster paced. The treatment is normally more functional than cosmetic and the equipment/instruments may be simple but they get the job done.

Pressure all day

NHS dentistry is usually quick and to the point getting the treatment quickly and efficiently in the time allocated. For example, for an NHS check up they may have 10-15 minutes for an appointment, if they are lucky (pre COVID-19).

In this time the nurses must clean the surgery, set up for the patient, check the paperwork is ready, get the patient, do the charting, have the equipment ready, help devise a treatment plan on the computer, maybe develop or file the digital X-rays, make sure any paperwork is signed and then start all over again.

Sometimes the patient or the dentist may want to complete the filling there and then. The nurse will have to quickly set up for a filling, normally running late as well due to emergency patients.

The pressure is on all day – they cannot blink for a second. At some point they must process the contaminated instruments and then collect them to restock the surgery.

More complex

But a private check up may look completely different. Appointment times are anywhere between 30 minutes to 60 minutes.

The dental nurse will usually have much more time to do all the jobs. They will also have much more time to interact with the patient, building a relationship up with them. As a result, it is more than likely the patient will come back for any treatment they may need.

When we come onto discussing treatment you will look at more complex procedures in a private dental practice rather than an NHS practice. The materials and equipment is more complex and technical. Consequently, the patient will expect more and have higher expectations.

The dental nurse must learn how to nurse in a different way, especially when it comes to implant surgery and surgical procedures. They may be sitting for hours nursing with an implant surgeon. They must know how to retract correctly as the treatment is more complex.

The work is more intense – they need to have more knowledge and likely have more cover with their indemnity. The job can be more varied. Most treatments for an NHS dental nurse in practice will be very similar.

Both roles can be very stressful in different ways. For me (and people may disagree as every practice is different) I got bored with NHS dental nursing because it was very ‘samey’. The dental nursing role in private dentistry opened up a whole new world (I must reinforce this is not in hospital).

Do you think there’s misunderstandings associated with dental nurses?

If you took 10 NHS dental nurses and 10 private dental nurses they would all have their own opinions. The role has changed so much even during this pandemic.

Private practices are running similar to how they were with COVID protocols in place whereas the NHS practices are very limited or may be a UDC hub.

What have your experiences been like?

I liked to have time to interact with patients and time to do all the jobs at a reasonable pace. There is so much more paperwork nowadays and so many more boxes to tick. I believe it is very difficult in dentistry, NHS or private.

There are so many more limitations in the NHS world. This is only my opinion from my experience over the last 25 years.

Is there anything you think needs to happen going forward to help improve dental nursing as a profession?

Dental nurses need recognition, they are trained, qualified and very organised people. They are now allowed to do so much more. But there is still a stigma around dental nurses.

Indeed, years ago you could walk off the street and start dental nursing – this is not the case now. But this is not the same role it was and it can be very intense and stressful, even more so after COVID-19, whether it is NHS or private.

This should reflect in the money they are paid. But unfortunately as the role has progressed, this hasn’t in many places.

I have read that more and more dental nurses are leaving the profession and it is very difficult to find dental nurses now. The dental nursing role needs recognising for what it is now and not for what it was 10 years ago.

I feel that dental nurses never have enough time to do anything. They need more time. As the role has grown – whether it be NHS or private – there is more to do but no more time is given to do it (in most cases).

Most dental nurses love their job and they want to do it efficiently.

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