Following the latest Dentistry’s Big Question, Preetee Hylton shares her thoughts on the salaries of dental nurses and why now is the time for them to demand fair pay for their skills.
The short and sweet answer to last week’s Big Question ‘Are dental nurses paid enough in the UK?’ is a resounding ‘NO’ as we take a look at the numerous responses received on social media. Here’s why:
Reason one
Dental nurse students juggle work (often full-time) along with studying for a Level 3 qualification (NEBDN, City & Guilds, NCFE CACHE) and are often (unreasonably) expected to perform flawlessly and unsupervised, in practice, within weeks of commencing training and employment. Most of them are paid the national minimum wage and even less for those who have opted for apprenticeships.
Reason two
Once qualified and registered with the General Dental Council (GDC), dental nurses are lucky to see a mere fifty pence per hour pay rise and their employers seem surprised to see them leaving for better options. If we care to have a look at the GDC scope of practice for dental nurses, we will realise that we are not there to ‘sit pretty and hold the suction’.
We have various responsibilities alongside assisting our patients and clinicians, such as health and safety, cross-infection control, safeguarding, data protection, monitoring our patients for any signs of a medical emergency, providing oral health and post-operative instructions, stock control, testing and validation of equipment, as well as acting as a chaperone and an independent and unbiased witness. We are also expected to be one step ahead of the dentist we’re working with, which means that we need to have similar dental knowledge to the clinicians.
Reason three
We are responsible to pay our annual retention fee (ARF) to the GDC, to invest in our continuous professional development and have adequate indemnity to be able to practise as a dental nurse. While some workplaces do cover these expenses, most do not.
Reason four
We expect (or hope) that we would be remunerated accordingly if we have post-registration qualifications but sadly this is not often the case. This plays a role in the lack of retention of dental nurses in practices as they will choose to find a workplace that will utilise their full scope of practice and reward them for doing so. I strongly advise that we effectively negotiate professional growth alongside extra renumeration and recognition during our appraisals and interviews.
Reason five
Dental nurses have historically been, and perhaps still are, discouraged from discussing or comparing their wages within the team, under the guise of it being considered as ‘tacky’ or ‘crass’ by certain employers. However, this is merely a facade aimed at hindering open and constructive communication. Fortunately, the emergence of social media has provided a platform for transparent discussions on this matter.
An example would be the 2024 pay reviews shared by employees of certain corporates – one had the audacity to send out a communication about a pay rise, only for us to realise that they were merely adjusting the current hourly rate of their dental nurses to match the new rate of national minimum wage.
Reason six
Dental nurses working in NHS practices do not have a defined pay structure and are excluded from accessing NHS discount schemes or the generous pension schemes available to their counterparts in hospitals or GP practices. One of the three components of the dental recovery plan mentions the aim to enhance dental services in the medium and long term by nurturing and expanding the entire dental workforce, but unfortunately did not consider the essential role of dental nurses in the dental team. We need a foundational overhaul coupled with sustainable funding in addition to a care model which recognises the entire dental team, including dental nurses, which facilitates effective engagement with patients.
Reason seven
Based on the above, why are we still debating about the retention of dental nurses in dental practices when it is glaringly obvious that many now opt to work for agencies or freelance? Clearly, the attraction lies in the higher earnings, access to more varieties of dental treatment, and increased flexibility, therefore offering them a healthier work-life balance. Some dental practices choose to employ only trainee dental nurses as they are considered cheap labour and then request locum dental nurses to train them in-house.
I earned minimum wage as a trainee dental nurse in 2009, I started in a new (NHS) practice as a dental nurse at £6.50 per hour in 2012, where I became head dental nurse, then practice manager (in addition to being a receptionist and expected to cover as a dental nurse when we were short-staffed, as well as be a witness and a mentor for trainee dental nurses) at £11.50 per hour in 2014/2015.
About three years ago, I was invited to attend an interview for a dental nurse role at a private practice by a prominent dentist. Despite possessing a fairly impressive CV, they offered me an hourly rate of £11.50, which was significantly lower than my earning at the time (I am still at the same dental practice, where I am shown that I am appreciated for my skills, experience and input towards providing excellence in dental care). Needless to say, I declined the offer as it felt like an insult to my qualifications, experience, hard work, passion and to my dedication to dentistry.
These wages were not acceptable then, they are not acceptable now.
Take charge
Why are we still competing for dental nurse roles that are advertised for less than £14 per hour? Why are dental nurses holding post-registration qualifications still applying for roles which are offering less than £16 per hour?
I strongly advocate for taking charge of our own worth and value. It is time to demand fair compensation for our expertise and contributions in dentistry.
Dental nursing is a predominantly female profession. I would hope that it is not the reason for unfair and unreasonable wages – this would be a debate for another day!
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