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For the fifth part of our series focusing on women in the dental field, Dental Tribune International (DTI) interviewed Debra Worthington, a dental nurse with more than 40 years of experience who was recently elected president of the British Association of Dental Nurses (BADN). She has held various positions as a dental nurse, head dental nurse and unit manager and discovered her passion in orthodontics. A founding member of the Orthodontic National Group, a specialist group for orthodontic dental nurses and therapists in the UK, she served as its president for three years until 2021. In conversation with DTI, she speaks about her contributions to dentistry, current challenges for dental nurses in the UK and her future aspirations for the BADN.
Ms Worthington, you have been a dental nurse for over 40 years. You must have such a wealth of knowledge and experience. How has dental nursing evolved since you started?
When I started working, we were still called dental surgery assistants and accordingly our association was called Association of British Dental Surgery Assistants. At one of the association’s Annual General Meetings, it was agreed to re-claim the title “dental nurse”—a good change really. In 2008, statutory registration with the General Dental Council was introduced for all dental care professionals, including dental nurses.
Generally, I would say that nowadays dental nurses have a voice and can work more independently. They can run their own clinics, in which they can apply fluoride varnish and take radiographs and impressions, providing that they are adequately trained, competent and indemnified. In that respect, things have changed, but there is still more to accomplish for the profession.
What would you say are some of the greatest challenges for today’s dental nurses?
I think that there is still a bit of a divide between the dentist and the dental nurse. I am not saying that dental nurses are not valued, but it’s just not the same. I think—and that’s something we have heard from our members too—that the skills of dental nurses within the dental team are still not used to their full potential.
Another problem is the salary. I know that this is concerning a lot of people at the moment what with living costs constantly increasing, but for dental nursing, the pay just does not keep up with what dental nurses deserve, if you compare it with the responsibility they have.
There is also the question of recognition by the National Health Service (NHS). Dental nurses who work in practices, even NHS practices, are not employees of the NHS, and therefore, they have none of the benefits of working for the NHS. This is an issue, and we have been campaigning for this to change.
All of this was particularly highlighted during the last three years. Although dental nurses helped out hugely during the COVID crisis, many of them volunteering to help out in hospitals and in ICUs, wearing all this additional PPE for the entire working day, their efforts have never been properly recognised.*
You have been a member of the Advancing Dental Care review group, and you have worked on reforming dental education and training to provide more targeted care. Could you tell us more about this group and its aims?
This group consisted of people working in different positions of the dental team. We looked at the dental workforce as a whole, including dentists, trainees, junior dentists, dental hygienists, dental therapists and dental nurses, and explored how we could change dental education and training to produce a skilled multi-professional oral healthcare workforce and to improve skills and make better use of the skill mix in each of the disciplines.
I have to say that I was a bit disappointed with the final report, as there was not as much for dental nurses as I had hoped. In my opinion, the scope of practice for dental nurses should be widened. I see no reason why dental nurses could not be part of the primary care network and offer, for example, smoking and alcohol cessation advice. This could have such an impact on the overall well-being of patients, since oral health and general health share so many links. In addition to improving oral hygiene, dental nurses could really help prevent long-term systemic disease.
“If I achieve anything, it will be more recognition for dental nurses.”
Last year, we published an interview with past President Jacqui Elsden about the BADN’s menopause policy. Are there any new developments that you would like to share?
We keep promoting the menopause policy at various shows. I will be speaking about it at the BDIA Dental Showcase in London and the North of England Dentistry Show in Manchester, both in March. In May, I will be speaking at the British Dental Conference and Dentistry Show in Birmingham.
What are your aspirations as president of the BADN for the future?
If I achieve anything, it will be more recognition for dental nurses. I would like to initiate discussions about improving pay, which won’t be easy, but it will not keep me from trying. Also, as mentioned earlier, I would like to expand the scope of practice for dental nurses to give them more recognition.
To ensure the next generation of dental nurses, we are spearheading a project to produce an online career leaflet, to be sent out to colleges and schools that talks about careers in dentistry other than that of dentist. Currently, the information going out mostly concentrates on the profession of dentist, so we feel that there is a lack of information for school-leavers on other career options within the dental team.
*After this interview was conducted, following a meeting with Debra Worthington, Labour MP Cat Smith wrote to the Chancellor of the Exchequer and the Secretary of State for Health and Social Care. In her letter, she addresses the issues of pay and lack of recognition by the NHS of dental nurses, leading to the current crisis in dental nurse recruitment and retention.