Dentistry

...of the treatment side of dentistry such as crowns, bridge work, fillings and the good old extractions too.

For crown and bridge work, I'd need my treatment trays, plus I'd need to have fast and slow hand pieces and the files and burs for the dentist to use. I'd also need to have powder and water ready to mix alginate for taking impressions as well as filling in lab slips ready for the item to go to the lab the next day. Patient care ...
...than the average filling and for nervous patients this can be quite an ordeal and the nurse needs to keep them calm and reassure them and of course liaise with the dentist very closely so there are no mistakes made that may prolong the procedure or scare the patient!

After every patient who had crown or bridge work it would be down into the basement to autoclave all the instruments and put the impressions taken in the fridge overnight.
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I don't think Ciao likes me anymore...they don't reply when I suggest a new category, what have I done that is so bad? OK, I'll take it that Ciao just has problems at this time, I'll leaving them quietly in a corner and get on and write this review...

As a qualified dental nurse, dental therapist and assessor for trainee dental nurses, I get asked a lot about dentistry, toothache, oral health but I very rarely get asked about my job and what my roles involve. I decided to write this review as a promotion for dental nursing predominantly and also to show people it's not all about holding the suction pipe in someone's mouth!

BECOMING A DENTAL NURSE- ENTRY REQUIREMENTS & TRAINING
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There are a few ways of becoming a dental nurse & entry requirements vary. In general, a person wishing to become a dental nurse should have the following qualifications:

5 GCSE's A-D including English, Science & Maths
or
GNVQ in Health & Social Care
or
NVQ level 1 in a health related field

In addition, it is desirable to have experience of study at A-Level. Subjects which are desirable are: English, Biology, Chemistry, Sociology, Psychology & Mathematics.

As I mentioned, there are a few routes to becoming a qualified nurse:

1. Training at one of the dental hospitals in the UK on a full time, paid course, this is normally a 2 year course and is the route I took to becoming qualified.
Entry requirements vary, normal entry is with GCSE's only but if you do not have these, alternative qualifications and experience are normally taken into account. Places can be hard to get, in the hospital I trained in, there were only 12 places available and over 300 applicants for those places.
It is advisable if you want to go down this route to get yourself some hands on dental experience. Ask a local dental surgery if you can come in and watch a dental nurse at work, get a part-time job in a dental surgery and read as much as you can about the course which you will be taking.
Most hospital courses will give you both the NVQ level 3 in Dental Nursing and the NEBDN (National Examination Board For Dental Nurses) Certificate, on completion of the course.

Pros
~~~
Earn whilst you learn
Recognised qualification at the end
Chance to see a varied case load

Cons
~~~~
Wages are circa £9k per annum
Workload is high

2. Training with a practice on a NVQ Course. You can apply for a job with a dental practice and do an NVQ level 3 in Dental Nursing to become qualified. An assessor will normally come into your work place, will ask you questions, ask you why you do certain things and will observe you working. There are drawbacks, you are reliant on either someone in the practice being qualified to asses your work or your employer (or you sometimes) paying for an assessor to come in to the practice. When I was assessing, there was a real shortage of assessors in Dental Nursing & I'd often have 8 or 9 nurses to asses rather than the 2 I normally like to have! It can take any length of time from 8-9 months to 3 years, depending on how fast you progress on the course and how often you meet with your assessor.

Pros
~~~~
Earning whilst learning
Great opportunity to work and study and learn from your dental surgeon
On the career ladder already
If you change jobs, you normally can continue your NVQ
No prior experience needed

Cons
~~~~
You may have to pay to do your NVQ
You may not have an in-house assessor
Can be poorly paid at this level

3. Training with a practice on a NEBDN Certificate Course (Day/Evening Release)
Like the NVQ, you can obtain your NEBDN qualification whilst working in a practice. Normally this course is done via a day release to a local college or an evening course. Both course can take up to 2 years. This course is a little less hands on than the NVQ, as you actually to have to come out of work to do it. The course is useful but maybe not as practical as the NVQ. You learn more about instruments, theory on this course in my experience, but you get more practicality from the NVQ, but I stress this is only my opinion.

Pros
~~~~
Earning whilst learning
Slightly more recognised than NVQ in my experience
Evening courses fit around work

Cons
~~~~
Day release means day off from work & losing experience & money
Normally have to pay for courses yourself
Can't do this course if you aren't employed in a dental surgery.

So that's training and entry, so once you've decided to be a dental nurse, what should you expect to have to do in the course of your work?

DENTAL NURSING: A DAY IN THE LIFE:
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I know a lot of people who have said to me dental nursing is easy, what planet are you on? Dental nursing is a lot harder than passing instruments and using the suction. The nurse is the dentist's right hand person, you have to think ahead of the dentist and you have to act as the dentist's eyes and ears with the patient. You also have to be there as a supporter for the patient, as a comforter, as their friend and you have to ensure their comfort & safety throughout.

I will lead you through a typical day of mine so you can gauge what hard work it is!

8.30am:

• Open up practice for manger, turn on lights, computers, check patient lists for the day, ensure emergency slots are kept free & check all notes match what appointments we have for the day.
• Go into basement, turn on autoclaves, x-ray developer,compressor, fill autoclave with purified water, check developer and fixer liquids are at an acceptable level for the day ahead. Put the autoclave on a start cycle and ensure it is working.
• Into allocate dental surgery for the day, switch chair, x-ray machine & overhead lights on.
• Ensure masks and face guards are set out for the dentist. Fill up water bottles for spray & ensure compressed air is coming through.
• Check procedure trays are set up for the day's treatments and ensure enough spare instruments are available.
• Check that we have enough amalgam, composites and other mixes & enough lab slips and bags for work to go to labs.
  Wipe down all surfaces with disinfectant spray and dry.
  Place mouthwash and tissues beside the patient chair
• Set up dentist's table for first patient
• Turn on PC and bring up first patients notes
• Make up cold sterilising solution for plastic instruments that cannot be autoclaved

9am-12pm: Morning Surgery Starts - Check up's this morning through until 12pm & emergency surgery 12-1.

*Welcome patient, ask them to sit in the chair & place protective bib on. Check they have filled out a health questionnaire.

*Ensure dental surgeon has a mirror, probe and periodontal probe out for adult patients & mirror and probe for children.

*Dental surgeon passes paper notes over and asks patient questions about health, allergies etc., it's my job to make a note of any important points on the paper notes and on the computer

*The dental surgeon will start examining the patient, normally a dental surgeon will examine not only the teeth of the patient, but also the gums, tongue, lips inside the cheeks, the palate and all other soft tissues. The dentist will say whether or not there are any abnormalities.

*The dental surgeon will then 'chart' the teeth & I will fill in both on the computer and on the paper notes too, charting where the patient has fillings, what materials they are, whether the patient has cavities or not etc.

*After examination, the dentist may take x-rays, after the film has been taken, it is my job to develop the x-ray and record the patient details in the x-ray book and make out an x-ray holder with the patients name & date of birth on it.

*After the x-ray is being processed, it's time to run back up the stairs to the surgery and clean the instrument, place them on the dirty tray ready for autoclaving. Then the surgery needs a wipe over with antimicrobial spray and set up for the next patient and so on for 4 hours!

After every 3 patients, the instruments would need to be autoclaved for sterilisation.

Emergency Surgery: 12-1
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It is important that the nurse is on the ball at emergency surgery as they usually are very busy, so I ensure I have a prescription pad out ready, labels ready for the patients name address. I ensure I have a full set of extraction forceps ready and instruments ready for 1 part of a 2 part root canal treatment & that everything is ready to go straight away for the dental surgeon.

The dental surgeon will discuss with the patient what they find and accordingly I will start getting ready. If some one has a really rotted tooth that cannot be repaired, I will pick out the correct pair of forceps according to the tooth that is being extracted, I will also get packs ready for the patient to bite on and an after-care pack ready.

The next patient might need a filling, so I need to look at the notes and see if they have a troublesome tooth, if they do, I generally nip out and ask them quickly what the trouble is whilst the dentist finishes with the current patient. I can then relay this to the dentist.

Generally we would see 6-7 patients in one hour, normally it was extractions of infections here and 9 times out of 10 we would run over into lunch hour.

In my lunch hour:
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I would obviously have lunch but I would also have to reconcile the x-ray films with the holders, check to see if we had any crown or bridge fittings for the afternoon and check that the work had been returned from the lab, if it hadn't it would be down to me to ring the lab up and get the item delivered or even have to go and pick it up! If the item wasn't ready I would have to ask one of the receptionists to phone the patient to advise them.
I also need to check the notes once more and double check for any changes or cancellations.
I then go back to my surgery 10 minutes before the start of afternoon surgery and set up ready for our first patient

2pm- 5pm Afternoon Surgery
Afternoon surgery was when we would do most of the treatment side of dentistry such as crowns, bridge work, fillings and the good old extractions too.

For crown and bridge work, I'd need my treatment trays, plus I'd need to have fast and slow hand pieces and the files and burs for the dentist to use. I'd also need to have powder and water ready to mix alginate for taking impressions as well as filling in lab slips ready for the item to go to the lab the next day. Patient care is important in these procedures as they can be longer than the average filling and for nervous patients this can be quite an ordeal and the nurse needs to keep them calm and reassure them and of course liaise with the dentist very closely so there are no mistakes made that may prolong the procedure or scare the patient!

After every patient who had crown or bridge work it would be down into the basement to autoclave all the instruments and put the impressions taken in the fridge overnight.

For fillings, I need my filling trays, I'd need to look at the notes for the tooth or teeth that were being worked on and what materials I'd need to make the filling, it could be good old silver amalgam or a posh white composite filling, ensuring that the right materials ere ready to go at the right time is very important to my job, if I have mixed something too early, it may dry out and not set, if I mix it too late, saliva may get into the cavity and cause infection, so being on the ball is really important.

Day End
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After all the patients had been seen the nurse will need to ensure their surgery is shut down for the night and everything is safe to be left. Sharps bins need to be put away. The surfaces need to be wiped. All instruments need to have been autoclaved and put away and x-rays given to the dental surgeon to report on. Cleaning solution needs to be put through tubing for the hand pieces and the suction tubing. This process can take up to 45 minutes after you finish work, it depends if the place you are working in has cleaning staff and what they do in the surgery.

So day to day it can be hard work.

DENTAL NURSING: WHAT CAN I EXPECT TO DO?
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As a dental nurse you can be expected to do many tasks and they will vary from surgery to surgery but in general:*Mixing filling materials

• Give oral health & hygiene advice
• Reception work
• Care of anaesthesia drugs
• Care of instruments
• Taking & developing x-rays
• Aspiration of oral fluids & debris
• Packing small amalgam fillings
• Stock ordering
• Ensuring sharps are disposed of safely in a sharps bin
• Keeping your surgery clean & tidy
• Care of all machinery
• Supervising trainees and work experience students

Basically, you can be asked to do anything and you should be willing to try your hand to any task, dental nursing isn't a career for those who think it's an easy life or for the faint hearted, I could tell you tales that would make you shudder with horror of what I have seen in peoples mouths. The nicest being bitten off finger nails embedded in a child's gum, YUK!You have to be prepared to start early & work late outside of your normal working hours. You my have to participate in an 'on-call' rota with your dentist which may mean you getting out of bed at 3am to deal with someone who has a huge infection and making their face sell to the point of affecting their breathing. I've been there so many times and at first it seems glamorous and exciting practising at some ungodly hour but after a few sessions, the novelty wears off and you drive home thinking 'Yes, that was good but I'm now awake AND I have work in the morning!'.

It's a very hard job to switch off from too, although I have moved away from the profession now, I still get asked about toothache, tooth problems and even family and friends are guilty of it and if you have seen something gory or particularly interesting, it does stay with you!

DENTAL NURSING: CAREER PROSPECTS
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There are no shortage of dental nursing jobs in the UK. Dental nursing isn't particularly well paid, qualified nurses can expect an hourly rate of anything between £6.50- £9 per hour or more if they work for an agency. Unqualified or trainee nurses can expect and hourly rate from national minimum wage for their age group up to around £6 per hour but like anything, it varies from place to place.

Working conditions can be hard under these pay conditions but it is a job that can pay well if you are in the right (normally private) practice.

After you have become a qualified dental nurse you can do 2 years post qualifying experience and then apply to train as a dental nurse or a hygienist, a course that takes around 27 months. Like dental nursing hospital course, these are normally well over-subscribed so I would advise you to get as much experience in this field in those 2 years as you can and speak to people who have qualified and get an insight into what the course is like, it's bl**dy hard work I can tell you!

If that's not your thing, practice management is an option, you can work in various settings but normally corporate groups have the most openings in this field.

Also available to you:

• Training & teaching nurses
• Assessing NVQ candidates
• Sales rep for dental/medical companies
• Tooth whitening for private companies
• Working for a dental insurance company
• Research
• Many more, too many to list!

DENTAL NURSING: IN CONCLUSION
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I am so glad I went into dental nursing, it has given me some amazing skills to set me up for any line of work. The career prospects can be very good and there are some practices out there that can offer you a career ladder even as a trainee nurse so whilst you may want to start out as a nurse but they can offer you the opportunities to take courses which may lead to jobs in management.

Equally there are some not so great dental surgeries, some which think dental nurses are something they have stepped in and it is important not to stay in a practice if you do not feel happy or more importantly, safe, there, no matter how good the career prospects might be!

It is hard work, I will make no bones about it but if you are willing to put not just the working hours in but the hours of work needed to become qualified then you will certainly reap the rewards.

If you'd like to become a dental nurse, have a look in your local paper, job centre and on the internet for dental nursing positions in your area.

Thanks for reading, if you'd like any advice on becoming a dental nurse, please leave me a message in my guest book or private guest book & I'll try to help best I can.

 

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