Mandy Monger discusses her time working as a dental hygienist and why she’s made the decision to step back from dentistry.
Hi, I’m Mandy and have been asked to write about my experiences working as a hygienist and why I recently decided to leave the profession. Well I feel a book coming on –Confessions of a Dental Hygienist.
I had the privilege to train as a hygienist at R.A.D.C Aldershot as a civilian with the British Army. I qualified in June 1989. How many of you in your training, went on a week long adventure training exercise climbing Snowdon? Kayaking and abseiling, and a weekly two mile timed run?
When the extended duties came in I continued my career development with King’s and at the Eastman Dental Schools.
I went into self-employment and two general dental practices. I had no nurse support, so providing patient comfort with self aspiration was paramount. A colleague recently reminded me that even then I would voice that 20 minutes was not enough time for a PGT 1.
Rewarding
Alongside general practice I was delighted to work with Marks and Spencers for eight years. Based between four stores, I provided oral cancer screening and set up drop in and chat oral hygiene areas in their association rooms quarterly.
I was blessed with two children and worked two days a week. As each group was joined, so did I – helper mum and always oral health educator to Brownies, Cadets, Scouts, school classes and anyone I could fit in.
I then went back to community dentistry. I’d been a very proud DSA in the community services, and the orthodontic and oral surgery department at the hospital.
I loved it. High needs, special needs, complex cases, domiciliary care – it was all so rewarding. I delivered presentations and was back in a supportive team, salaried and visible in the community. At this time the PCT had the contract for delivering dental services to HMP. I’d worked in Broadmoor, and found myself in Parkhurst once a week and biannually for the officer health and wellbeing days.
Back to hospital dentistry, now called the maxillo-facial department. Clinics were varied. I treated cleft palates, TMJ, phobic patients, and mouth cancer patients with all the complications that come with the treatment involved, both physically and mentally. I’d missed the huge team involved and loved every minute of every day. This included weekly theatre sessions.
I haven’t mentioned that we moved with my husband’s job. I’d worked in Hampshire, Surrey, Berkshire, Isle of Wight, and the next move was to Worcestershire. I decided it was time to retire back into part-time general practice to look after my shoulder from using hoists, knees from domiciliary visits and it would be another high security establishment, I’d done my bit.
Contracting COVID-19
So working in Worcestershire and Gloucestershire – what happened?
On the 13th March 2020 I contracted COVID-19! No daily Boris briefings yet, and I missed the shelves being stripped of toilet rolls and pasta. There was no testing available (I have since had a positive antibody test result and am currently taking part in a trial) and as I recovered and raised my head, practices had been closed.
Initially, I felt really let down as I thought I was a key worker. I had put my heart and soul, passion and enthusiasm into ‘prevention is better than cure’ for 31 years as a dental hygienist.
There was no clear guidance. Then, it was guidelines not law. The GDC and CDO left me feeling abandoned and disappointed. The CQC and GDC started quoting things like ‘rests with the dental provider’ and ‘feel comfortable offering’. What had happened to ‘not withstanding the mantra of always putting the patients interests first’?
On a positive note, the BSDHT have been amazing. The BDA saying the nation’s dental services face decimation was not at all what I expected.
Dentistry has always been a profession which is flexible and adaptive so now it is time to ‘build back better’. With an opportunity for better collaboration between dental services and other primary care teams for integrated oral care.
Job satisfaction comes from relationships with our patients; that ongoing connection with each other through the ups and downs, and then face-to-face dental care stopped. So as a DCP I wanted to ensure oral health was not a forgotten element of health. I wanted to deliver better oral health prevention with stabilisation of dentitions and offer sign posting for more complex care.
Journey into teledentistry
How to provide this? I had personally never heard of Zoom but just wow! Oral hygiene begins in the bathroom, so this oral health education way of delivery was a perfect opportunity to turn around hygienist appointments to not just be about ‘a scale and polish’.
Personally, I found my patients felt comfortable with the educational changes and how they perceive ‘us’ and their own oral health.
We must all take positives from a negative situation. I’ve enjoyed my journey in teledentistry with a remote provision of services and I truly believe ‘my’ patients appreciated the interaction while many hygienist rooms remain closed. I also uploaded oral health lessons on the practice’s Facebook page.
As recently as the Online Dentistry Show we were being told best practice for gingival health was a combination of AGPs, using ultrasonic and handscaling instrumentation. This would mean reduced patients seen in a clinical day. There has been lots of discussion regarding pay and fallow time that I am not getting involved with today. But I wish all my colleagues all the very best in building back better.
Inspiring
I spent many years removing burnished calculus and looking at lingual defects caused by over handscaling. Additionally, I spent many years persuading patients to ‘give it a go’ in best practice with fantastic results.
I truly believe in full mouth disinfection using the Cavitron, followed by meticulous handscaling, polishing and motivating the patients by giving them the facts. Therefore, I cannot ‘go back’ to ‘something is better than nothing’.
I feel I would be anonymous with the PPE now required to deliver ultrasonic scaling. My patients here in Staffordshire ‘trust’ me, I’m sure. But a post-COVID move just didn’t feel right for me. So I donated my scrubs , sharpened my hand scalers and bequeathed them.
I made the decision to retire from dentistry, a career I have been absolutely passionate about. I have met some amazing people and hope I have inspired many too.
Lockdown lessons
I have completed more than 200 hours of dental CPD to embrace a return to work and had a fit test for an FFP3 mask , so I was all ready. In March I completed COVID-19 ‘Tackling The Novel Coronavirus’ with The London School of Hygiene and Tropical Medicine and Public
There was a volunteering need. As an NHS responder, I collected prescriptions and shopping for those shielding. I eventually carried around a collapsible seat and a flask of coffee so I could sit and chat with them. A local ‘Virtual Friendship Matters’ group was set up, and yes I have done an OH session. I just had to.
I host this every Monday morning on Zoom. The initial challenge was getting the over 80s tech savvy. I started my journey into digital skills. As a result of attending these online courses, I am on a panel bimonthly with a business and intellectual property centre as a voice from the volunteering sector. Their statement is innovate, grow and prosper.
So today is the opportunity to build the tomorrow you want. My statement today is collaborate, communicate and work remotely.
I wish you all the very best in the next chapter of dentistry and remember:
‘Obstacles don’t have to stop you. If you run into a wall, don’t turn around and give up. Figure out how to climb it, go through it, or work around it’ – Michael Jordon.
And with that, good luck and be safe.
