College of General Dentistry Careers

Making the move into private practice

Dr Pouya Zohrabpour, GDP and co-creator of the Two Dentists YouTube Channel, describes his journey towards becoming a fully private associate dentist, and the support he has received from the College’s Certified Membership Scheme.

Many young dentists struggle with imposter syndrome, often hesitant to engage in private dental practice or transition to a fully private setting. I graduated in 2020 and have recently embarked on the journey to become a fully private associate dentist. The experiences I’ve gathered over the past few years have been instrumental in easing this transition, helping me overcome imposter syndrome, and instilling confidence in the quality of dental care I provide.

Shortly after graduating, my colleague and friend, Dr. Ali Gowie, and I made the decision to launch a YouTube channel named “Two Dentists.” This initiative was born out of our shared frustration during the lockdown, as we grew tired of lengthy hour-long webinars. Our mission was simple: to create informative, polished, and easily digestible educational videos within the field of dentistry. We aimed to make these videos accessible to both dental newcomers and students.

Initially, our content focused on the intricacies of the new patient examination process, quickly gaining popularity on our channel. We covered a range of topics, from guiding dental students through their first patient interactions to providing insights on dental history collection, conducting comprehensive dental examinations, mastering all the essential diagnoses, utilizing radiology effectively, and excelling in treatment planning.

As time progressed, our content portfolio expanded to include diverse video series, such as our comprehensive exploration of dental photography and Loupes, which resonated strongly with our audience. Running our YouTube channel has opened doors for valuable collaborations with fellow dental professionals, nurturing our ongoing journey of learning and personal development. The channel has provided me with constant motivation to seek further knowledge, which I can then share through our videos.

During my foundation training year, I faced a pivotal decision regarding whether to pursue Dental Core Training (DCT). This choice weighed heavily on my mind as I sought advice from friends and colleagues. However, the diversity of opinions and my own uncertainty about the ideal career path left me in a state of indecision. Ultimately, I chose the associate route to focus on improving my general dentistry skills.

I’m certain that many others have found themselves in a similar situation, which is precisely where the new CGDent Certified Membership Scheme and Career Pathways can make a significant difference. As a young dentist, having a clearly defined career pathway, carefully mapped out by a professional body, offers me a sense of assurance that I’m on the right trajectory to expand my knowledge and evolve into a more proficient practitioner. Knowing that my progress will be acknowledged by the College and that I can work my way towards becoming an accomplished practitioner is incredibly motivating.

The Career Pathway provides a structured ladder to guide one’s professional growth, with clear steps leading to the achievement of the “accomplished practitioner” status. Currently classified as a “capable practitioner” “within the program, I am actively working towards the next milestone of becoming an “experienced practitioner”. One of the requirements for this advancement is completing a postgraduate diploma. To meet this requirement, I have enrolled in a PGDip program in Aesthetic & Restorative Dentistry offered by the Advanced Centre of Excellence (ACE). This further education has significantly boosted my confidence in treating a diverse range of patients, particularly in the private dental sector.

The Career Pathway is underpinned by the College’s Professional Framework, which delineates five domains encompassing 22 capabilities expected of dental professionals. My discussions with my assigned Facilitator while navigating these domains have been enlightening. They have encouraged me to pursue self-development not only in technical skills but also in the soft skills integral to dentistry. For instance, I’ve focused on honing my technical knowledge through courses in my PGDip program and ensuring I apply this knowledge in practice. Emphasizing the reflective domain, especially behaviours and well-being capabilities, has motivated me to foster a friendly, supportive, and collaborative environment among my colleagues at the dental practice. I firmly believe that without the framework and pathway in place, many of these actions may not have occurred or could have been delayed. The YouTube channel, Career Pathway, and Professional Framework have all played pivotal roles in shaping my career, enabling me to evolve and find fulfilment in dentistry.

As I near completion of my PGDip, I’m keen to identify the dental procedures that resonate with me most and potentially niche down in those treatments. To me, a successful dental career entails working in a capacity that allows you to practice the dentistry you enjoy, on a schedule that suits your preferences. This journey is neither swift nor easy; it demands patience and thoughtful planning. However, with the right guidance and strategy in place, it can become a more seamless and rewarding experience.

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College of General Dentistry Blog, Careers

From dental nursing to senior academic in dentistry: a personal career journey

Dr Louise Belfield AssocFCGDent is the College Council‘s Dental Nursing & Orthodontic Therapy Representative and Chair of the College’s Research Advisory Panel. The first dental nurse in the UK to achieve a PhD, here she reflects on the key moments, influences and lessons from her career to date.

My career in dentistry started at the age of 17 with an apprenticeship in Dental Technology. I worked as a trainee Dental Technician for 18 months and developed skills in crown and bridge work. During this time, I wondered with increasing frequency about the patients we were making prostheses for and decided to apply for a patient-facing role as a Dental Nurse. I trained in a small mixed NHS and private practice, and in 2003 gained my National Examining Board for Dental Nurses (NEBDN) Certificate in Dental Nursing. I was fortunate to work with a supportive team, and I was proactively included in continuing professional development (CPD) activities. The critical CPD event that changed the trajectory of my career in dentistry was a session exploring the links between periodontal diseases and systemic conditions, such as diabetes and cardiovascular disease, and how the oral microbiome might connect them. This sparked my curiosity and drive to find answers. What might this mean for our patients? What might we be able to advise if we knew more about it? The only path forward that I could see was to embark on scientific training at university.

The decision to leave my practice and enrol on a university degree was a difficult one because I was very happy where I was, and I enjoyed Dental Nursing. As I had gone straight into apprenticeship after leaving school, I chose a BSc in Human Biosciences university course which included a “Year Zero” to cover the prerequisite scientific knowledge in lieu of traditional A-levels. Throughout the university course I continued practising as a dental nurse, working as bank staff for a local hospital trust. This provided invaluable experience and kept me clinically active in the profession. I worked across a range of settings, including domiciliary care, school visits, emergency clinics, dental access centres, special care dentistry, and even on a mobile dental surgery van. I also worked at an emergency out-of-hours weekend service, and in a private practice which I fitted in around my lectures.

It became apparent to me through the course of my studies that it was the immune system that was the pivotal link between periodontal and systemic diseases, and in the final year of my degree course I focused my studies on the periodontal pathogen Porphyromonas gingivalis, and how it interacts with immune cells. This formed the basis of my further studies leading to a PhD, investigating how these immune cells behave in response to P. gingivalis when they are involved with oral cancer or chronic inflammation. As is often the case at the end of a PhD, there were many new questions formulating and I knew I wanted to continue to investigate these relationships further to answer some of these questions.

Career in dental research and education

At the end of my doctoral studies, an academic position became available and I was appointed as a Lecturer in Biomedical Sciences in 2013. This has enabled me to explore both the scientific and educational facets required in an academic career, and I have been able to establish research in both of these areas. My scientific research focuses on host-pathogen interactions, and I have been fortunate to work on multiple projects, including development of three-dimensional oral mucosa models, association of subgingival lipid A profiles with periodontal disease status,1,2 and in 2019 I received the Colgate Robin Davies Dental Care Professional Research Award from the Oral and Dental Research Trust (ODRT), for a project investigating modulation of osteoclast differentiation and activity by endotoxin tolerance. This Dental Care Professional (DCP) specific award was instrumental in developing an independent research career and I remain grateful to the ODRT for the opportunity.

Subsequently, working together with two colleagues at the University of Plymouth, we established the Oral Microbiome Research Group, where we run clinical and translational research investigating links between human health and disease, and oral bacteria. Two current clinical studies link the oral microbiome with pre-eclampsia, and formation of cerebral abscesses.3 Our research also explores how modifying the oral microbiome can be detrimental to maintaining oral and physiological health mechanisms; a study using chlorhexidine mouthwash to disrupt the normal microbiome found that a decreased diversity of species was associated with a decreased salivary pH buffering capacity, increased lactate and glucose levels, and reduced availability of nitrate and nitrite, with an associated increase in systolic blood pressure.4

Alongside my scientific research, I have also been able to develop scholarly activity, with a focus on inter- and intra-professional education, particularly relating to assessments and standard setting in multi-cohort programmes.5,6 Having come into higher education via a non-standard route, an area I have been particularly keen to invest in is access and participation, and a significant part of my academic role has been to develop a Foundation (Year Zero) entry pathway for the BSc Dental Therapy and Hygiene programme at Peninsula, with the specific focus on Dental Nurses, who make up the majority of our cohort. This Foundation pathway has been running successfully now for three years, and we will welcome our first cohort of BDS year zero students in September 2023, specifically designed to enable fairer access to dental education for local, South West students with non-traditional entry backgrounds.

Engagement with the professional community

I remain actively engaged with the Dental Nursing community through a number of external roles; I uphold my registration with the General Dental Council (GDC), and I am a trustee for the NEBDN, where I also chair the Education Standards Committee. In 2020, I was appointed as a Dental Clinical Fellow with Health Education England, which continues to afford me an insight into NHS dentistry, service commissioning, workforce challenges, DCP skill mix, and training needs, in line with the Dental Education Reform Programme.7 I am also a representative for Dental Nursing on the Council of the College of General Dentistry (CGDent), and with a dedicated and experienced team, we are working to establish the first Faculty of Dental Nursing. I am also grateful to the College for the opportunity to chair the Research Advisory Panel, espousing the message that research is open to all dental professionals.

Key learning points and recommendations

Instrumental in my career have been support and encouragement from those I work with, and seizing opportunities despite the frequent imposter syndrome! While by no means perfect, there tends to be more clarity in the pathway to an academic career for dentists, which is lacking for other dental professionals, which means it can be extra challenging to carve your own route. Promisingly, I come across more and more outstanding DCPs in academic positions and I hope this will continue. This is one of the reasons I am excited about the CGDent Career Pathways in Dentistry: Professional Framework and the establishment of the faculties, and to promote the CGDent vision to make research opportunities accessible for all members of the dental team, to pro-actively support Dental Nurses and all team members to excel in their profession to their fullest potential.

The skills and experience I accrued as a Dental Nurse helped me to progress in other areas, including academia and research; working as a bank dental nurse had its challenges, arriving each morning to a new practice, with different staff, surgery set-ups and protocols was difficult at times, but I learned to be adaptable, and to think on my feet. Communication and team working skills were vital; and I was privileged to work with a variety of patients with their own range of perspectives and experiences and I learned a lot from them. Finally, working in a high-pressure environment, developing effective time management was crucial to being a competent Dental Nurse and these skills have also served me well in academia. I would wholeheartedly encourage anyone with an interest in research or an academic career to pursue that, to reach out to potential mentors or advisors for guidance, and to explore the CGDent Career Pathways frameworks, as well as membership of the College and its Faculties.

References

1. McIlwaine C, Strachan A, Harrington Z, et al. Comparative analysis of total salivary lipopolysaccharide chemical and biological properties with periodontal status. Arch Oral Biol. 2019;110:104633.

2. Strachan A, Harrington Z, McIlwaine C, et al. Subgingival lipid A profile and endotoxin activity in periodontal health and disease. Clin Oral Investig. 2019;23(9):3527-3534.

3. Roy H, Bescos R, McColl E, et al. Oral microbes and the formation of cerebral abscesses: A single-centre retrospective study. J Dent. 2023;128:104366.

4. Bescos R, Ashworth A, Cutler C, et al. Effects of Chlorhexidine mouthwash on the oral microbiome. Sci Rep. 2020;10(1):5254.

5. McIlwaine C, Brookes ZLS, Zahra D, et al. A novel, integrated curriculum for dental hygiene-therapists and dentists. Br Dent J. 2019;226(1):67-72.

6. Zahra D, Belfield L, Bennett J. The benefits of integrating dental and dental therapy and hygiene students in undergraduate curricula. Eur J Dent Educ. 2018;23(1):e12-e16.

7. NHS Health Education England (HEE). New plans for dental training reform in England to tackle inequalities in patient oral health. HEE. 21 September 2021. [Internet]. Available at https://www.hee.nhs.uk/news-blogs-events/news/new-plans-dental-training-reform-england-tackle-inequalities-patient-oral-health-0 [Accessed Dec 2022]

This account was first published in the Primary Dental Journal (vol. 12, issue 1, March 2023)

Update (June 2023): Since this article was published, Louise has been appointed Academic Head of Assessment at Brunel University Medical School and has stood down from the College Council to focus on her new role; however she remains on the College’s Research Advisory Panel.

College of General Dentistry Blog, Careers

Transforming oral health: A fellow’s journey

Dental Hygienist, Frances Robinson AssocFCGDent, has recently completed the Clinical Oral Health Transformation Fellowship with HEE. As the first ever dental care professional in any clinical fellowship role, Frances explains what was involved.  

A fellowship is a position, often combined with clinical work, that focuses on the learning and development of the individual taking part. Fellowship roles in the healthcare profession aim to expand opportunities for aspiring leaders; helping them gain the necessary experience and skills for future system leadership roles. As such, there are a range of opportunities to be involved with projects and programmes and to work in settings outside a clinician’s normal exposure. There can be specific goals of writing, submitting, and publishing papers, attending meetings and conferences, and working on particular projects, as well as networking. The balance of these is dependent on the host organisation.

I have just completed a one-year position with Health Education England (HEE) as their Clinical Oral Health Transformation Fellow. HEE’s purpose is to support the delivery of excellent healthcare to patients, by ensuring that the workforce has the right numbers, skills, values and behaviours. Thus, the areas I worked on related to the development of the oral health work force.

I was the first dental care professional (DCP) to be awarded the clinical fellowship, these roles are typically fulfilled by a dentist. I am extremely grateful for this innovative appointment both for my personal development and the development of my career, but also for other DCP colleagues, for now it has opened up new realms of opportunities for us to progress in system roles.

I applied for the role because of the potential to gain experience working in the public health sector, whilst allowing me to work clinically at the same time. Having completed a Masters in Dental Public Health in 2017 – spurred on by my interests in health inequalities research – I felt this position would be an excellent opportunity for me to develop my career.

At the CDO stand with Sara Hurley and other fellows at the BDIA showcase

During a fellowship there is flexibility to align the projects undertaken to individual interests, whilst working for the greater aims of an organisation. This means there is a real opportunity to tailor a role to where there is the most personal or organisational benefit. My aims for the year working with HEE were to work on projects that I’m interested in, for example oral health inequalities, oral health empowerment and promotion, increase my skill mix and exposure to multidisciplinary team working in primary care, as well and develop opportunities for leadership and management for all members of the dental team.

I am currently writing up multiple papers to be published; one evaluates the success of a pilot that aimed to reduce the number of paediatric patients sent to secondary care for dental extractions under general anaesthetic. A subsequent paper will evaluate the success of the “return to work” therapy scheme, a programme aimed at supporting Dental Therapists who have not been using their full scope of practice, back into therapy work by providing them with training opportunities, supervisor support and a practice placement. I will also be helping to write a concept paper for a Dental Hygiene postgraduate training programme.

During my time with HEE, I have had the chance to sit on various working groups like a “Managed Clinical Network” and interact with external organisations such as Public Health England, academic institutions, professional societies and local councils.

A clinical fellow may also have the opportunity to attend courses and gain qualifications that are not linked to their clinical work; I was selected to complete an Institute of Leadership and Management, level 7 qualification through HEE. I received three days of training with UMD Professional and then completed a research element which involved interviewing my colleagues at the HEE dental office.

Furthermore, I am currently completing a “Becoming an Expert Educator in the Healthcare Professions” course with the University of Nottingham. These additional skills and qualifications are important for demonstrating tangible outcomes from the year.

It has sometimes been a trying year due to the pandemic – working from home during a fellowship has meant less interaction with colleagues and difficulty integrating into an office very different from a clinical setting. Natural communication with colleagues is often stilted when working virtually. I subsequently created ice breakers for meetings with my peers to stimulate organic conversation!  

There are other fellows across the country with HEE and in other organisations for example with the Chief Dental Officer, General Dental Council, Care Quality Commission and NHS England and NHS Improvement (NHSE&I). We have a clinical fellow networking group where collaborations across work streams can be facilitated and a journal club takes place. This has given me the chance to network with new professionals across medicine and dentistry which has been really enjoyable! The fellows try to see each other in person despite being spread out across the country– the most recent of which was at the BDIA Dental Showcase at ExCel London.

As I was the first fellow at Health Education England to be a DCP I was – and still am – in a unique position to be an advocate for DCPs, working hard to make our voices heard across a variety of settings. I was asked to do a presentation at the BDIA conference on workforce and skill mix. I focused on the skill mix in our systems, policy, planning, commissioning, leadership and management. I am passionate about DCP representation in all of these areas as I truly believe that if we are represented throughout the system we will have a more empowered workforce. If you’re interested in taking up a Fellowship position, keep an eye on NHS jobs, HEE jobs, FMLM for dentists and your professional society pages.

Presenting at the BDIA showcase

The College of General Dentistry has a unique structure with exciting opportunities to create connections between different dental professionals against an academic backdrop. There are no other organisations in the industry now that represents all dental registrants in this way. The careers pathway programme will be able to support individuals navigating their fields; there will be guidance, support networks and mentors available to enhance learning and progression. I personally am very excited to have a structure in which to work, with industry recognition of the level attained. I know that many DCPs have much to offer the wider industry with postgraduate qualifications and extensive experience in many areas, as well as evidence of enhanced learning. The College will enable these efforts to be verified through a framework where all dental professional are assessed equally. This certainly is an exciting time for us all.

Frances Robinson chairs the Dental Hygiene & Dental Therapy Group on the College’s Career Pathways programme.

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