Dental nurses are the most highly rated members of a dental team. But the profession risks losing more than one third of them in the next two years.
This is according to new figures published from Dentistry Census.
Dental nurses make up the largest sector of the dental register. And 84% of dental professionals consider their role ‘essential’ to the success of any practice.
However, Census statistics also indicate that 39% of dental nurses are looking to quit dentistry in the next two years.
With 99% of dental nurses made up of women, feedback reveals that 88% are earning less than £25,000.
Low pay was compounded by the fact that 74% of dental nurse respondents deemed the General Dental Council (GDC) annual retention fee (ARF) of £114 per annum to be ‘too high’.
The GDC only introduced the option for DCPs to pay the ARF by instalments in March 2021. This followed pressure within the dental profession amid the pandemic.
Poor rewards, challenging Covid-19 regulations and Brexit restrictions on immigration have also been cited as causes for the dental nursing drought.
The figures come as the Office for National Statistics reveals wage growth in the UK is struggling to keep up with spiralling inflation.
From August to September 2021, Dentistry, in collaboration with DD, undertook its own Census. The aim was to explore the current state of the profession and the future implications for dentistry.
Surveying 816 dental professionals from across the four nations, it included a focus on dental nurses and their experiences of dentistry.
This included earning, their attitudes to learning, the impact of Covid-19 on relationships and mental health, and their employment plans for the coming two years.
With a gap to fill in the dental nursing employment market, many suggest there is a crisis in recruitment. While others argue this could be beneficial to those dental nurses who are qualified, experienced and remain within the profession.
Retention is about value
Fiona Ellwood is president and executive director of the Society of British Dental Nurses (SBDN). She is currently looking at ‘meaningful and purposeful ways’ of increasing the dental nurse workforce pool.
She suggests that any practices struggling to attract and retain dental nurses need to address key issues. And this is not about financial reward in isolation.
‘While dental nurses need to be rewarded proportionally, fairly and appropriately, retention is also about value, recognition, respect and career opportunities,‘ she says.
‘It is important for the whole of the profession to understand dental nursing qualifications and pathways. With consideration given to population and workforce needs. As well as personal aspirational progression expectations.’
She adds: ‘Change needs to happen from the top down, middle out and bottom up. It must include key stakeholders across all four nations. We then need dental workplaces to shine a spotlight on what dental nurses do to help deliver care to patients.’
Census feedback showed that some dental nurses felt ‘stress, not motivated’, ‘overworked and underpaid’, ‘worthless, angry and disrespected’ and ‘undervalued’. Ultimately, 63% of dental nurses felt they had a good work-life balance.
Around 40% reveal that work routinely makes them ‘happy’, 37% ‘content’ and 35% ‘confident’.
Fiona also highlights the importance of dental nurse educators and mentors in helping dental nurses to recognise and celebrate their own value.
‘Dental nurse education has historically been classed as a vocational level education. This is one of the biggest barriers to progression and integration to broader fields.
‘Many in the wider healthcare setting do not value the role of the dental nurse. Or the level of their education, and this can have a huge impact on morale. Money is important, but it is not the only game changer as a recent SBDN survey showed.’
Dentist Neel Kothari, from High Street Dental Practice in Sawston, Cambridge, agrees the recruitment and retention challenges are not without a number of solutions.
He says: ‘Dental nurses have chosen their profession for a variety of reasons. Historically, there have been a large number of applicants for this role. This undoubtedly has influenced pay.
‘However, whilst pay isn’t the only way to value a team member, it goes a long way in showing respect and acknowledging the work they provide.
‘Dental nurses are looking for what we all look for; fair pay, respect, a role within in a healthy environment and a team culture where they feel supported.
‘With the current rates of inflation, poor pay will mean that some dental nurses will be forced to leave the profession in order to keep up with bills, whether or not they want to stay.
‘That said, the situation is changing. As demand for dental nurses increases, we can already see with job advertisements that pay is beginning to rise.
‘The reality is that, without dental nurses, a dental practice simply cannot operate.’
Relationships and wellbeing
According to statistics, 44% of dental nurses said they felt ‘somewhat unsafe’ when practice doors reopened following the first lockdown from March until June 2020.
Now, however almost the same number of dental nurses (43%) feel as safe as they did before the pandemic began.
When it came to the pandemic’s impact on relationships, just over half (52%) of dental nurses said Covid-19 had no impact on their relationship with their employer. One third (33%) felt their relationship with the majority of patients worsened slightly due to the pandemic. And 43% said that Covid-19 had no impact. More than half – 56% – said patients still valued what they do.
Results also suggest the pandemic’s impact on mental health has been variable. With 8% saying they had experienced suicidal thoughts.
Meanwhile, 63% felt their mental health had ‘worsened slightly’. And 11% said it had ‘worsened significantly’. However, 25% reported there was no impact whatsoever.
But support was there for many dental nurses. A quarter (25%) felt extremely well supported by their employer/principal/primary contractor. While 24% felt quite well and 29% passably supported.
In addition, 60% felt they have access to support for their mental health should they need it.
Among the respondents, 19% had already sought help for their mental health during the pandemic.
Last year, a review led by the University of Plymouth showed that whilst studies reveal dentists suffer an increased level of stress and burnout, there has been little or no research on the wellbeing of dental care professionals – and that included dental nurses.
SBDN’s Fiona Ellwood believes more professional support should be forthcoming for dental nurses who sometimes get overlooked when it comes to the mental health challenges that often present in the workplace.
She says: ‘Mental health care is not just for the pandemic. An on-going support network for dental nurses is vital.
‘Patients talk to them more than they do the dentist. Dental nurses often take on the stresses and strains of the dentists – either directly or indirectly.
‘They also face having to navigate their way through many of the challenges in practice.’
She adds: ‘Commonly they are unlikely to be able to afford private health care or legal support if needed.
‘At times during the pandemic, they have felt nobody was holding their hand. And sometimes the only answers out there were to follow links and make sense of complex documentation that came out at speed.’
She believes more needs to happen in the workplace. In particular with the embedding of psychological safety and the elimination of stigma. ‘There truly needs to be normalisation of mental health. And open conversations and not clichés and lip service,’ she adds.
Locum dental nurses were left particularly vulnerable, Fiona says. Forced to make decisions in highly challenging circumstances, this often added to the burden of stress.
‘If you demonstrate as a team that you care about health and wellbeing and nurture a sense of belonging, then staff will stay. Ultimately, civility saves lives and respect for colleagues is key to this. Dental nurses need to feel valued, respected and recognised. Part of that lies in how the team celebrates successes. Thanking people in public is important.’
For her, morning huddles not only improves communication across a team but also help to ensure patient safety.
Dental nurses were split down the middle when it came to unwinding after work. With 48% challenged by the prospect and 52% having no difficulties switching off.
The same was the case for the impact of work-related stress on their relationships. Around 44% admit that inside and outside of work they had suffered. But 56% saying they’d seen no change at all.
Meanwhile, figures suggest 15% are considering a career break in the next two years. And 16% will seek to retrain for another clinical role. While 10% look set to retire and 42% have no plans to change their current working status.
We would like to thank all the dental professionals who took part in this research at such a challenging time. We would also like to thank DD for their support.
The Dentistry Census is based on a survey of 816 dental professionals from across the four nations undertaken from August until September 2021, in collaboration with DD using Surveymonkey to collect the data.
Catch up with previous Dentistry Census results
Is NHS dentistry on the brink of collapse or in need of reinvention?
Click here to download the full census.
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