Delivering Smiles to Seaside Locations

As part of an exploration of dentistry in ‘unusual environments’, Eschmann speaks to Katie Rowe, a dental nurse who played a key part in the initiative Smiles at Sea, created by Smile Together – an employee owned community interest company that delivers emergency and community care to patients across Cornwall and the Isles of Scilly.

 In the UK we often take easy access to dental care for granted. However, for some patients finding the opportunity to see the dentist is not so straightforward, especially those that work in challenging industries such as fishing. 

Understanding this, in June 2018 with funding from Seafarers Hospital Society and in partnership with The Fishermen’s Mission and Healthy Cornwall, Smile Together took a mobile dental unit to harboursides across Cornwall and Brixham to provide dental care and health checks to fishermen and their families. Katie Rowe, Project Lead Dental Nurse for the initiative explains:

“We were inspired to start this initiative as many of the families and fishermen in the area were in need of dental care. In fact, 70% of the patients we treated during the initiative hadn’t seen a dentist in over 5 years! To make Smiles at Sea a reality my manager, Joy Callender, had arranged for us to borrow a mobile dental unit (MDU) from Community Dental Services in Bedfordshire for two weeks in June so that we could provide these people with the dental care they needed.

“I liaised closely with The Fishermen’s Mission to put together a timetable that would see us at key harbourside locations on dates and times (and tides) that would best suit the fishermen, and from there I raised interest in the initiative with posters and letting local businesses know what were going to be doing so that they could help spread the word.”

Of course, offering dentistry in this manner is fairly unique, and the team involved in Smiles at Sea wanted to provide dental care without having to interrupt the daily schedules of the fishermen they wanted to treat.

“Once the MDU had arrived at its location and been set up, the volunteers and I went out and about to proactively encourage fishermen and their families to pop by. The checkups and treatment ran on a first come, first served basis so the fishermen didn’t have to wait long if at all, and therefore had plenty of time to carry on with the rest of their busy day. Each patient had a free check-up, immediate dental treatment, oral cancer screening and subsidised further treatment with Brighter Dental (the private dentistry arm of our business) as recommended by our dentist on the day.”

“Throughout the two weeks I was at every location with my colleagues to help set up the MDU, and coordinated our volunteers who came each day to promote Smiles at Sea and encourage fisherman and their families to come for a checkup. I was able to resolve any issues or problems immediately and was able to personally manage the decontamination procedure each day.”

Offering dental care from a small mobile unit is bound to bring some challenges, and the team soon found that they had plenty to face.

“Being summertime many of the harboursides were busy and therefore the logistics of getting the MDU safely into some of the (very tight) harbourside locations was interesting! Smiles at Sea also coincided with this summer’s heat wave and we were positioned in some relatively exposed locations, often in full sun. However, I’d packed suncream, sunhats and plenty of drinking water for us all, there was air-conditioning in the MDU plus fans, and of course we could go swimming in the sea after hours to cool off!

Operating out of a small, mobile unit offered space restrictions, but did this affect any daily protocols such as infection control?

“We maintained infection control exactly the same way as we do in our usual clinical environment. We used the same products to clean down the equipment such as Clinell wipes, hand washing procedures were the same as the MDU had access to fresh water from running taps so we used our regular hand soap and alcohol gel. The majority of the instruments used were disposable and were therefore placed into a large sharps bin immediately after use. Any instruments that were not disposable were placed into a sealed box, sprayed with protective spray and transported to the nearest clinic to be disinfected and autoclaved.

“We adhered to GDC regulations for patient care, cross infection regulations, and health and safety guidance at all times just as we would in a standard dental clinic. The MDU did come with its own policy and user guidelines though, and we had to follow these regulations as well!”

It’s initiatives like Smiles at Sea that push the profession forward in the shared goal to treat as many patients as possible. It’s easy to forget that rural communities and those who work in demanding industries may not have the time or access to dental care, so offering these people a mobile option enables professionals to help support their communities.

“Smiles at Sea was a tremendous success and I gained so much from this experience. It’s not an opportunity many dental nurses would get, but working for a dental social enterprise which invests its profits back into the local community means we get to be involved in exciting projects such as this. I love working for Smile Together and being able to genuinely make a difference to our patients!”

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