The GDC currently recognises 13 various fields of dentistry with regards to their specialist register. You are not required to join a specialist list to practise a specialty, however, only dentists on these specialist lists have the right to use the ‘specialist’ title. In this series of articles you can find out more about each specialty from experts in their respective fields, with advice on the career pathway as well as sharing their experiences as a specialist.
Dental Public Health is a non-clinical specialty involving the science and art of preventing oral diseases, promoting oral health to the population rather than the individual. It involves the assessment of dental health needs and ensuring dental services meet those needs.
In the following article, Dr David Conway, Consultant in Public Health discusses how you can establish a career in this field.
Clinical Senior Lecturer in Dental Public Health (University of Glasgow)
Honorary Consultant in Public Health (NHS National Services Scotland)
I graduated from University of Glasgow BDS in 1996. Following brief periods in general dental practice, hospital dentistry in Bristol and Edinburgh, and SHO posts in oral and maxillofacial surgery at St John’s in Livingston, I attained FDS RCS (England) in 1999.
I returned to Glasgow in 2000 for a clinical lectureship in dental public health combined with a specialist registrar training post based in NHS Lanarkshire and NHS Argyll and Clyde Health Boards. I completed the MPH at University of Glasgow in 2002 and attained the certificate of completion of specialist training in dental public health in 2005 (FDS DPH RCS) alongside Fellowship of the Faculty of Public Health ( FFPH). I was awarded a PhD in 2008 for research on the epidemiology of oral cancer from a socioeconomic perspective.
In 2008 I took up the position of Senior Clinical Lecturer in Dental Public Health at the University of Glasgow. Since 2005 I have held the position of Honorary Consultant in Dental Public Health with NHS National Services Scotland Information Services Division where I am currently the dental clinical lead and research strategy lead.
Dental Public Health is the science and art of preventing oral diseases, promoting oral health and improving quality of life through the organised efforts of society. It is about improving population health, tackling oral health inequalities, and improving the quality of dental services.
A career in Dental Public Health can be very diverse. Before you commit to a career in DPH, it is essential to experience the full range of dental service jobs (including general practice, community, and hospital services). It starts with specialty training which usually involves a Masters of Public Health (MPH) taught training programme which needs to have a significant oral health component (and research project). It is one of the few specialties where the training (and indeed the work and career) is very much aligned with public health medicine. Training is usually based in local territorial health boards or health authorities responsible for the delivery of dental services. There is also an academic training element related to the research project component of the MPH programme, and occasionally some regional, national, or even international experience. As with all dental specialties there is a corresponding academic lecturer training route which usually involves a PhD in addition to the NHS training. Following training there are multiple options open working in local health board, regional, national, or international roles, or a combination. Increasingly dental public health posts have both a dental and generic public health roles and responsibilities (e.g. including child health, public health nutrition).
Most definitely diverse nature of job: no day is the same. There are a wide range of challenges, and complex problems to resolve or work on. It involves team work, community work and public engagement. There is a sense that you are looking at the bigger picture – the population’s health. There is also a stronger prevention focus – indeed part of the dental public health challenge is to shift dentistry from a treatment reactive care model to one of anticipatory or preventive care.
You have to leave the clinical patient care behind, leave the instant or relatively instant feeling of treating a patient’s problem. This is the hardest and most critical decision to make. The mainstay of undergraduate and early career training is focused rightly on patient care and dental treatment. So to take the plunge and leave that behind is a difficult decision, but one which must be made and made positively.
If you want to improve the population’s oral health, tackle oral health inequalities, improve the quality of dental services in a bigger scale then dental public health is for you. If you have a prevention focus and want to move upstream to tackle the determinants of oral diseases then dental public health is for you.
While working in dental practice in Bristol and in oral and maxillofacial surgery house jobs, I was frustrated by the obvious inequalities demonstrated in the poorest families and children having the greatest burden of dental decay, or in the poorest most deprived suffering most and having worst outcomes from head and neck cancer. Rather than just continually treat these patients, I wanted to stop or attempt to prevent these diseases.
Combined with an active interest involvement in politics, this seemed to be a career that really fitted with my aspirations.
But as I have said, leaving the patient interface is a difficult decision. It took a lot of soul searching, and a lot of discussions with many individuals from within and out with dental public health for me to take the plunge. One of the key conversations I remember was with an oral medicine colleague and mentor who said it was important that dental public health had strong representation, that bigger decisions about strategy, planning, and service organisation, were not left to managers, but “clinicians” with real understanding of the impact were part of the leadership and decision-making process. I have held onto this. Dental public health is a clinical specialty, we are clinical leaders!
4 highlights spring to mind – completing my PhD (I think my wife agrees with that one!); having a 3 months summer attachment at the World Health Organisation International Agency for Research on Cancer (IARC) in Lyon, France; supporting the development and evaluation of Childsmile – the national oral health improvement programme for Scotland, which has begun to transform child oral health in Scotland.
As a trainee, I undertook a portfolio of work in relation to homeless health including undertaking a health needs assessment, working with the voluntary sector, and developing a homeless dental service. Obviously the more you go into a problem like homeless the further upstream you want to influence or change – i.e. the health needs are one thing but the social and economic challenges are the key. The problem is not dental services for homeless people, the problem is the causes of homelessness in the first place.
No. I am still on the pathway and journey – always looking forward.
There is no such thing. But I can guarantee over 100 emails (not all important!!). Desk / office work – teleconferences, meetings, presentations, project management tasks. From academic perspective there is a lot of research project grant writing, paper writing / reviewing, and student mentoring. Evenings of reading are not uncommon. The best bits are opportunities to get out and engage with stakeholders in oral health – dentists, dental teams, and patients and public.
The above is the minimum typically expected from prospective applicants. However, it is strongly recommended to check the essential and desirable criteria listed in the person specification provided for specific specialty training posts (StR). An exemplar person specification can be found in the ‘Further Information’ section at the bottom of the page.
Health Board / Authority specialty training (4 years) including a Masters in Public Health (usually with significant oral health module and oral health project) undertaken part-time over two years.
Academic pathway (as with standard pathway) + PhD usually takes 7 years in total.
Having a MPH before entry would reduce training by a year – but is not essential.
The key decision is to leave the direct patient contact / “toothface” behind. This is a difficult decision to make. I would urge those considering a career to arrange to talk to colleagues, to arrange work shadowing opportunities, and to read widely. I would also urge students to take the decision to work in dental public health for positive reasons, rather than reasons such as a dislike for direct clinical work.