Career spotlight - dental therapy

The number of registered dental therapists increased by 23.5% last year, making them the fastest-growing group of dental professionals in the UK. As Rachael Simpson and Miranda Steeples explain, the new generation of dental therapists has a bright future and a lot to offer in modern dental practice. 

With more than 30 years’ combined experience in dental therapy, the DDU’s new advisors, Rachael and Miranda , have done it all. We asked them about their careers and what advice they have for dental therapists-to-be. 

What made you both decide on careers in dentistry?

Miranda Steeples: My career path is a bit unorthodox. I became a professional entertainer and dancer after my A-levels, but at 28, I felt in a bit of a rut. I had a good job in a bingo hall, but I didn’t want to get a gaming licence to be a manager or have to work evenings and weekends anymore.

Then I went on holiday with an old school friend who was a dentist and she was badgering me to ‘sort my life out’ and suggested I become a dental nurse. When we got back, she arranged for me to shadow the dental nurse at her practice on Saturday. I took a dental nurse trainee post on my day off from the bingo because I felt I had nothing to lose. I loved it because the dentist spent lots of time training me and he was a great mentor. Then in 2006, I started the National course, which had a fantastic tutor, and I realised that I really missed studying.

Rachael Simpson: When our careers advisor at school asked us to think about what we wanted to do for work experience, my nan suggested that I come in and shadow the dental nurses at the practice where she was working as an assistant lab technician. I spent a week with the dental nurses, reception team, hygienists, dentists and at the end, the practice principal offered me a job as a trainee dental nurse when I left school. Once I’d done my GCSEs, I started working Monday to Friday and went to college in the evenings to do an NVQ Level 2 in Oral Healthcare and then a National Certificate in Dental Nursing.

Describe the professional journey from dental nurse to dental therapist.

Miranda: I dropped one of my shifts at the bingo hall to work half a day each week with the dental hygienist and I was struck by how her patients seemed to look forward to their appointments – they weren’t scared at all! She told me: ‘You could do this too – you have science A-levels and you can talk to people.’

I set my heart on a dual dental hygiene and therapy course at Leeds University for two reasons. I really liked the fact that there was so much shared learning with different groups, such as local anaesthetics with the dental students. And I wanted to have a proper student experience – Leeds was far from home, which meant I wouldn’t be tempted to come back at weekends. The course was 27 months long, and it was intense as there was a lot to cover, but I graduated in 2009 with a Graduate Diploma in Dental Hygiene and Therapy.

Rachael: I’d been working as a dental nurse for a couple of years when I decided I wanted something more. I’d started working with the practice orthodontist, so I funded myself through an orthodontic dental nursing course at Liverpool for a day each month for 10 months. After really enjoying that experience, I started thinking that I’d like to be more hands-on and work directly with patients, so I went back to college two nights a week to study for an A-level in biology.

Like Miranda, I went to Leeds to study for a hygiene and therapy diploma. I was inspired to apply because one of the dental nurses at my practice went to Leeds and I’d had conversations with her about how good the teaching was and what a brilliant city it was. It was my first taste of independent life away from home at 21 and I made some fab friends from day one.

Did you both find therapy posts straight after graduating?

Miranda: I went to work in a general practice in Sussex which was a dental hygienist role but included one afternoon each week of operative dental therapy. Sadly, that element tailed off in that practice because the role of dental therapist wasn’t well understood back in 2010 and those patients just wanted their dentist to carry out restorations.

Things have changed, I’m pleased to say, especially during the pandemic when it was more difficult to book an appointment with a dentist. For example, patients would ask me to look at a sharp tooth, and I’d tell them they had lost a filling or broken a tooth. By that point, patients had got to know me and would ask if I could help, so I ended up placing quite a few temporary fillings and advising patients to see their dentist when they could.

Rachael: I liked the variety of being a rota dental nurse so when I qualified, I chose to work three days as a therapist in NHS practice in Stoke and was employed two days in private practice. It’s not as common but I’ve been fortunate to be employed as a therapist in private practice at an hourly rate with holiday pay. Most therapists in general practice work on a self-employed basis but that has advantages too in terms of hours and clinical freedom.

Both of you have loads of different experiences on your CVs – can you give us a flavour of these?

Miranda: One of the things I’m proudest of is volunteering for a dental charity project for children in Cambodia called ‘Mini Molars Cambodia’. I’ve been out there five or six times over the years, carrying out procedures like the Atraumatic Restorative Technique (ART), using a spoon excavator and giving preventive advice. As you can imagine, there are plenty of challenges, such as materials setting quickly in the heat, or not having the specific forceps for a lower tooth extraction, but it’s taught me to think on my feet.

And in 2014, I got involved with the SouthEast Regional group of the British Society of Dental Hygiene and Therapy (BSDHT) as they needed a treasurer. I’d always been a member, and it was nice to be involved with a group of like-minded people and broaden my horizons. In 2018, I became Honorary Treasurer and was then elected BSDHT President between 2022 and 2024. That was a baptism of fire, but I loved the new challenge of writing articles, delivering speeches and presentations, and having the opportunity to speak up for our profession.

Once I completed my term as President, I realised I didn’t want to go back into full-time practice, so I started looking around for other roles. Soon afterwards, I was approached by Tempdent about a part-time teaching role on their Level 4 Apprenticeship Oral Health Practitioner Course. That really spoke to me as my mum, dad, and sister worked in education and I think it’s important to find ways to empower and upskill dental nurses. I’m now teaching two days a week and I’ve just started working for the DDU in a new role called a DCP adviser for the other three days, plus I’m still working in practice for one day each month.

Rachael: In the 17 years since qualifying, I’ve worked in loads of different environments with completely different patient groups. After general practice, I had a post in a hospital oncology department treating head and neck cancer patients and ensuring they were dentally fit to have chemotherapy and radiotherapy and reviewing them after their treatment. That required good communication and teamwork within a multi-disciplinary team. It was demanding, but lovely to see patients come out the other side of treatment feeling and looking better.

I worked for the Ministry of Defence for two and a half years as the only civilian in the dental team at Stafford Barracks, although I moved on because I was missing dental therapy practice. I spent five years in the Community Dental Service, where I did lots of hall crowns, restorations, fluoride applications and provided treatment under inhalation sedation. I also worked with anxious child patients, having completed a Diploma in Paediatric Dentistry for therapists with the Royal College of Surgeons of Edinburgh.

And after that, I worked in the Prison Service in a Category B prison where I got to use my full scope of practice doing hygiene treatments and restorations. That was a really good experience, but by the end, I was ready for a completely new challenge. I saw a maternity leave teaching post at Sheffield University and by the end of the nine months, I knew I wanted to get into teaching. That led me to a current part-time post at Liverpool where I supervise and support therapy students two days a week, leaving me three days to work as a DCP adviser at the DDU.

What are the biggest career challenges in dental therapy?

Miranda: Patients are familiar with dental hygienists but there is less public understanding of what a dental therapist can do, and I think that’s sometimes been the case for colleagues in the dental team too. However, things like direct access, the GDC’s new Scope of Practice guidance and the exemptions for administering fluoride and local anaesthetic have all raised awareness of the role, as well as opening up access to care for patients. It’s helped increase autonomy for dental therapists who own their own practice, although being in a general practice setting as part of a team works just fine too, provided you can reach an agreement about payment and other terms.

Rachael: Making sure you find a role that’s right for you. It’s tempting when you first qualify to just get a job as soon as possible but we all have different needs and personalities so it’s important to get the right fit. If you’re going for an interview, don’t be scared to interview the company or practice as well. For example, check they understand the scope of practice of a therapist and that you’re not going to be practising as a hygienist (unless that’s what you want to). Every position I’ve taken, I’ve always had the attitude of what can I bring to this role but also what can I gain from this opportunity.

What do you find most rewarding about being a dental therapist?

Miranda: The most personally rewarding are those patients who have been dentist avoiders for whatever reason. Some have been petrified and in tears and I’ve been able to talk to them about what we can do to make this tolerable, such as taking things in baby steps. Once nervous patients trust me, they completely relax and it was quite hard to tell some of my long-term patients that I was moving on. A close second, has been my voluntary work in Cambodia and helping get kids out of pain, making them comfortable and improving their appearance.

Rachael: When you see a very nervous child who won’t even sit on the chair and you spend weeks on acclimatisation, getting to know them, letting them pick up the equipment and explaining what it does. There’s nothing better than being able to finish their treatment and seeing them return with a big smile on their face and thank you card.

What personal qualities do you need to be a dental therapist?

Miranda: Being adaptable. You might have a plan for what you want to achieve but perhaps the patient has changed their mind, you might not be feeling at your best or there’s a problem with the equipment. You need to be able to stay calm and professional to come up with a new plan and not berate yourself if the appointment doesn’t go exactly as you want to.

Communication skills are so important too and there are a lot of similarities to my previous life in entertainment: when you step out on stage, you have just a few seconds to convince your audience that you are worth listening to and to build trust. The same applies to building a rapport with patients.

Finally, you need the self-awareness to work within your scope of practice and level of competence. You’ve got to ‘know what you don’t know’ and have the confidence to say no. For example, if a dentist asked me to fit a stainless-steel crown, I’d say no, because I haven’t done that since university. Even though it’s within my scope of practice and I would be indemnified, I can’t say that I’m competent or confident, which is even more important.

Rachael: Communication skills for definite but also good time management and organisation and being an effective team player. I’d also say empathy is really important. It’s easy to tell a patient what to do but it’s no good just wagging your finger. You need to be able to understand their personal circumstances and put yourself in their situation to get to the root cause of why they are struggling and really make a difference.

What would you advise anyone who is training to be a dental therapist?

Miranda: Above all, have compassion for yourself as well as your patients. A lot of dental therapists are perfectionists but sometimes the gold standard isn’t achievable, and you should be happy when you have done the best you can for your patient. Of course, you need to be upfront about mistakes and reflect on your practice, but you also need to be kind to yourself.

My other top tips are:

• accept that you won’t click with everyone you meet and that’s OK
• the more you put into your career the more you’ll get out of it, so keep your eyes open and say yes to interesting opportunities that could enhance your life
• get out there - join professional organisations and go to conferences; mix up your CPD rather than reverting to online courses only
• ask for advice if you need it – talk to peers and colleagues, phone the DDU for dento-legal advice – it won’t affect your subscription
• professional isolation can be a problem. Make an effort to talk to your colleagues; don’t wait for them to knock on your door or just go and eat lunch in your car.  

Rachael: If your goal is to work in a dental practice, that’s great, but be aware that there will be so many different opportunities out there for you. Throughout my career, I’ve always been ready to move on when I feel I’ve reached the limits of a role. It’s always been on good terms, but I enjoy developing my skills and knowledge in different areas.

Keep asking questions – I still do this after 17 years as a therapist – and invest in your personal as well as professional development. Paying attention to your CPD, your health and wellbeing and working on skills like communication and leadership will ensure you are the best you can be for your patients and colleagues.  

 

Resources for dental therapists  

• British Society of Dental Hygiene and Therapy (BSDHT)  
• British Association of Dental Therapists (BADT)
• College of General Dentistry - open to all members of the oral healthcare team
• British Society of periodontology – open to dental therapists and hygienists
• British Society of Paediatric Dentistry – open to DCPs
• NHS dental therapy careers – careers information and live vacancies
• About BASCD - useful for those who work in the Community setting - useful for those who work in the Community setting 

 

The DDU is here for you as a student and throughout your dental career. Visit the join DDU pages to explore the benefits of membership now and beyond graduation.

Need help? Contact us

Student members can contact our dento-legal advisers for support or call us on 0800 374 626 between 8am and 6pm Monday to Friday

 

 

 

 

This page was correct at publication on 12/11/2025. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.