Dental Tribune International

Interview: “This could be the beginning of a new way we do local dentistry”

By Monique Mehler, Dental Tribune International
July 29, 2021

Fiona Perry, from Perthshire in Scotland, started her journey in dentistry as a dental nurse in the early 1980s, and a couple of years later, she qualified as a dental hygienist at King’s College London. Today, Perry still does the same job but with a significant twist: she is the country’s first mobile dental hygienist. Dental Tribune International spoke to Perry about her passion, what a typical workday on the go looks like and how sustainable dentistry plays into it all.

Mrs Perry, what made you choose dental hygiene as your area of expertise?
I was encouraged by the dental hygienist in the practice where I was a dental nurse. I worked in a busy NHS practice where the clinician drilled and filled. I wanted to be able to tell patients how they could avoid treatment and look after not only their mouths but also their whole body.

Fiona Perry. (Image: Graeme Hart/Perthshire Press Agency)

What is Flying Smiles Mobile Dental Hygienist and how did the idea come about?
I used to joke with my elderly patients about who would look after their implants and bridges when they became homebound or did not have the necessary dexterity. I asked them whether they had told their families that they would need help in cleaning their teeth later in life. About this time, I attended a lecture on dementia awareness presented by Alzheimer Scotland. A video titled The Appointment was shown, and this gave me an idea for my practice. I then left my job to go travelling with my husband and daughter around South America for six months, and the idea grew.

I registered with the Care Inspectorate in August 2020. My practice consists of myself and my husband as my chaperone. He is a translator and works online, so he can work as I scale. I am actually now at the point of actively looking for a dental assistant to help me.

On your website, it says “There is a real need for a more accessible method of delivering good quality dental hygiene”. Can you elaborate on why there is a need and how this lack is noticeable?
In Scotland, there is a government document called Oral Health Improvement Plan which brings to light the growing demographic of people keeping most of their teeth for life but states that there are not the services available to look after them.

At present, dentists are busy catching up with the backlog, as in the UK we had a complete lockdown of dental services for three months. Patients who have not been able to access dental services are looking for alternative ways to have a basic dental assessment and have their teeth cleaned without going to a dental surgery. I provide this for them and then add an individual oral disease prevention plan. Hopefully, this prevents them from needing more complex dentistry and keeps them healthy until they can see their dentist.

In the UK, less than 40% of people regularly attend a dental practice. This can be owing to age, work commitments, or disabilities. For example, if you are a farmer in rural Perthshire, you need to wash, dress and then travel for up to an hour to get to a practice—that can be a headache if you are busy with lambing or calving!

What does a typical workday look like for you?
It has been a big learning curve to run a business after 30 years of being employed as a dental hygienist. Monday is my admin day on which I do the work of a receptionist, keep a diary, follow up on queries, manage my marketing and place orders. I’m not a great social media user so I have now employed someone to take care of this aspect of marketing. The rest of the week consists of seeing patients and sterilising and processing instruments in the local decontamination unit. I have a sterilising unit in my house. I am very flexible and see patients when it suits them.

Routinely, when I am going to see patients, I pack the following in either my hybrid car or cargo bike: a folding dental chair, drawers on wheels for equipment, boxes on wheels for my shop, hand-washing items, uniform, shoes, a hair covering and an emergency bag.

Under UK General Dental Council standards, when doing domiciliary work there is the expectation that the practitioner carries a full emergency bag. This is very expensive and not sustainable as most drugs end up expiring without having been used. I am fighting for this to be amended for my service. My service is just a small part of dentistry, and as yet, I have not needed to use local anaesthetics.

Fiona Perry in full PPE. (Image: Katie Arrowsmith/SLMS.com)

You are very dedicated to the topic of sustainability. Why is this so important to you and how do you manage to practise eco-friendly dentistry on the go?
Environmentally, we are in a global emergency, and we have to consider that in our work setting; therefore, I have completed a course with the Centre of Sustainability within Dentistry and have joined Health Care Without Harm. I use my cargo bike not only to keep me fit but also to show the local village that you do not need a car for short journeys—even with equipment.

I have investigated and sourced eco-friendly products for my dental shop—even small-headed bamboo brushes. I am the only supplier in Europe for these; they are made for the Asian market. Most bamboo brushes are made with heads large enough for giants’ teeth! I continue to look into the sustainability of bamboo and I am considering whether the TePe GOOD range is more sustainable. As a business owner, I can ask my suppliers about their sustainability policy and can ensure that all my products come from a sustainable organisation.

Ultimately, oral disease prevention is best for reducing the carbon footprint. If you are healthy, the planet will be healthier. If I can prevent patients having to have invasive, carbon-rich dentistry, then I am helping the planet.

Which part of your job do you find the most satisfying?
There are so many things which I love about my profession. These include, but are not limited to:

  • seeing patients smile and receiving their feedback;
  • visiting them again and noticing how there is less work for me to do because their oral health has improved;
  • being able to have a chat with those who are on their own;
  • not having any time pressure while doing my work;
  • being my own boss;
  • riding my cargo bike; and
  • looking after the planet.

I also love the fact that other professionals are interested and that this could be the beginning of a new way we do local dentistry.

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