Dr Maria Cockle Cares in Cornwall

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Dr Maria Cockle says “Emergency dental care – it’s tough, but someone’s got to do it

Dr Maria Cockle is an emergency dentist from Smile Together, a member of the Association of Dental Groups (ADG). Here, she describes her role – both the lows and the highs…

At Smile Together CIC, we run community dental services and several emergency clinics across the county. These provide weekday services for any dental emergency through a dedicated call centre, as well as weekend services for bleeding, swelling or trauma. We operate with what appear to be generous appointment times but the twenty or thirty minutes soon tick away when a very anxious patient who has not seen a dentist in a decade arrives with complex oral health problems.

There are many such patients in our area. Yes, we enjoy our work but it can be an uphill struggle because there is a huge demand for our service and there is always the feeling that we are making a tiny dent in a problem we can never solve. It’s tough, but someone’s got to do it!

Luckily, my team and I love the work we do – helping people, relieving their pain and reassuring them. I also like that the job is varied. In one week we might meet farmers, fishermen, tourists, truck drivers, surfers and sailors, and another a poisons expert and someone researching volcanoes. That’s the beauty of being an emergency dentist.

Oral health in Cornwall

In many ways our situation is similar to that in any emergency clinic across the country, but Cornwall has particular challenges. Indeed, contrary to the impression many people form when they visit the beautiful scenery here or enjoy a glass of wine beside a marina full of expensive yachts, Cornwall is a very poor county.

There is an acute shortage of NHS dentists and people wait more than two years to get a place at an NHS practice. Many people cannot afford private dentistry, and in some areas more than 40% of children are growing up in low-income households [1].

The cocktail of poverty, low government investment in dentistry, high rates of drug and alcohol addiction as well as travel difficulties in the county are among the factors which contribute to poor standards of dental health. For these reasons, I spend a lot of time performing extractions.

After my first month here I was horrified to realise that I had carried out more extractions than I had in the entire year previously in general practice. If we carry out pulp extirpations it is almost impossible for the average patient to have the rest of the root canal therapy carried out because of the lack of NHS dentists. Sometimes we end up seeing those patients again for an extraction a few months later when they have tried and failed to find a GDP.

Job satisfaction

Job satisfaction comes from the knowledge that we are doing something worthwhile for the people who need us most. On good days a spike of job satisfaction appears every half hour like the peaks on a heart monitor graph. This is very different from my experience in general practice where I worried about meeting patients’ exaggerated expectations of cosmetic treatment.

In my time here I have found a renewed enthusiasm for dentistry by focusing on core issues such as pain relief and treatment of infection. Such work is not for everyone as the focus is narrow and it’s easy to lose skills in other disciplines of dentistry, so it’s important to maintain wider professional interests through courses and CPD. The Smile Together Training Academy is invaluable in this respect.

As a community interest company we have a duty to plough our profits back into our local community. Such outreach activities take a variety of forms, like setting up tooth brushing clubs and oral health programmes in primary schools as well as engaging with hard to reach communities. In the last two years we have used a mobile dental unit to carry out treatment for disadvantaged groups, homeless people and for fishermen.

Because of their work patterns fishermen often find it difficult to access dental care and their general health can be worse than the general population. This summer, with funding from The Seafarer’s Hospital Society, the loan of a mobile dental unit from Community Dental Services in Bedfordshire and working in partnership with the Fishermen’s Mission and Healthy Cornwall, we took a ten-day tour of fishing ports in the South West.

We carried out emergency treatment and oral cancer screening for fishermen, 70% of whom had not seen a dentist for five years, according to our internal statistics.

I consider the chance to go out and meet people one of the perks of the job, and after a hot, sweaty day in the mobile unit to step out onto a beautiful quayside and take a refreshing swim. As I said, it’s tough, but someone’s got to do it!

For more information about the ADG visit www.dentalgroups.co.uk 

1] Cornwall Live: Find out how bad childhood poverty is in your Cornwall neighbourhood. Published 12 Feb 2018. Accessed online 4 October 2018 at https://www.cornwalllive.com/news/cornwall-news/bad-childhood-poverty-neighbourhood-cornwall-1195165

Body text photo by Adam Gibbard