Miranda Steeples: ‘I believe we have much to celebrate'

By Kate Quinlan

Miranda Steeples, BSDHT President

Introduction

As BDJ Team celebrates its tenth anniversary in 2024, to mark the occasion we thought we'd catch up with some important people within dentistry to reflect on the past decade and look forward to the next.

This month we meet Miranda Steeples, President of the British Society of Dental Hygiene and Therapy (BSDHT) 2022-2024. Miranda has been practising as a dental hygienist and therapist since 2010.

Interview

What originally led you to a career in dentistry?

Miranda: I have one of my oldest friends to thank for my career in dentistry! Her name is Lydia and we went to school together. She always knew she would be a dentist and she persuaded me to try my hand as a trainee dental nurse. I had previously been working in entertainment as a dancer and singer, and at that time was working as a bingo caller - so quite a change! I found that I enjoyed studying and learning new things, and, despite being a night owl at heart, it was never a chore getting up early to go to work at the dental practice. My tutor at college was inspirational and really pushed my friend Mhairi and I to excel, and we sat our dental nurse exam early. By then, I was also working with the dental hygienist, Sharon, and between her and my dentist, James, they talked me into to applying for a place to study dental hygiene and therapy. I doubted my ability, they didn't, so to get them off my back I applied, and got a place at Leeds University. The rest, as they say, is history!

Miranda playing Cinderella in 1998

What was your relationship with oral health like growing up?

I always went to the dentist growing up, and one of my earliest memories was that my deciduous lower right lateral incisor and canine came through joined together, each roughly half-sized, and in the space of just one tooth. I recall my dentist being very excited by this and having an x-ray where we found there was just one tooth underneath. To this day, it is not clear what tooth it is, but nobody seems to notice that I'm one short on the lower anteriors!

Miranda with dentist James Dawson in 2007 before she left to go to the University of Leeds

Looking back to 2014 when BDJ Team was launched, what was your working situation at that time?

In 2014, I was working full time across a number of different dental practices in East Sussex, mostly within the scope of a dental hygienist, with a little bit of dental therapy restorative work as well. Ironically, 2014 was the second time that I had travelled out to Cambodia with Lydia and others to offer dental care to children there on a voluntary basis. So, I was already doing direct access there: examining the children, charting, formulating a care plan for them and just doing it!

Were you already involved with the BSDHT?

Yes, I had been a member since I was a student and had maintained it. 2014 was the year I became the Regional Group Treasurer for the South East Regional Group.

I believe that part of being a professional is belonging to your professional organisation and being a part of something bigger.

Back in 2014 do you think you could have imagined that you would become BSDHT President?

Absolutely not! That was never on my radar. I joined the Society because I felt like it was the right thing to do, and I still do. I believe that part of being a professional is belonging to your professional organisation and being a part of something bigger. That was where my motivation for becoming more involved with BSDHT came from. In 2014, I was feeling like there had to be more to life, to working life, than what I had; I wanted to try and make things better for my profession. I have always been quite outspoken and will say what I believe to be the right thing at the time, so I believed it made sense to do this in a group where we all basically feel the same and could come together as one voice. I don't always get it right, but it always comes from the right place, with good intentions. And that's why I stood for President, to try and do the right thing by my professions, and to try and make things better.

Had the creation of Direct Access had any impact on your working situation in 2014? Has it since?

I would not say so in 2014, though it has done since. Mostly in the sense that when I have moved on from practices and then patients go on Google and can find me at another place. It's always such a compliment when you see a familiar name on the day list and they come in all delighted to have tracked me down. I'm always so flattered that they make the effort to do this. Direct access gives patients the flexibility to see the clinician they want to and when they want to.

What do you think are the most significant developments within dentistry over the past ten years? Most recently of course, it has been announced that dental hygienists and therapists will be able to supply and administer certain types of medicines without dentist sign-off.¹

Within the past ten years, since direct access, things have really changed for dental hygienists (DH) and dental therapists (DTh) in the last two years. It was announced that we could also see patients under direct access in the NHS system as well. This gives NHS patients the option to see a dental professional for an oral health review and for some of them, seeing a DH or DTh will be a great option. This spring has seen us be able to apply for a Personal Identification Number so we can open and log a full course of treatment on the NHS, which will make it easier to track how much work is being done by DH and DTh. Finally, yes, the approval for the Exemptions Legislation has been a long journey for the past 11 years and it is wonderful to see this finally realised. We are waiting for final sign off from parliament and then there will be some education to follow before this mechanism can be used, but I am hopeful this won't be too far away now.

What developments within dentistry do you hope to see evolve or emerge looking ahead to the next ten years?

I hope to see even more collaboration and team working between the different dental professions. DH and DTh now have the authority to work to their full autonomy for the benefit of patient and the public, and now just need favourable, supportive conditions to be able to do this. Our colleagues need to have a full understanding of what we are able to do for patients and to appreciate this and trust in our abilities.

It would also be great to see that, if we are undertaking more of the NHS dental work, that we are also treated equitably with our colleagues who are dentists in being able to access the NHS pension.

I would like to see more of us going into further education and professional development, such as MSc programmes, or learning and developing more skills to enhance patient care. Anything to raise our profile and develop our profession has to be a good thing! I would like to see all the dental professions being encouraged and supported to work to their full skillset, and be treated and to feel like we are all valued members of the oral healthcare team.

Have you enjoyed your tenure as BSDHT President? I have seen your ‘Miranda on the move' posts on social media. What have been the most memorable occasions as President?

I have had a wonderful time and have loved every minute of it. It has been such an honour and privilege to serve the Society and my professions, and to use my platform to try and make things better for us, that has been at the heart of all that I have done these past 18 months. I would say that the most memorable occasions are when I have been out and about presenting on behalf of the Society. It takes me back to my entertainment days, and I enjoy the buzz of being on stage and having the opportunity to spread the word about BSDHT, about being a DH and DTh, and how brilliant we all are!

Are you pleased with what the BSDHT has achieved for the professions it represents in recent years?

Yes, absolutely, we have played an instrumental part in working with BADT and getting the Exemptions work across the line. We are present at as many meetings as we can be, reminding the people in the room that we are very much there; we respond to consultations on behalf of the Society and the professions; and have representatives taking part in other pieces of guidance work with other organisations, such as BSP and SDCEP. We have continued supporting members with educational opportunities in different formats (journals, webinars, and face to face study days and annual conference). We have our Coaching and Mentoring programme, and provide ongoing support both personally and professionally as needed.

When you hand over the baton, what will you be keen for the next President to focus on?

I think it will be continuing the good work that Diane Rochford started, and I have continued, with being present and visible, and by maintaining our relationships with other organisations and our collaborators within industry.

Will you miss being President?

I think I will miss it very much! It is hard work sometimes, all-consuming, as Diane always used to say to me, ‘it is a role not a job', and you have to accept the time and focus it requires. However, the positives far, far, outweigh any negatives, there will always be negatives, but the opportunities I have had, the lovely people I have had the chance to meet, have all been wonderful. I have come to realise that I am a better clinician now I do it part time! It is hard work treating patients five days a week, for me anyway, and I think I am a happier clinician now I am not doing it every day. I have enjoyed the variety that being President brings: the meetings, the presentations, the writing of articles, letters, guidance documents, and the conferences and socials; it involves a lot of being ‘on the move', but I do love it!

Do you have any exciting plans coming up that you'd like to share?

I was really honoured to be invited to be an Ambassador for the Mouth Cancer Foundation recently, so I hope to be able to do some work to support them, either with fundraising, writing or presenting, to use my skills to help support their work. I have a few other ideas up my sleeve, but nothing is confirmed yet! I still have six months to go, so who knows what else may present itself in that time? I am feeling quite relaxed about this, and open to future opportunities that might be enjoyable and that I can do a good job at.

How can we make things better within dentistry? How can we improve access to care for patients? We can start from within, being kind and supportive to each other, within every single dental practice or workplace.

We read in your regular BDJ Team column that the BSDHT is celebrating 75 years on 6 July 2024² and regional groups are undertaking 75 hours of community support, or voluntary work. Can you provide us with an update on this?

There is a wide variety of wonderful things that members are doing: there are people who volunteer with their cub, scout, guide, and brownie groups; someone who works with a hedgehog rescue; another member who helped create a playpark in their local village; someone who works with rescue teams for people in distress at the coast; some charity marathon runners; and people who give blood. All these things are brilliant to hear about, and the other sides of this project are to raise awareness of our professions in people's communities, to help show that we're not just about teeth, and also to shine a spotlight on the small local organisations that may benefit from having a spotlight on them to help raise awareness of them as well. I am hopeful that our First Smiles initiative, which is kindly supported by Oral-B, will also contribute to this, and that we may be able to get volunteers to go to 75 schools this year!

BDJ Team Editor Kate Quinlan with Miranda at the launch of National Smile Month

Do you think the future is bright for the oral healthcare team, despite the crisis within NHS dentistry and other problems affecting dentistry in the UK?

I do, yes. There is certainly low morale across the oral healthcare team, and so much negative press at the moment. I'd like to see us look for the positives which are out there - dentistry has never really been noticed before. People, the media, the government, haven't really paid us much attention before, but now they are, now they are listening, and so it is the perfect opportunity to not keep stating what the problems are - they are well-documented and known - but to start to offer solutions. How can we make things better within dentistry? How can we improve access to care for patients? We can start from within, being kind and supportive to each other, within every single dental practice or workplace. Choose kind and reasonable communications and treat colleagues respectfully, working together and not pulling in different directions when we all want to achieve the same outcomes. Certainly, within the DH and DTh professions, I believe we have much to celebrate, barriers have been lifted which have inhibited us before and there is a move for us to be able to work to our full capacity and capability. We need to take these opportunities and run with them: let's see how far we can go!

Thank you so much Miranda for contributing to BDJ Team over the last couple of years, and congratulations on BSDHT's coming anniversary!