Why Ohh! hygiene-only practice is leading the way in the promotion of oral health and preventing disease

Jacqui Armstrong is the owner of Ohh! Oral Health Hygienist Ltd., her hygiene-only practice in Cumbernauld, North Lanarkshire. Here, Jacqui talks to Siobhan Kelleher, Clinical Support Advisor for NSK about setting up her practice, the challenges she has overcome and why she believes that stand-alone hygiene practices are going to be the future for promoting excellent oral health and preventing disease.

SK: It’s lovely to meet you Jacqui and for you to enlighten us about your journey so far in your fabulous new practice Ohh!

So, in 2013 the government changed the rules allowing the general public to access a dental hygienist directly without the need for a referral from a dentist. What are your thoughts about this and how did you see this as an opportunity?

JA: I was really excited about this change and I thought it would be a great platform to have a new direct access model. In 2013 I was working for a large corporate and although the chief executive asked me about direct access, the head office was against it; they thought it was a mistake, that it shouldn’t be allowed to go ahead and were not keen to promote the idea. However, after a long discussion the chief executive did eventually change his mind about direct access, but to this day I still don’t think it’s fully understood by the profession.

It is not always understood, or in some cases, still not deemed acceptable by other dental colleagues who perhaps don’t fully understand how qualified we are as hygienists and therapists, in diagnosis, in promoting health and preventing disease, oral cancer screening and our unique role in the care of the patient. I think unless there is more education about that at grass root level in dental training, we are never going to get the message out there.

We are no longer there to just help dentists, we are stand-alone, highly trained professionals in our own right. We were given direct access, it gave us our wings to fly and then tethered us to a post with lack of  prescribing rights, which hopefully is now about to change. How can you grant Direct Access but still we are not allowed to make educated decisions on the basics of fluoride application or local anaesthetic?


SK: Dental hygiene is clearly your passion.

JA: I’ve never thought of it as just being dental hygiene. My mantra since I’ve become a hygienist is really about whole health, not just oral health. The mouth is on top of the gut, the entrance to the digestive and the respiratory system. Over 90% of systemic disease is strongly linked to the health of the mouth and gums. I see it about educating patients to make them healthier, promoting health, preventing disease with every patient’s treatment tailored to them. And now having my own practice, I’m able to really embrace that.


SK: When you were setting up, what challenges did you face and what are the challenges maybe that you see going forward?

JA: If you ask any hygienist or dentist who has opened a squat practice, you have to be slightly mad to do it. The challenges are immense but they are worth it. My biggest challenge wasn’t really the setting up of a squat practice because I know what I was taking on. My issues were when I reached out to the trade, to set up my account and organise supplies of my own stock. There appeared to be a lack of awareness that as a dental hygienist I could open my own practice; I was asked how many dentists I was employing or how could it possibly work without a dentist and there seemed to be little understanding of patient group directives (PGDs). It is still a battle even now but hopefully it will get easier now more hygiene-only practices are opening.

It is very difficult opening your own practice and I think you’ve really got to want it. You also need the right team behind me. I’m in an extremely fortunate situation because I have a very tolerant husband and three daughters who all know how much I love my job. They are the basis of my team alongside my dental nurse, Levi, who has worked with me for a number of years – they are all cheerleaders in the background, pushing me on.


SK: Tell us about the equipment you have in your practice. I believe you use some NSK equipment so why did you choose to use NSK and what are the benefits to you?

JA: I love NSK for a number of reasons. I’ve been using the NSK Prophy-Mate since I first trained as a hygienist and since then I’ve never been without one. Why would you want to do a basic scale and polish when you have this amazing piece of kit which patients love and that excels in its promise to remove tooth surface deposits and staining?

NSK’s rep for Scotland is Angela Glasgow who is absolutely fantastic. She is like Wonder Woman for anything you need and she is always at the other end of the phone. I’ve had a few incidences when my handpiece has had to go in for repair and being self-employed it’s devastating if my full clinic is at jeopardy because we don’t have enough handpieces to get through the day. Angela is always there on her white horse with loan equipment to save us.

I have lovely relationships with lots of dental suppliers and their reps, but I have to say NSK customer service is second to none. Plus I love the equipment. As well as the Prophy-Mate I have the Perio-Mate biofilm eraser and the Varios ultrasonic scaler which I changed over to from the Cavitron. The feedback from the iPiezo engine in the Varios is amazing. The clarity from the LED optics when you’re working around the teeth is just fabulous and the feedback tells you when something isn’t right on the surface of a tooth. It’s a terrific bit of kit to have in my hand and I don’t know now how I would work without it.


SK: What more do you think could be done to encourage patients to adopt better dental health?

JA: We could do a lot more through the media – not just with incentives such as National Smile Month but by educating the public on the effects of oral health on systemic health. However, I firmly believe that the change has to start within the dental profession as a whole. Dentistry to me does not put enough emphasis on promoting oral health and preventing disease and there still needs to be a big shift in attitude as to the role of the hygienist and therapist in a dental team. Hygienists and therapists are educators, so I would ask dentists out there to let us educate your patients as a dental team focused on prevention and oral health.


SK: You are certainly paving the way for others. What would be your message to somebody wanting to start their own hygiene practice?

JA: Just start! There’s never a right time, you’ll never have enough money in the bank – you just have to do it. There are hurdles, but they’re jumpable. A few of us have now done it so if anything, we’ve done some of the hard work for you. You won’t be the first, there is somebody out there who’s already done it so the precedent is set. The more who do it, the easier it will become because it will become the norm. It is hard work, but the benefits far outweigh the hard work. You will get to a point eventually when it’s all been worth it.

Listen to this interview in full here.


Jacqui Armstrong - Principal Dental HygienistJacqui Armstrong – the journey so far

My journey to Ohh! has spanned over 30 years in a diverse career in dentistry within the NHS, private sector, hospitals, the Royal Army Dental Corps, teaching and specialised roles. Overseas charity work with Dentaid (providing services in Uganda) and more recently studied with the renowned Botulinum Toxin Club (BTC) – botulinum toxin and dermal fillers, Dr Tim Pearce – Mastering Complications in Aesthetics and Lip Masterclass, and Annette Matthews (W Skin by Skin Smiles Success), guru of all things Skin Science and beyond!


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