Living the dream!

Dental hygienist and practice principal, Joanne Knox, explains how she came to open Pure Dental Hygiene, hygiene-only practice in Northern Ireland.

Keep it clean signDental hygiene is my passion. Since I was a child it was my dream to be a dental hygienist. I not only enjoy the meticulous clinical work but also building up lasting relationships with my patients and educating people on the need and the benefits of seeing a hygienist regularly.

In 2013 the government changed the rules allowing the general public access directly to a dental hygienist without the need for a referral from a dentist. I saw this as a significant opportunity for hygienists to become a more accessible independent entity and I wanted to be the first hygienist in the country to set up my own surgery.

I was fortunate to work in a practice for many years that was very accepting and proactive in terms of dental hygiene and when the law changed they were supportive and happy for me to pioneer independent access to hygiene care under the umbrella of the practice. This worked well for a time but I increasingly felt I was not truly independent and I wanted more, so I started to look at setting up on my own.

The challenges

I had always wanted a surgery in Coleraine, County Londonderry close to my family and I had seen a building there I felt was ideal. Unfortunately, at the same time my mum was taken seriously ill and caring for her took precedence over everything else so I thought no more about it.

Very sadly my mum died in August 2020, but totally unknown to me she had left money specifically in her will so I could go ahead with pursuing my independent dream. The building I wanted was still available and knowing this is what she would have wanted, I decided to go for it.

Not only was I dealing with the loss of my mum, we were in the grip of the COVID-19 pandemic and just for good measure I also got married! I signed for the building and we started renovation work in October 2020, all under lockdown restrictions. Despite having a focus and an endgame, nothing was ever straightforward. I used to just walk into work and clean teeth but this was now a steep learning curve like no other.

The level of investment needed to set up a practice is significant, especially when you’re starting from scratch. There is also the prescribing issue where hygienists still need a dentist to prescribe drugs – so was it worth the bother? I was very much led to believe it wasn’t possible and that it wouldn’t be worth my while but I wanted control and ownership with quality as the bottom line.

Getting started

Pure DentalOne big benefit of opening during a pandemic is that I was able to build the practice around the needs of the pandemic so the surgery is probably nothing like it would have been if I’d opened two years ago. I have two surgeries which means I can alternate to allow for fallow time, air filtration systems have been installed and there is a ‘donning and docking’ room with a washing machine and tumble drier so all our gowns can be washed and changed for each new patient.

I have no receptionist, just my nurse to assist me and I see one patient every hour on the hour, though this may change as patient numbers hopefully increase. I also have an associate dentist joining me on a part-time basis which will help solve the problem of dentist prescriptions. Post-pandemic I may take on more staff but for now I want to keep it manageable.

Reliability and support

I rely mainly on ultrasonics for my work and for that reason I use the NSK Varios Combi Pro. I love the Varios because of its versatility. It’s easy to move between surgeries, there’s a wide variety of tips available and you can change frequencies and the air/water flow which patients find gentler and easier to manage.

My previous ultrasonic machine from another manufacturer had maintenance issues and often broke down. I’m acutely aware that if my machine goes down I can’t make any money – it’s my bread and butter and one of the most important machines in the surgery. When the old machine needed fixing it had to be sent away; there was no local product support and I could be left without it for weeks at a time and I certainly wasn’t willing to buy two machines ‘just in case’.

Despite this, I originally had no intention of moving to a new manufacturer and I’d never used NSK before. But once I looked at the Varios I knew it was the machine for me. I now get fantastic support from NSK’s local product specialist, Jonathan Singh, who is always there if I need him.

Of course the pandemic has meant there is a new focus for dental practices on scrupulous hygiene measures to protect both patients and staff. I have also purchased an NSK iClave plus autoclave which is ideal for fast instrument sterilisation plus it has a USB data logger which means I can download and store all cycle data for total traceability.

I’m learning as I go about my equipment and I did have a few teething problems but Jonathan has been superb in helping me get through them. It’s so good to have that sort of backup available and I couldn’t recommend it more – NSK’s support to me is priceless.

My dream for the future

Opening Pure Dental Hygiene has been my dream and just a few months in I really do feel I’m living it – I have no regrets so far! My aim is to grow a successful business in which I’m respected and seen as a centre of excellence within the industry, known for the quality of patient care we provide. I want dentists to see the services I offer as an advantage and not a threat and I warmly welcome referrals from any dentist who currently does not offer hygiene services.


Joanne KnoxJoanne Knox
GDC 5893
Company Director and Principal Hygienist at Pure Dental Hygiene NI
14 Sandel Village
Coleraine BT52 1WW
Northern Ireland

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