Christina Chatfield discusses her pioneering approach to hygienist-led dentistry in founding Dental Health Spa, and the impact of the seaside backdrop of Brighton on her life and practice.
Nestled a stone’s throw away from Brighton’s lively seafront, a dental practice breaks all the norms. Dental Health Spa is an innovative hub founded by Christina Chatfield, a pioneer in reshaping the landscape of dental hygiene practice. A dental hygienist, she’s been a catalyst for transforming traditional perceptions about oral health. She is also widely considered something of a trailblazer in the industry.
Christina has lived in Brighton since relocating from Scotland 30 years ago. It’s not her only milestone. Last year marked the 10th anniversary of direct access for hygienists in the UK. Christina was part of the British Society of Dental Hygiene & Therapy and the British Association of Dental Therapists’ lobbying group at the time, which created the future for prevention in the UK.
She celebrated her 60th birthday on Christmas Day 2023. Christina is now anticipating a fresh dawn for her business – but more on this later.
Back to the beginning
Christina’s journey in owning one of the first hygienist-led practices in the UK has been marked by resilience and a deep-rooted passion for her profession.
It began in 1984 when, aged 22 and newly qualified as a dental hygienist (she started in dentistry as a YTS dental nurse), Christina contracted hepatitis and fell seriously ill.
She also unexpectedly fell pregnant with her first child, daughter Lori. Her son Michael came 11 months later, and then her son Ross. She split up from their father when the children were seven, six and four. By her mid-20s, she was a single mum of three.
She admits she’s impulsive, evidenced by her decision to move south to Brighton with the kids (her father and grandmother were born and brought up there) despite most of her family living in Scotland. She’d seen a job advertised in Worthing and promptly upped sticks to leave her hometown for a new life.
‘I had the kids young and had to find the means to support them – that was my driving force. Hygiene gave me a good self-employed life. I didn’t take holidays; I’d work until 8pm on Saturdays and do shifts at a pub. I was quite driven.’
And it is thanks to her ability to problem-solve and push hard in the face of adversity that Dental Health Spa exists at all. Her bravado in challenging the conventional norms of dentistry has made her somewhat of an outsider.
Dismantling that patriarchal pyramid of practice life didn’t always come easy.
A different outlook
Dental Health Spa opened its doors in 2007 when a change in the law allowed dental professionals other than dentists to own and run dental practices.
Its innovate approach focused on preventive care and hygiene services was a game-changer.
Breaking away from the traditional referral-based model, Christina’s vision of marketing directly to patients for preventive dental care transformed how people perceived oral health services.
Situated on Queens Road, the main thoroughfare down to the seafront, Christina believes the location played a crucial role.
‘It was essential for easy accessibility and visibility. Ensuring that potential patients were aware of our services was imperative.’
Financial challenges
But her ideal of a mutual referring service between her and local dentists to keep the business buoyant didn’t happen, and when the 2008 recession hit, managing finances proved challenging.
She explains: ‘At the time, calculations showed that setting up a functioning dental hygiene practice in a prime high street location required a £200,000 cash injection. But how do you obtain funding when your business model aims to challenge the status quo within a massive industry like dentistry, with laws and industry bodies against you?
‘The original funding was achieved by setting up a three-way partnership. The sheer scale of the challenge to succeed proved too much for my partners. Three became two, then two became one when they got cold feet and withdrew. Even the bank threatened to withdraw at one point.’
However, thanks to financial support from friends and family, she managed to buy out her partners to keep the business afloat.
‘Carol, my sister-in-law and business partner, and her husband Phil became guarantors for £16k debt as my credit rating was so poor at the time,’ Christina recalls. ‘A business needs cash flow – without it, good businesses go bankrupt, so credit rating is important.
‘Other monies came from friends and family – without which Dental Health Spa would not be where it is today. I never lost faith in the business model. I knew the law could be changed and it would succeed, which it did in 2013 with direct access.’
Bumps in the road
But even after the relaxation of GDC regulations, the road to success wasn’t without challenges, and Christina faced tough chapters, particularly during the tumultuous times of the pandemic.
During COVID-19, she fought hard for businesses like hers that fell through the gap of government support schemes and established herself as something of a spokesperson in media circles.
She has spoken up for other causes, too. Her dedication to raising awareness about oral cancer and HPV vaccinations for boys has significantly impacted the dental landscape.
She created 500 Miles 4 Smiles with others, an initiative to raise awareness about mouth cancer. One of the group’s first endeavours was to embark upon a 500-mile walk from Kirriemuir, Scotland (her hometown) to Brighton with Sarah Murray as co-driver and Tepe’s Elaine Tilling ever-present with her support. The profession enthusiastically embraced it, with many joining Christina and her colleagues along the route. But the initiative didn’t end there.
Rebranding as Moveit4smiles, they also undertook to climb Striding Edge, Tryfan Cnicht, Blaven, Mount Suilven and, post-COVID-19, Bla Bheinn on the Isle of Skye. And, Christina says, it has created a unique team and made her realise its capabilities.
‘The camaraderie is amazing, and the campaign is only successful because we all bring different skills to the group.’
Something to prove
Christina also climbed Kilimanjaro with hygienist and friend Emma Smith and walked the legendary Camino de Santiago, the challenging pilgrimage across Europe, to continue efforts to raise oral health awareness.
The commitment to walk what is regarded as a highly spiritual journey coincided with Christina reaching the same age as her mother had been when she encountered serious health issues. Once again, personal experiences drove her professional path.
So, where does this indomitable fighting spirit come from?
‘It is probably because of how I was brought up,’ she says. ‘Mum and dad split up when I was nine, and we moved from a five-bedroom house to a council estate. I was determined to make my own path. My drive comes from always having to prove myself.’
Even as a teenager, she pushed hard – she had a paper round, worked as a potato picker (strawberries in the summer) and delivered milk. She had to earn money to buy necessities, including her school uniform.
Because of this and family illness, she vows to live life to the fullest. Her recent commitment to focus on her wellbeing gives insight into what drives her.
Time to reset
She remains the clinical director of Dental Health Spa but stepped back from clinical practice two years ago. The COVID-19 lockdowns and Monday morning anxieties forced her to recalibrate life.
She joined a fitness boot camp and took up cycling and running. Regarding her fitness levels now, she says: ‘I have found my right place with that’. Interestingly, there is a crossover between her passion for getting patients invested in their oral hygiene and engaging with her fitness. ‘More than anything, fitness is about habit forming and behavioural change,’ she observes wryly.
With age, she’s grown smarter about her health. She enjoys fitness training, changed her relationship with alcohol (it’s no longer a stress reliever) and is committed to a digital detox early each evening. But swimming off Brighton beach is what truly floats her boat. It is in the cold waters of the Channel where she feels at home.
The sea is now her safe space and gives her thinking time. She says: ‘A sea swim frees up space in your head. I stopped looking back and now look at the opportunities and adapt and adopt.’
The stretch of the Channel on her doorstep became her solace four years ago. Amid battling anxiety, she was invited to join a community of diehard swimmers, the Salty Seabirds, who gathered every Monday to experience the thrill of an early-morning ocean dip. It provided an unexpected calming effect, and she has not looked back.
Thriving in partnership
Sleepless nights and imposter syndrome plagued her, but another turning point came in the form of Victoria Clark, her trusted practice manager and business and marketing manager.
Anxious that Victoria would find her management style somewhat chaotic, Christina shared her concerns with her soon-to-be partner. But that initial conversation paved the way for a healthy working partnership. Brutal honesty is very much, it seems, ingrained in Christina’s DNA.
She recalls: ‘Victoria came into my life in 2019, a year before COVID. She left during the pandemic and, for financial stability, worked for her brother’s dental practice. As she was self-employed then, no furlough was allowed, although I did try to give her some financial support. After the pandemic, she returned.’
One area in which Christina has been lucky is in those who work with her. Sister-in-law Carol Oram is Dental Health Spa’s director, financial manager and head of HR and has worked there since 2009. Kitija Jaksta hired as a trainee dental nurse eight years ago, is now her full-time assistant manager.
Finding balance
‘Post-COVID, investing in and recognising the importance of management has been key – and helped achieve a better work-health balance,’ Christina says.
Her superpower is knowing when to pivot to adapt to a changing world. Turning 60, she vows ‘not to go into this decade with any regrets,’ which is why rifts have been healed and grudges shed.
‘I’ve learned to let go, forgive and finally move on. All that negativity has gone,’ she says.
As a consequence, this has moved her to a better place. She celebrated her 60th birthday with family and friends over Christmas, sharing a traditional Scottish meal of haggis, neeps and tatties with entertainment from a ceilidh band and a drag queen. Despite her geographical move south, her heart continues to beat strongly for Scotland.
Beyond dentistry
Dental Health Spa will soon undergo a regeneration of its own. A refurbishment will mark a fresh chapter. The décor and branding will change, and they are investing in two new surgeries. The centrepiece will be a mural showcasing the work of celebrated Brighton artist Lois O’Hara.
Christina says: ‘The focus of the clinic will also shift a little to embrace wider health issues such as mental health, systemic health and endometriosis – issues that are close to my heart. If patients can find something within your working environment that they relate to beyond their dental health, it can ignite a spark.’
The benefits of stepping back from Dental Health Spa – arguably tricky when she lives above the clinic – grants her opportunities to ‘be more present for my family’. Something she feels has been lost over the years.
As a mum of three and a businesswoman, life hasn’t always been kind to her, but she is an optimist prepared to seize the good things in bad times. ‘As awful as it was, COVID-19 allowed me to step back in a way that patients would not have otherwise accepted,’ she says.
Now that Dental Health Spa is entering its next chapter, Christina can finally enjoy its success. But does this slowing down mean the maverick in her has been tamed? With a new dawn comes another dip in the ocean – and fresh ideas – so one suspects the answer is probably not.
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