A mobile dental unit is helping fishermen in Cornwall and Devon look after their teeth, as KIRSTIE NEWTON discovers the coastal dentists.

It’s a sunny autumn day in Padstow. Blue skies frame the yellow sand bars of the Camel Estuary, and a splash of purple adorns the harbour wall. The striking mobile dental unit run by the Smile Together team is doing steady business, its presence carefully timed to greet fishermen as they return from a morning’s work.

As it turned out, it wasn’t such a great fishing day, the waters being lumpier than expected. Consequently, the dental team aren’t as rushed off their feet as they were in Mevagissey, Newlyn and Newquay (and over the border in Brixham, on the south Devon coast). “The guys are probably working on their boats or mending their nets,” says Fisherman’s Mission officer Mike Dale, who works closely with Smile Together to ensure the touring surgery reaches as many members of his community as possible.

These are folk for whom the conventional appointment system doesn’t work. “If they haven’t been able to fish for a while and a trip comes along, they will jump on that boat – and could be away for seven days at a time,” Mike explains. If that means missing an appointment made six months earlier, so be it – paying the bills and feeding the family comes first.

The knock-on effects are predictable. Poor oral health can result in toothache at sea, which can have a negative impact on concentration and compromise safety in what Mike describes as “the most dangerous occupation in peacetime Britain”. He recounts tales of DYI dentistry – tooth extraction with pliers, or the use of table salt to numb the pain.

This is why fisherfolk must have an ENG1 seafarer medical fitness certificate to be able to go to sea. The checklist includes BMI, cholesterol levels, blood pressure…and dentistry. The Fishermen’s Mission’s SeaFit programme aims to help them stay healthy by making appointments as easy as possible, in the most popular fishing hubs.

“It’s all about keeping them fit so they can go to sea,” says Mike. “They are all self-employed, so if they don’t work, they don’t get paid.”

Enter Smiles At Sea. Since 2017, this award-winning programme has been delivered by Smile Together Dental CIC, working in partnership with the FishMish and the Seafarers’ Hospital Society. Smile Together is commissioned and funded by the NHS to provide urgent and emergency dental treatment: “If you dial 111 with a dental emergency, you will get put through to us,” says project lead Joy Callender. “The idea is to keep people out of A&E where possible.”

It’s a service in real demand due to current pressures on the NHS, with many people struggling to register with an NHS dentist and waiting lists in the private sector too. Smiles at Sea offers fishing families procedures from scale and polish to permanent fillings and simple tooth extraction, with referrals through NHS routes for more complex oral surgery.

Dentist Jamie Robbins and dental nurse Hannah Lodwick have been kept busy in Padstow: “Nothing too drastic,” says Jamie, “mostly broken teeth and decay, belt-and-braces stuff.” Everyone who visited needed treatment, and crucially, “none were currently registered with an NHS dentist, and had no means of paying for private treatment,” continues Jamie. “It’s a picture pretty consistent with Cornwall in general.”

A typical patient is James Swabey, 31, who fishes for hake, monk and turbot on a gillnetter. Although based in Padstow, he fishes out of Newlyn due to the size of his boat, entailing an hour-long commute each way. “Last week I was meant to be home until Friday, but wound up going out on Tuesday because the weather was good,” he says. “You can’t not go and miss out on the money.”

All this makes it hard to make and keep appointments, and he lost a place at an NHS practice for missing two on the trot. The last time James saw a dentist was three years ago, at a similar Smiles At Sea event before the pandemic; he has been waiting for two and a half years to see one privately. “Each time I was home, it wasn’t convenient – eventually I gave up.”

A wisdom tooth has been giving James some gyp, resulting in a lot of fiddling with cocktail sticks out at sea. The Smile Together team give him advice on how to avoid getting food stuck in it, and refer him for a hospital appointment for more detailed work.

Joy takes him through a survey in which he reveals a habit of chugging energy drinks to get him through night watches. One bottle contains the equivalent of 11 teaspoons of sugar. Again, the dentists confirm that such drinks are popular with the population at large and not just fishermen.

Prevention is part of the cure. There’s quite a village of advice here, including Cornwall Council’s Healthy Cornwall team, the health and social care champion Healthwatch and even the Covid vaccination team, making the harbour a convenient one-stop shop. Harbourmaster Bryn Philips pops in to lend his support: “We do anything we can to help the fishing community, because Padstow is a fishing port,” he says.

While Smiles at Sea is an annual event, Smile Together works year-round with other communities in need, such as supporting Cornwall Health for Homeless pop-ups in Penzance and taking the mobile dental unit to Newquay’s DISC (Drop In and Share Centre) for scheduled appointments and to distribute oral health packs containing a toothbrush, toothpaste, two-minute timer and tips.

The Seafarers Hospital Society is supporting Brighter Smiles financially over a five-year period, in which time all parties hope to see a great improvement in overall oral health. If successful, the charity will consider expanding into other areas where fishing communities are struggling to access dental care.

Certainly in Cornwall, Smiles At Sea appears to be inspiring fisherfolk to take better long-term care of their teeth. “In Mevagissey, several people said they had registered with a dentist as a result of seeing us,” says Hannah Lodwick, proudly. “That’s exactly what we want.”

For further information about Smile Together, call 0333 405 0290 or visit smiletogether.co.uk.

Smiles at Sea 2022 in numbers

  • Five harbourside locations: Mevagissey, Newlyn, Newquay and Padstow in Cornwall, and Brixham in Devon.
  • Eight days.
  • 103 fisherfolk (active and retired) and their dependent family members.
  • 12 per cent hadn’t visited a dentist for five years or more.
  • 37 fillings.
  • Ten extractions/root removals.
  • 25 scale and polish.
  • Ten X-rays.
  • 13 patients referred for further care, including for suspected oral cancer
  • 99 per cent promised to visit again.