In the latest of World Dental Reporter’s regular feature articles on dentists and dental professionals throughout the world, we focus on Romanian entrepreneur Dr Luana O’Connor, and how she overcame the challenge of securing a place at dental school in Bucharest and now hopes to build her HappyDental practices into an international brand associated with dental excellence.

Luana O’Connor (the Irish-sounding surname is that of her Irish husband, who met Luana in Romania where he was setting up a software company) runs HappyDental, which consists of a practice with three surgeries and four dentists in Ploiesti, and a smaller practice with one surgery and two dentists in rural Gornet, half an hour away. Ploiesti, an oil town and location of one of the leading oil universities in the world, is an hour from the Romanian capital, Bucharest, and has a population of about 230,000. In an average week the Ploiesti practice sees over 150 patients while the rural practice sees over 100.

Initial training
O’Connor qualified as a dentist in 1998 from Titu Maiorescu University in Bucharest, the culmination of a difficult journey to achieve her ambition, particularly since her studies took place in the decade following the fall of communism in Romania in 1989, with all the confusion that that entailed. When she applied to dental school there were 20 applicants for every place, and it took three years and three applications before O’Connor was finally accepted onto the course.‘In Romania many parents drive their children in the direction of medical training, so the demand for university places is high,’ she explains. ‘In addition, the Titu Maiorescu University had a high reputation and provided  an excellent level of training.’ O’Connor believes that her determination to secure a place in dental school showed that she was dedicated to training as a dentist and that she was seriously committed to her future career.

O’Connor claims she was attracted to dentistry firstly as it didn’t involve any mathematics which she didn’t like at school, but more importantly because she felt that not only did she have good manual dexterity but also she wanted to work in a caring profession ‘without being in the confines of a hospital’.‘Working with people was my goal,’ says O’Connor, ‘but in an environment that I could influence and control.’

O’Connor was not alone in her happiness in starting dental school: ‘I loved the camaraderie among the students in my year. You could feel the positive energy every time you entered the classes and I really enjoyed that.’ One of the biggest thrills for O’Connor, however, was finally being able to work with real patients: ‘at that point you felt that you had truly come a long way,’ she says.

The challenges of her studies were numerous – for her family too. The university was private so all tuition fees had to be paid by her parents, who took on extra jobs to support her through the six years of study.

Within three years of graduation, O’Connor took over the rural dental practice in Gornet, and in 2002 opened the practice in Ploiesti. ‘Having two practices within three years of graduation is moving fast,’ admits O’Connor, ‘but I am a highly motivated person and I thrive on challenges. I believe in moving forward at all times while maintaining the highest levels of care for my patients.’

In the main practice at Ploiesti the four dentists have varied skill sets that include general dentistry, orthodontics and oral surgery. Two dental nurses work with all of the dentists as required, and the lead dental technician from a local dental laboratory visits the surgery regularly when the components supplied by the lab are being fitted. ‘This enables us, as dentists, to provide the highest quality fixtures,’ says O’Connor. ‘It also enables us to make adjustments with the dental technician present so that he understands what is required.’

O’Connor works at the rural practice two half-days a week, assisted by one dental nurse, and another dentist mans the practice for the remainder of the five-day week.
As well as looking after her family O’Connor works on average ten hours a day from Monday to Friday. After a morning team meeting at HappyDental she then sees patients before heading home to spend time with her family and take her two daughters to swimming, dancing and piano lessons.‘Spending quality time with my daughters and husband is truly relaxing for me as they present a different set of challenges to my working life,’ says O’Connor. ‘I am lucky to have two wonderful, intelligent daughters who keep my energy levels high. If I have a spare moment I also love to curl up with a good book.’

Dental care in Romania
The main barrier to accessing dental care in Romania is money. Children under 18 are given free dental care, but there is little or no provision for adults by the government, although they are treated in an emergency. The options are either to pay a premium to an insurance company and choose from a list of dentists where they will receive a discount, or just to pay the dentist directly.

‘The Romanian diet is very similar to the southern European diet – lots of meat and vegetables,’ says O’Connor. ‘There are no real inherent dental issues, but poverty means that people leave their teeth care and dental care to the last minute or until when the pain is just too much to carry on.’
HappyDental is launching its own dental plan for patients where, as a member, the patient receives two free dental check-ups a year, and one free cleaning treatment a year. Members also receive discounts on all general dental work. The plan is aimed at lower income families to encourage them to take better care of their oral health, so O’Connor hopes that many new patients will join HappyDental.

Activities carried out in the practice
At present HappyDental conducts a lot of extractions and fillings where general dentistry is concerned. ‘We love to see children at HappyDental,’ adds O’Connor. ‘This is another key reason I became a dentist, so in our practice we aim to provide children with as positive an experience as we can.’

HappyDental has also seen a growth in cosmetic dental treatments, and specialises in providing implants and Lumineers. We do not provide veneers in my dental practice as they entail destroying healthy teeth,’ says  Dr Luana O’Connor. An advocate of minimally invasive dentistry, O’Connor is the first and only dentist in Romania trained to provide Lumineers. These strong, porcelain laminates, as thin as a contact lens and unlike veneers, are bonded to natural teeth after moderate etching, so there is no removal of sensitive tooth structure. In addition, Lumineers can be removed.

It was O’Connor’s husband Sean who came across Lumineers when researching minimally invasive dentistry on the internet. He knew of his wife’s dislike for the cosmetic destruction of sometimes very healthy teeth to acquire a ‘Hollywood smile’, and undertook some research on alternatives. ‘Lumineers satisfied my criteria of exposing my patients to as little invasive dentistry as possible,’ says O’Connor. ‘I think that this approach and thinking is growing globally, with the patients’ oral health being the priority.’

In 2008 O’Connor travelled to London for extensive training with Den-Mat, who invented Lumineers over 20 years ago. She began providing Lumineers at HappyDental the following year. Today she is being considered by the company to be the Romanian distributor for Lumineers, and is already spreading the word about Lumineers in Romania and online with her Facebook group ‘Lumineers for you’.

However, the take-up of Lumineers by patients at HappyDental has so far been slow; O’Connor knows this is primarily due to cost. ‘ Nevertheless, slowly patients are beginning to come over to Lumineers as in general Romanians are becoming more and more conscious and appreciative of the benefits of having a great smile as well as having healthy teeth and gums. We get at least one enquiry per ten patients about aesthetic dental work, whitening, Lumineers and crowns, which is a huge increase on two years ago.’

Dental tourism
HappyDental has also seen the effects of dental tourism, receiving overseas patients looking for aesthetic dental treatments in Romania at considerably lower prices than in their own countries, such as the UK and Italy. ‘We are also seeing a rise in patients who are looking for general dental treatment as the prices in Romania can be as much as 70% cheaper - and we use the same dental products as our foreign counterparts.’ For example, HappyDental offers implants from only e500 which includes all of the components for an implant except for the finishing crown.

The future
Never one to rest on her laurels, O’Connor is now studying for her Masters in Implantology and will graduate in June 2011. This particular course is the first of its kind in Romania to be recognised worldwide, and O’Connor was one of 20 dentists chosen from over 500 applicants. ‘I felt that with the growth of implants it was best to be as highly trained as possible,’ says O’Connor. ‘I was excited about the technology; it has so many beneficial advantages to the patient as to be almost untrue. It negates the use of appliances such as bridges that can otherwise damage healthy teeth, and the patients can be given exact fittings, which enables them to keep their teeth healthy.’ O’Connor completed the additional training required by the Romanian dental authorities to start implant treatments two years ago and was then invited to take the Masters after proving she was skilled in this particular area
of dentistry.

It is clear that O’Connor is also remarkably skilled in juggling her diary and maintaining a good work-life balance, and says that her secret is patience: ‘there is so much to accomplish and time is limited but by being patient you can achieve balance; one key element to this is a partner who encourages me to achieve my potential one step at a time.’  O’Connor’s biggest ambition is to be remembered as a caring and professional dentist, and to build her HappyDental practices into an international brand associated with dental excellence. ‘When I set up HappyDental I had a mental image of a space that was relaxed, calming and which inspired patients’ confidence in my professionalism. Ultimately, being able to provide pain relief and dental care for patients is what makes my work as a dentist so rewarding.’