Articles, Dentistry

Pendulum swings

It was 55 years ago that I was applying to dental schools for admission. I tell you this not to reminisce about the 'good old days' but to give a sense of perspective about how decisions made in one's teens can affect the rest of our lives.

This week dental schools were notified that there would be a 10% cut in student intake this autumn. Those starting in 2014 could be retiring in 2060, one hundred years after I started as an undergraduate. Decisions made now can have long lasting effects.

When ‘the powers that be’ decide on how many students to train they, are trying to estimate how many dentists will be needed to meet demand many years ahead. When I was a student more dentists were needed because people wanted teeth saved, not extracted. They opened a new dental school in Cardiff to meet demand. In addition many young dentists came from Australia, South Africa and Ireland to swell the ranks.

By the time I had been qualified for 25 years, oral health, in terms of caries at least, was improving. So they reckoned they did not need so many dentists and three dental schools were closed, one in Edinburgh and two in London, the Royal and University College. By then we were seeing many more from the European Union thanks to freedom of movement.

By the time I had retired the pendulum had swung the other way. Access to NHS dentistry was the problem and two new schools were built, in Devon/Cornwall and Lancashire, as well as encouraging more immigration.

Now we have under-employed dentists in some places so the shutters are going up again. We also have uncontrolled immigration from the EU and hygienists/therapists who can do many of the tasks which were formerly the domain only of dentists. Estimating demand in five years time is a hopeless task, let alone what demand will be in 50 years time.

We also need to ask why the taxpayer should pay the lion's share of the costs of training dentists. Is it to provide sufficient dentists to staff NHS dentistry? Or maybe to enable dentists to set up in private practice? If the latter, shouldn't they pay for their own training? Before the last election the Conservatives were saying that newly qualified dentists should be made to work in the NHS for a time.

No I have no glib answers. I have seen too many swings of the pendulum. But I return to my original point. The decision to reduce student intake numbers this year could have an affect well into the reign of King George VII.

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