What Britain’s ageing population means for the future of dentistry

From falling birth rates to rising living costs, Britain’s population trends are transforming the profession. David Willetts discusses what these changes mean for dentists, patients and policymakers alike.

Tell us a little about your background and the areas you’ve focused on during your career

I’m president of the Resolution Foundation, a Westminster think tank focused on living standards. I also sit in the House of Lords, and previously served as a Member of Parliament, including as Minister for Universities and Science in David Cameron’s coalition cabinet. That experience underpins my continuing interest in higher education, about which I wrote A University Education.

I’m very interested in science and technology, and I’ve also written about demographics and generations. I wrote a book about fairness between the generations called The Pinch, arguing that the younger generation were having a raw deal compared to the opportunities enjoyed by my generation, the baby boomers. Quite a few young adults buy The Pinch to give to their parents at Christmas – often as a reminder that the ‘Bank of Mum and Dad’ perhaps ought to help them out a bit!

In The Pinch, you explored generational fairness and demographic change. What conclusions from that work do you think are most relevant to dentistry and healthcare today?

I’m very interested in demographic change, which has a huge impact on society, and in fairness between the generations. Part of the promise of a modern economy is that each generation should be better off than the one before – that’s part of the deal, if you like, and something every parent hopes for their children.

That’s very relevant to dentistry in several different ways. Dentistry is a great example of how modern society can deliver on that promise through fluoridation.

Thanks to fluoridation, people under about 55 generally have better dental health than those who grew up without it. If only more social and economic measures showed such clear progress.

The post-war baby boom saw two peaks – in 1947 and 1964 – with over a million births each year. You can track those cohorts through society like a python swallowing a pig. Soon, nearly a million people will reach 80, the largest number Britain has ever seen – and most grew up before fluoridation.

A second surge in the mid-1960s is now reaching their 60s and beginning to retire. But if you look right down at the younger generation, we did have a mini baby boom in the early 2000s, peaking at around 800,000 births in 2011–2014. That’s now feeding through into more teenagers, with implications for schools, university places and dental care.

But after that came a very big fall in the number of babies being born. That means fewer very young children, anguished debates in local areas about whether all the primary schools can stay open, and in some cases possible closures.

Given these demographic shifts, what do you see as the main opportunities and challenges for dentistry in the years ahead?

There are clear changes in the way dentistry is delivered. One is the growth of corporate structures rather than individual practices. Another is the gender shift: more women are entering dentistry, reflecting a broader trend across the professions.

Behind that is a surge in the number of young women going into higher education – significantly overtaking men. Educational and professional opportunities are now being taken more by young women than by young men, and that affects the character and the way in which dentistry operates. There are some big trends here, of which dentistry is a part.

I’m also interested in how technology can improve public services, however – and dentistry is one area where technological advances can be tracked very clearly.

It shows how high-quality care can be delivered while managing costs, through innovation and new approaches – dentistry is a great example of a profession with a continuing drive to innovate and do things differently, without assuming the old ways are automatically the best ways.

What do you see as the biggest priorities for leaders in dentistry to focus on in adapting to these changes?

An ageing population is a major challenge for healthcare in general, alongside changes in the environments where people live.

Secondly, there is the wider problem of living standards, which we focus on here at the Resolution Foundation.

Sadly, since the financial crash of 2008, living standards in Britain have been doing badly. It’s been a problem across advanced economies, but especially since Brexit, Britain has done particularly badly, with little significant improvement.

That matters because many people are paying for their dentistry privately. There was often an assumption that prosperity would keep rising, that people could afford higher bills. But that assumption doesn’t hold. Patients may not be able to pay as much as hoped, and there are still many people on low incomes for whom NHS dentistry remains vital.

So for those people leading dental practices and businesses, is it essential to understand these wider pressures in order to grow while still meeting patient needs?

Yes. Dentists need to understand these pressures: the changing age mix of patients; the benefits of fluoridation for many; financial constraints; expectations of technological progress; and the continuing need for NHS access for those who cannot afford fees. These are all wider social trends, and they shape how dentistry is delivered.

You’ll be speaking at the ADG Conference in November. What themes will you be exploring there, and how do they connect to dentistry?

I’m very much looking forward to speaking at the ADG Conference. I’m not an expert on dentistry, but I am interested in the big trends that influence it. I’ll be talking about demographics and the different deal that different generations are experiencing.

We at Resolution Foundation are very focused on living standards, with a tough story of barely any increase in recent years. I’m also very interested in regulation and in how we encourage new technologies. I hope those themes will be relevant to dentistry, as they are to many other professions.

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