Practice Makes Perfect – the problem of supply issues

There is no quick fix for the supply issues we are experiencing – and like it or not, the NHS is not in a strong position when it comes to dentistry, explains Nigel Jones.

Back in 1990, when I first started working with the dental profession, dental plans were viewed warily due to the experience of professional colleagues in the United States.

However, the version of dental plans that materialised in the UK had some significant differences from their US counterparts, such that capitation and maintenance plans are now viewed as a welcome and important part of the UK dental scene.

One of the key points of difference in these plans was in how they were priced. It has been a cornerstone of membership plans in the UK that it is the practice owner who is in control of the monthly fee charged to patients for the plan.

This allows the dentist to factor into the plan pricing variations in practice running costs, as well as oral care philosophy and length of appointments.

In those early days of my career, I was reliably informed this was not the case in the US, where control lay with the dental plan providers who had managed to position themselves as being the best source of new patients for dental practices.


Dental insurance plans were marketed direct to potential patients who purchased the product on the condition that they sought care only from practices that appeared on a preferred provider list supplied by the insurance company. For a practice to feature on that list, you’ve guessed it, the practice had to agree to abide by the fee scale demanded by the insurance company.

In a world in which competition for patients was intense, my understanding was that many US dentists simply had to accept this loss of control over their treatment fees, or risk having insufficient patients to remain financially viable.

By now, I’m sure many of you have worked out where I’m heading with this trip down memory lane, as other observers have commented on parallels with the role of the NHS in the UK.

However, such models only really work where supply exceeds demand. That is no longer the case for dentistry on this side of the Atlantic where the shoe is now on the other foot.

Perhaps it could be argued that the cost of living crisis and looming recession will cause the footwear to change places yet again, given an inevitable dampening of demand for dentistry.

However, despite talk of the wider use of hygienists, therapists and overseas dentists, there is no quick fix for the supply issues we are experiencing and an imbalance in favour of the supplier of dental care looks likely to remain for the foreseeable future.

Like it or not, the NHS is not in a strong position when it comes to dentistry.

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