Following Labour’s general election win, Ben Atkins calls for the new government to consult the profession on NHS dentistry reform.
The main thing the government needs to do for dentistry is value everybody’s input. They need to actually understand what our profession and the dental health community needs rather than just paying lip service to it.
As a snapshot of what that might include, the biggest thing we need to do is educate patients and anyone else who is responsible for patients’ oral health. This would need to be fully preventive care based.
You could start with an area such as what counts as emergency dentistry. For example, an overview of the different access points and how to use the system correctly. Patients need to understand what the current rules are, what is classed as emergency care, and how they can access it. My idea of an emergency is not necessarily what counts as an emergency to a patient.
But on the flip side is how to access NHS dentistry and what is classed as NHS dentistry. For a lot of patients, what they want – which is often based in aesthetics – and what they need – which is more health-based – can be poles apart. We need to have standard rules, then we as profession can work with our patients to understand what they want and how we can deliver it.
I believe that we could get the funding within dentistry to work, but we would need to change the rules to be very much based around prevention and behavioural change. For example, understanding what sugar does to our bodies.
Thinking outside of the box
If you want to solve NHS dentistry in its current form, you need to open the doors to more dentists coming into the country and more dentists qualifying. Historically, we’ve closed these doors. I think we can do that very quickly if we get the general dental council to work with legislature a lot faster.
But long term, we need a contract that is fully revamped and empowers the dental team to work with patients rather than just the traditional drill and fill. Dental diseases are fully preventable – we can arrest decay very, very quickly. However we need patients to be aware of how to do that. Our job is to empower those patients in that journey. So a preventive journey is really critical in any contract that we have.
It’s actually quite a simple fix, but they’ve got to listen to our profession. We can’t just keep being negative about the contract. We need to suggest ways to evolve the system, rather than just asking for more and more money. Realistically the funds of the nation are not in a healthy place at the moment, so we’ve got to think outside the box.
Is a core service the future of NHS dentistry?
I struggle with the idea of a core service. I would consider that a continuation of the drill and fill strategy within dentistry – we need to be more radical than that. In theory we can have everything on the NHS, because if you get the prevention right you don’t need to restore.
I get where people are coming from. It’s a lot simpler to say that we could have a simple core service for drill and fill or emergency cover. But that’s perpetuating the idea that we drill teeth rather than healing them. I think we’re a much more intelligent bunch than that.
You just have to look at the preventive journey that we’ve already been on from the 70s when we used to have television presenters with missing front teeth to where we are now. We can go a lot further with prevention, but we need to fund early intervention rather than the drill and fill itself. The drill and fill suggests that we’ve failed in prevention. We just need to get the population to value prevention as much as we do.
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