President's Address 2010-2011

Looking back over my career and if I include my student days I have spent over 50 years in dentistry, hardly believable, and I am led to wonder where we are now compared to where we were then. Some comparisons are relatively easy in that in those days we used boiling water to “sterilise” re sharpened, used needles for local anaesthetic. Surgical gloves did not exist for dentistry, hand pieces may be got a wipe - how different things are today!

Caries was rampant and many people lost their teeth through “pyorrhoea” as we didn’t understand periodontal disease at all. Amalgam was the filling material of choice and if we were feeling aesthetic the odd silicate filling got done at the front. We were good at making acrylic dentures, lots of these, as they were easier to produce than the old vulcanite dentures that had just slipped into history. We also had enough understanding of lumps and lesions in the mouth to know when to refer them.

Of course the advances in dentistry over the 50 years have been enormous. From the aetiology of dental disease to cross infection control, from implants to composite filling materials and from all gold restorations to all ceramic restorations everything is better, brighter and based on sound scientific principles.
 
 The cutting edge may have changed but basically we are doing the same job now as we were 50 years ago. Then we were filling holes and spaces one way or another to restore masticatory function and to a certain extent restore some aesthetics, and now we are doing the same thing, nothing has changed – it’s all far more sophisticated agreed, but basically, we are still filling holes and spaces and restoring function. We have just found different ways of doing the same job.

With the understanding of the aetiology of dental disease we have managed to improve the dental health of many of our patients educating them along the way and helping them to take responsibility for looking after their own mouths. However within the population at large both caries and periodontal disease are a long way from being eliminated and we would have to say the public are far from beating a path to our doors for us to rid them of their disease and have function and aesthetics restored.
50 years ago only 50% of the population ever visited a dentist on a regular basis and the figures for today are much the same. The rest get by with occasional visits for pain relief.

It would seem we have come to a cross roads in British Dentistry in which we have to decide what are the basics needed to remove disease and restore function at the most affordable level for the patient, for the government and the taxpayer. This is so called “core” level dentistry and should be the function of the NHS regardless of whatever method the dentists working in the NHS are paid. It should be basic, not advanced dentistry and would be greatly helped by the increasing use of Dental Therapists and Registered Technicians working alongside dentists.
The rest, those patients that can afford more sophisticated dentistry, should be expected to pay for their dentistry to fill in the holes and spaces and restore function and aesthetics.

We, our members, are right at the forefront of this kind of dentistry. We have worked hard, we have studied hard and we are the people who, at the end of a difficult, complex treatment plan involving lots of leading edge techniques know that our patients leave our surgeries happy in the knowledge that they look good, are pain free and their oral function is fully restored to give them many years of comfortable smiling and eating.

It is no wonder that our founding fathers coined the words emblazoned on the President’s badge of office of “Care, Competence and Continuing Learning”. It is this phrase that continues to lead our members to the top of clinical patient care and ensures we stay at the top and at the front of British Dentistry. I consider it a deep privilege to be made President of the BSGDS and to be able to lead the Society during the rest of my year in office.

Phil Lang
President of the
British Society for General Dental Surgery