Sir, it was with incredulity and disappointment I read the article entitled Why re-invent the wheel if you've run out of road? by the Chief Dental Officer for England (CDO).1
The CDO references a 30-year-old book by my 'cons' Professor 'Dick' Elderton on the merits of minimally invasive dentistry as if it were some new concept in dentistry.2 Where has Dr Hurley been for the past 30 years? Many current dental procedures utilise some of the most cutting-edge and non-invasive techniques available today. Guided implant procedures provide the most obvious example, with CT guided placement reducing surgery time, increasing long-term success, and significantly reducing levels of post-operative morbidity.
There is clearly a desperate need for the reorganisation of NHS dentistry into a basic, core service, free of charge, in line with the rest of the NHS service. All other services could then be delivered via private dental practices, eliminating the often confusing and litigious mixing of 'private' and NHS dentistry. A move that would surely be welcomed by regulators and indemnifiers alike.
Over the past weeks we have seen many well-researched and practical standard operating procedures (SOPs) published by various dental associations,3 corporate dental bodies,4 and devolved government.5 Even with the release of the CDO's 'Prompt to Prepare' and 'Resumption of Dental Services' letters published on 28 May, why are we still waiting for detailed guidance, SOPs and strong leadership? Perhaps the CDO should recall the often-used phrase from our alma mater Professor Crispian Scully: 'when the going gets tough, the tough get going'. The CDO rightfully recognises the leadership that many dentists have shown in England during the COVID-19 pandemic. It is a shame that the profession has not witnessed the same trait in the current CDO.
In a recent poll of dentists in the British Association of Private Dentistry, 97% of its members called for the resignation of the CDO. Clearly, the profession feels totally let down at this unprecedented time. The CDO's commentary merely serves to underline how out of touch the CDO is with the level of skill, expertise, knowledge, and fortitude that GDPs possess to safely care for their patients and dental teams.
References
- 1.Hurley S. Why re-invent the wheel if you've run out of road? Br Dent J 2020; 228: 755-756. [DOI] [PMC free article] [PubMed]
- 2.Elderton R. Principles in the management and treatment of dental caries. In Elderton R (ed). The dentition and dental care. pp 237-262. Oxford: Heinemann Medical Books, 1990.
- 3.BAPD Return to Practice Position Paper May 2020. Available at https://bapd.org.uk/pdfs/3410-Corona-BAPD-Policy-Document.pdf (accessed May 2020).
- 4.Standard Operating Procedures for Portman Dental Care Practices. May 2020. Available at https://www.linkedin.com/feed/update/urn:li:activity:6669673903541010432/ (accessed May 2020).
- 5.Remobilisation of NHS Dental Services in Scotland. May 2020. Online information available at https://www.scottishdental.org/wp-content/uploads/2020/05/CDO-Letter-Remobilisation-of-NHS-Dental-Services-20-May-2020.pdf (accessed May 2020).