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A recent trip to University College Cork in my role as BDS External Examiner led to a chance encounter with a retiring colleague who has had an esteemed career in dentistry. While sitting in his office, I noticed a whole back catalogue of Dental Update going back as far as 1982. My colleague explained how throughout his illustrious career, Dental Update had served him very well and kindly offered me the set to take away with me. Travelling with hand luggage meant I could only take a random sample of four of the older ones, and I was pleased to see the 1982 edition still had Professor CE Renson as Consultant Editor, so quite a collector's item.
As I commenced the return journey, a quick scan of the March 1982 issue at the airport showed that it covered such topics as ‘Full dentures for young children’ by R Bedi and H Devlin, and another item, ‘The elderly patient: dental care in the geriatric hospital’ by Robert Cutler
A few points from the 1982 issue were rather thought provoking:
In overall terms, the number of young children who are provided with dentures is very small. Of those examined in in the national survey of child dental health in England and Wales, only one had received an upper clearance and full denture.
Young children requiring full dentures fall broadly into two groups: those who are edentulous owing to a dental abnormality and those rendered edentulous as a result of severe caries.
With regular reports of children having clearances under general anaesthetic, I wondered whether we might need to dust off some of our techniques that we perhaps thought were historical. Indeed, even if we wanted or needed to, how many would have the necessary skills to construct full dentures for young children?
At the other end of the spectrum of life, the 1982 issue discussed dental care in the geriatric hospital, giving insight into a challenge that has become more acute with an increasingly ageing population:1
‘Responsibility for treatment, except in geriatric wards or large teaching hospitals, tends to remain a no man's land, sometimes related to the community dental service, while the area health authorities have organizational problems of their own.’
As I read through this historical dental treasure trove, it alarmed me that 43 years on many of the challenges remain the same, despite much talk of using artificial intelligence and innovative advances in materials and equipment. How do we bring these innovations to those who need it most?
Past solutions may provide some insight to the challenges we face today. As Winston Churchill famously said: ‘Those that fail to learn from history are doomed to repeat it.’
A scan through another donated historical Dental Update from 1997 revealed an ever youthful looking Professor Trevor Burke staring out from the June 1997 issue with his editorial ‘A dental wish list?’ In this editorial, he provided his view on hoped for solutions almost three decades ago, just as a new Labour government came into office:
‘The result is now history and the new Labour administration has started work with great gusto. The content of the Queen's speech published on 15 May 1997, contains in effect the new government's wish list of policies it expects to implement. What if there could be a dental wish list for the new government? We are all aware that there is unlikely to be any increase in funding for dentistry in real terms, but there must be priorities which we as a profession, could suggest.’
This all started to sound very similar to the current situation with a new labour government and eagerly hoped for reform. Professor Trevor Burke suggested solutions in 1997 and, while this was a reaction to the situation then, the suggested solutions had an air of a dental Nostradamus in that the solutions then are very similar to those suggested now. Professor Burke suggested then:
‘Alongside an increased emphasis on prevention we could also hope that an increased awareness of oral cancer would prevail. At a recent conference at the Royal College of Physicians and Surgeons a panel of speakers was asked what other matters should be urgently addressed by the new government, and the issue of access to treatment was raised.’
Many years on, we pretty much find ourselves with much the same challenges and in many respects the same proposed solutions. Perhaps, if these solutions had been acted on then, change rather than demise in services would have occurred.
While finally boarding the plane, a LinkedIn post had the British Dental Association's wish list for this year (i.e. 2025). The BDA is hoping for:
As we start 2025, we can but try as a profession to advocate for change, and hope to implement it while working collaboratively to improve things for our patients wherever they are treated. Fingers crossed for much needed progress in the year ahead, where implementation of prevention at patient and national level remains key. For all of us, the hope is that 10 years from now, the wish list does not remain exactly the same, and some of the wishes have become more than just that.
This somewhat chance journey through Dental Update history has highlighted the ready resource for the whole dental team that Dental Update remains. While we look to Dental Update for solutions to help our patients, learning from a shared history may provide hope for a brighter future, particularly for those who need our care and expertise most.