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I recently attended the BDIA Dental Showcase exhibition, a masterpiece of organization by all concerned, getting so many stands and people together at the right place and at the right time. Given that the pandemic had stymied dental meetings since March 2020, it was refreshing to see that dentistry was getting back to normal, or was it back to normal? It was impossible to examine all the stands (circa 175) in depth in person, so, of the stands that I did not visit, I read the synopses in the show magazine and calculated the proportion of stands allocated to the wide variety of entities that contribute to contemporary dental practice.
Live dental meetings are not as prevalent now as they once were, the pandemic having put paid to those, with webinars such as those organized by Louis Mackenzie for (Dental) Update seminars thankfully stepping in to fill the void. Indeed, webinars will probably continue to be a no brainer for organizers, given that they can pay a speaker the same for a webinar beamed to hundreds of participants (but with no check on who is actually listening!) as they might for a ‘live’ lecture addressing a hundred people. It was therefore refreshing that Dental Showcase actually went ahead, given that attendees could ‘interview’ sales folk face to face about their wares, and it was interesting to note that the highest percentage of stands, at 31.8%, was what I allocated to ‘equipment’: in this was included, apart from the obvious (dental chairs and units), instruments, loupes, etc. The manufacturers of those obviously thought that dentists who were interested in re-equipping would attend the exhibition, where they could see and compare a variety of equipment under one roof, which seems an excellent concept for those who are renovating one or more surgeries.
The next most common proportion of stands (24.2%) was dedicated to a group in which I included, for example, finance, accounting, practice management admin and marketing – which could roughly be termed the business of dentistry. Clinical materials, including orthodontics, accounted for 11.0% of stands, while prevention, which included manufacturers of toothpaste and toothbrushes and mouthwashes, scored 8.7%. Organizations providing dental education and journals accounted for 6.3% of stands. Given the current climate, infection control seemed, to me, surprisingly low at 2.3%, perhaps indicating that the manufacturers of such had already had a field day and considered that everyone had already got their infection control sorted. The small number of stands (4.6%) dedicated to CAD/CAM, digital workflow and imaging could be considered surprising, given that this could be considered the dentistry of the future, indeed dentistry for the present for an increasing number of clinicians.
To summarize therefore, non-clinical seems to trump clinical. Is that appropriate? Having been there for many years, I know personally that dental practices have to operate on an effective financial footing in order for them to make a living for those who work in them, so the proportion of floor space devoted to the business of dentistry was not a surprise. However, the reduced proportion of stands dedicated to dental materials (the foundation of restorative dentistry, perhaps?) needs more explanation, given that 10 years ago, I counted those as 25% of the total.1 Worrying too was the fact that some major manufacturers of materials were nowhere to be seen. Perhaps this also reflects the changing demographic of dental personnel, given that an increasing proportion will not be practice owners (which they might have been in the past) who do not have control over the practice budget, and, by default and, more worryingly, over the materials that they use on patients. The small proportion of stands dedicated to prevention may also be considered a worry, but, on the other hand, some of those stands were the largest in the exhibition! I only counted the number of stands, not their floor area!
This is not the full story. Large dental exhibitions have, in the recent past, increasingly included a large lecture programme and the BDIA Showcase exhibition was not an exception. If those are analysed, a story not dissimilar to the exhibition floor space emerges, with the highest proportion of presentations at showcase being on business/finance/marketing (20.5%) (perhaps not a surprise as this had its own dedicated theatre), followed by workforce/staffing (15.4%), clinical materials/techniques (12.8%), prevention (11.5%), 3D/scanning/digital workflow (8.9%), aesthetic dentistry (7.7%), with contributions on infection control, implants, orthodontics, wellness, and sustainability, not forgetting the CDO's presentations. Does this again indicate that dentistry is increasingly becoming a business?
I also visited the British Dental Conference and Dentistry Show (BDCDS) in Birmingham recently. Were the same trends apparent? Yes and no! When the exhibitors were divided into the same categories as the earlier show, the ‘top two’ were the same, but in reverse order, with the most prevalent being finance, practice management/admin and marketing at 25.8% followed by ‘equipment’, at 19.8%. The figure for ‘clinical materials/orthodontics, was similar to the Showcase exhibition, accounting for 10.0% of stands, while prevention, was slightly less, at 6.6%. More organizations providing dental education (for example, some universities advertising master's courses) were there, this being 9.0% of stands, while the number of stands dedicated to CAD/CAM/digital workflow at the BDCDS amounted to 7.2%. In the lectures, the finance/marketing subject area was top, accounting for (no pun intended!) 21.3% of lectures, with workforce/staffing at 11.0%. Clinical materials/techniques comprised 18.7% of lectures, with ortho/aligners at 9.7%, and ‘wellness’, 8.4%. Alas, the blatant business side of dentistry remained evident in titles such as ‘how to add an extra £120,000 annual income’, ‘how to increase your sales’ or ‘how to gross over £1M per year’.
I believe that manufacturers of materials are ‘missing a slight trick’ by not exhibiting at these exhibitions. Every dental professional needs to be aware of what materials are on the market, and especially what material can be the perfect solution to use for the patients' needs. Dentists don't get this precise information from companies' websites, they get this information about the products and their components from discussing with the companies' representatives, in order that the clinician can analyse what is the best product to use in a given clinical situation. New products and developments must be shown in a hands-on way, showing the clinician the intricacies of using the material for its best outcome: surely exhibitions are a pertinent and cost-effective way to demonstrate latest techniques and innovations to the ‘end user’. Not every dentist needs to see the ‘sexy stuff used in the surgery’. If you don't put oil into a car, we all know what will happen!
Getting back to the figures that I analysed, one wonders if the emphasis is changing, with people joining the dental profession because they see it as a means of making money, joining a business rather than a profession, a view recently expressed in a short, but to the point, letter by John Aitken,2 in which he recalled a former colleague telling him that ‘he was only in it for the money’. It has previously been argued1 that, if reliable quality care is provided for patients, and the fee structure of the practice is on the right lines, the profitability of the practice will take care of itself. The only way for dentists to improve their credibility is not by cutting edge marketing, in my view, but by providing excellence in care for their patients. Attending courses for maximizing treatment plan acceptance is not, to me, the way to having happy and appreciative patients, given that a proportion of those who feel ‘pressurized’ into acceptance will later regret their decision and visit a lawyer. Dentistry has survived as a profession in the UK for over a century, but its days are numbered if it becomes more widely viewed as a business rather than a healthcare profession (the two being mutually exclusive), a trend that the figures that I have quoted appear to indicate. On the other hand, I ask: is it that the profession is changing, or are exhibitions changing to meet a differing demand (if it is considered that the clinical aspect of dentistry is well covered via alternative sources) and are the two linked?