8 Apr 2016  •  Dentistry Confidence Monitor  •  4min read By  • David Bretton

David Bretton’s views on the results of the Third NHS Confidence Monitor

Career prospects

The first thing that I noticed about the results was that as I expected, a large proportion of those asked (84%) are not feeling confident of their career prospects within NHS dentistry for the future. I think this lack of confidence comes because nobody knows what is going on!

There has been much talk about the proposed future of NHS dentistry but very little explained officially from the people at the top. I suspect associates are feeling the most uncertain about their futures in NHS dentistry, with therapists, hygienists and nurses all taking up much larger roles in the new system.

Associates have no other option but to up-skill and ensure they are in the position to offer services and treatments that others are not. In addition to this, the cost of practices is getting so high that funding this is going to be very difficult. Gone are the days when you could get your BDS and go and buy a practice and live happily ever after doing single-tooth, family dentistry all day. Those who are happy to take on the challenge and accept personal responsibility, engaging in never-ending learning will have great career prospects whatever; however, will this be in the NHS? I am not too sure.

Patient happiness

What’s more, the results also highlighted that confidence that patients will be happy with the outcome of attending an NHS dental practice in the future remains low amongst NHS professionals (74%).

I think this is a very difficult question to discuss as we are still all in the dark of how this new system will run. Pilots are providing little optimism, with dentists frustrated by the need for much longer appointment times (for full oral health screening and risk assessments). One of the biggest problems is that people (patients) do not like change! Patients are used to being able to come to the dentist, every six months, have a check-up and then have all the treatment they need straight away, carried out by that one person.

The new system potentially means patients could be sent away with a toothbrush and instructed to see a nurse every three months for preventative advice. Only when the oral hygiene has improved will they be able to have access to treatments such as crowns and bridges.

Is this the best approach clinically?

Yes – it is fundamental basics of dentistry that complex treatments should be reserved for patients with good oral health. Will patients like it? Definitely not! The patient will likely feel ‘messed about’ and will probably become frustrated by the possible need for regular appointments which may even involve missed work, etc. This will potentially result in further increases in complaints or the movement of patients to have certain procedures carried out privately, without having to wait for the NHS system to allow the required treatment to go ahead.

Confidence in the future of NHS dentistry

On the whole, confidence within the profession as to the future of NHS dentistry overall is very low (91%). Much of the lack of confidence comes down to the poor communication of what the future potentially holds. We are left in the dark, wondering what NHS dentistry will become. If we communicated as poorly with our patients as the ‘leaders’ above us communicate with us, we would be sure to find a letter from our regulator on our doorstep very soon!

To read the full results of the Third NHS Confidence Monitor, click here.

About David Bretton

David is a young graduate, qualifying from Newcastle in 2013. He now works in a mixed NHS and private practice at Honley Dental in Yorkshire. Since qualifying David has completed a number of courses in advanced restorative and aesthetic dentistry and he is very passionate about the profession.


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