NHS dentists pay price of successful treatments: Maintaining oral health will prove costly

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THE NHS dental services are facing a crisis of success as more people - particularly the old - keep their teeth and require expensive restorative treatment such as crowns and bridge-work.

The Commons Select Committee on Health has been told that the proportion of the population with no teeth has fallen from 37 per cent to 21 per cent in the 20 years to 1988. It is believed that the figure for total tooth loss fell to 17 per cent over the subsequent five years.

Brian Mouatt, chief dental officer at the Department of Health, has told the select committee: 'By the year 2008, only about 10 per cent of the adult population will have no teeth, and that will improve to 7 per cent in a further 10 years' time.'

He added: 'We can predict that 95 per cent of the adult population by the year 2018 will have more than 20 teeth. This means that we have a very much larger population to deal with in terms of maintenance of their oral health. There is going to be much less disease, certainly in youth.'

Mr Mouatt also told the committee that maintenance would put a heavy burden on dental services and the cost of restorative work would be high.

He continued: 'It also means we have to think about the skills mix of the profession because perhaps quite a lot of the simple maintenance of oral health in young people could be done by auxiliaries.'

Martin Smyth, the Ulster Unionist MP for Belfast South, asked if the extra costs would be met by the NHS, which devotes just over 5 per cent of its budget to dental services in England. Melvyn Jeremiah, an Under- Secretary at the department, replied: 'That is one of the questions that the Government has to address.'

The select committee investigation has become a forum for warfare over the dentists' contract. Asked to reply to the charge that they have been put on a 'treadmill' in which the harder they work, the less they get, the department said: 'Dentists have not been penalised for working harder.'