Letter: Checks on dental care

Checks on

dental care

Sir: There are important differences between medical and dental care that should be considered when making reference to the changes reported in the provision of NHS dental care ("Ministers study cut in free dentistry on NHS", 15 August).

For dental care the patient is expected to attend for a routine check- up within 15 months if they are to remain registered within the NHS. This is not the case for medicine, where there is no onus on the patient to attend.

People normally go to the doctor when they feel ill, and there is the benefit of feeling better having done so. This is not the case for dentistry; the majority of patients attend symptom-free. The dental examination is in effect a routine screening programme.

Finally, patient charges. In medicine, with the exception of prescription charges, care remains largely non-chargeable.

In a society which is becoming more "risk" oriented the question that individuals may be asking is whether the benefits of dental attendance outweigh the costs. This may account for the large decrease in registration levels that have occurred in the 25- to 34-year-olds seen. This age cohort has seen major reductions in disease levels when compared with older groups: their risk of future problems is in consequence far smaller.

The outcome that the Government needs to set is not based on the percentage of the population registered but what percentage need care but cannot obtain it.

PAUL BATCHELOR

Queen Mary and Westfield College

London E1

Sir: The worst error in your report was saying that porcelain crowns which cost at least pounds 150 have been withdrawn. I wish! When I qualified in 1981, a dentist got pounds 71 (worth more than pounds 120 today) for the type of crown in question. Today it is pounds 80.

There is not enough money in the public kitty to get us back to the financial position we were in. It is only a matter of time before NHS dentistry goes the way of the optical services.

Dr GUY SIMMONS

Barking, Essex