Dental Bodies Corporate (DBCs) are currently in the news. The main reason for this is the announcement from the General Dental Council (GDC) that the restriction on the number of DBCs in the UK will almost certainly be removed by the Government in the next few months. The obvious and immediate question this poses for dentists in general practice is 'So what?'

Before speculating on the possible ramifications of this move it would be sensible to look back at the development of corporate dentistry, especially over the last decade. John Chope, in his excellent article in the BDJ in 1997 (British Dental Journal 1997; 183: Oct 11 ) summarised the historical development and current situation with regard to corporate dentistry at that time, and since then the most significant event was the entry of Boots into the market in 1999.

Corporate dentistry has been with us since the early 1900s, enabling companies to be formed to carry on the business of dentistry and benefit from the laws of limited liability to encourage investors to invest in the company. Concerns about the potential conflict between commercial interest and professional care existed throughout this early period, and in 1957 the Dentists Act prevented the formation of any further DBCs, leaving a total of 27. A summary of the legal position has been described in the two articles in the BDJ published recently1,2

So what are the possible ramifications of the proposal to lift the current restriction and allow new DBCs to be formed? According to an article published in The Times on December 6th 2001 the main effect will be a reduction in the cost of private dentistry, especially implants. This prediction is based on the assumption that a number of companies (such as Superdrug, Dolland & Aitchison and Body Shop) will be opening high street chains of dental practices, increasing competition and driving prices down. Assumptions about the commercial potential of dental practice have been proved wrong before, for example the rapid spread of computerisation into dentistry in the 1980s which was followed by an almost faster withdrawal when companies discovered that dentists were not the 'goldmine' they had previously assumed.

The second assumption in the TheTimes article is that the lifting of the restriction on the number of DBCs will encourage franchises and partnerships, enabling dentists to pool administration costs. According to the article this will 'ensure money is spent on treatment and drive up standards'.

This seems to me to be a massive assumption that fails to appreciate that treatment standards tend to be a reflection of professional governance (initiated by dentists themselves) and patient demand (initiated by patients). Besides this, I am not aware of any significant evidence that standards of patient care and prices are any different in general practice when compared with those in DBCs at present.

There can be no doubt that a High Street dental practice is very attractive to some patients, especially if it is branded as part of a well-recognised and trusted retailer.

What about the reaction of the dentists themselves to DBCs? Initially there was a tendency for some practitioners to exhibit mild panic, especially if a dental practice that was part of a DBC opened up close to their own existing practice. Most of these concerns focus on the 'high street chain' concept, with parallels being drawn between opticians and dentists, with mixed views on whether this parallel is in fact appropriate to dentistry anyway.

Finally, and perhaps of most relevance, what about the patients? There can be no doubt that a High Street dental practice is very attractive to some patients, especially if it is branded as part of a well-recognised and trusted retailer. High street chains will almost certainly raise patient expectations, especially in the areas of non-clinical care, which will almost certainly create problems for practices that continue to remain self-focused rather than moving to a more patient-focused approach. It will be interesting to see.