Sir,- We read with interest the paper by Professor Tinker (BDJ 2003; 194: 369–372) concerning the increases in numbers and percentages of older people in the UK population. In this respect we feel that some work recently carried out by the Dental Practice Board and the University of Birmingham can add to the discussion of what this means for dentistry. The Dental Practice Board administers a database for the payment of all GDS dentists in England and Wales from which detailed treatment data have been retained, extending back more than eleven years. This archive of data has facilitated detailed analysis of treatment trends and rates of intervention and re-intervention. In particular we have analysed the association between patient age and re-intervention within one year of placement of direct restorations, where re-intervention may be by replacement of the restoration by one of the same type or different type of restoration, by crowning, by extraction or by other treatments. The figure, based on over 100,000 restorations placed in the year 2000, illustrates that restorations placed in older patients are more likely to receive re-intervention within one year than restorations placed in younger patients. Indeed, the one-year re-intervention rate increases with patient age, from about 6% at age 25 years to 16% at age 65 years.

Professor Tinker's paper has informed us that there will be an increase in overall numbers of older people in future and that they retain their teeth longer. If that is the case, then our findings indicate that the percentage and number of early re-interventions will rise, with consequential increase in the number of unplanned attendances. This may have implications for practising dentists in the future, especially if they are treating large numbers of older patients.