Sir, dental manpower is indisputably in short supply and promises by government of increases are welcome.

But one hears predominantly of more dentists being promised – another 1000 dentists in the short-term from a variety of sources and, when they graduate in five years time, another 170 trained in the UK.

I, like I Waite (BDJ 2004, 197: 170), worry about the suitability of foreign dentists. Foreign dentists are often not permanent and patients tell us they are not happy with frequent changes of dentist.

But do we need all that many more dentists? There are so many activities which can be delegated to ancillary personnel who are properly trained. We know that dental disease is decreasing and statistics indicate that the decay experience of children is likely to stay static over the next 20 years.

It is also known that the majority of caries in children is confined to a relatively small section of the population and that large cohorts of children experience no caries throughout their childhood.

Is it really necessary for a five year qualified highly paid dentist to 'check' every child's dental health every six months? Could this be delegated to therapists? I am not disputing that children should be seen every six months since, children in particular, if caries is present, need to be treated promptly. Their dental development also needs regular assessment.

But I am sure that a closely led team of a dentist and therapist(s) could develop an understanding wherein the therapist consults a dentist in order to provide a prescription/second opinion when a problem is detected. In treating adults, a similar approach could be adopted.

The key is in the 'closely led team' headed by a dentist with mutual respect being developed between the parties for each other's roles. Hygienists form another branch of this team: their value is well documented and widely appreciated.

Again, the key is a close working relationship between dentist, hygienist and patient.

Why then do we not hear of promises by government of more training places for such valuable personnel?

As treatment planning becomes more complex and patients become more demanding, there will be plenty of work for the current generations of dentists at least until the dentally fit youth of today reach middle age! And they will all need treatment for erosion!

By way of increasing PCDs, I was pleased to see the advanced stage of development of some universities in increasing places for PCDs.

It would be nice to hear more openly of these developments so that all parties delivering dental care might be more accurately informed as to future manpower developments and begin to develop the mutual respect referred to above.