Sir, it was refreshing to read Aubrey Sheiham's editorial in the British Dental Journal (2005; 199: 187) - Delivering dental care: changing needs and future requirements.

I quote: 'The dramatic improvements in dental health are a good test bed to evaluate the openness to change in dentistry.'

In the future it is likely that most people will require little dental care and most interventions will be simple; this is highlighted in the editorial.

As a practising general dental practitioner, I certainly agree with Professor Sheiham that there are insufficient incentives at present to stimulate activity in the direction of health improvement. Dentists should be rewarded on 'reducing treatment need' and 'activities that are less interventionist'. This would inevitably catalyse a clinician to care for greater numbers of patients, particularly if career pathways were developed along the lines outlined in the editorial.

The challenge for Government and PCTs/LHBs is to recognise models of care that demonstrate reduced treatment need through being less interventionist, that is person-centred care as opposed to treatment-centred care. Local commissioning could facilitate this but only if PCTs/LHBs are astute enough to recognise, and courageous enough to support, practices which generate outcomes that are different from the norm but in tune with health policy.