Sir, Professor Nairn Wilson in his excellent guest editorial Science in dental education (BDJ 2007; 202: 297) does not go far enough.

To make any real inroads into even going some way to delivering a dental education programme that would lead to a service for the population that would provide quality assured oral healthcare, the mouth needs to be put back into the body as a matter of urgency. There are certainly significant manpower and training issues here. While oral healthcare and dentistry are indisputably a medical speciality with their own sub-specialties, those responsible for delivering this care are trained as an entirely separate profession which seems at best illogical. It's not really part of mainstream healthcare, but some sort of indefinable add-on? A ludicrous thesis. Maybe John Tomes and the 'separatists' of history have a lot to answer for.

Currently dentists are trained in parallel with and alongside medics in human disease, the medical skills of surgery, prescribing, injecting drugs, the spectrum of diagnosis and generally dealing with, and accepting responsibility for, patients on a whole person basis and all that this involves. These skills will be needed often against a background of polypharmacy, varying degrees of wellness and illness for patients, through the very young to the geriatric and frail. Mistakes are known to have a significant effect. Holistic or not?

As time goes on (or perhaps even already!) it will make just about as much sense if we had decided to train a totally separate profession of say obstetricians, radiologists, dermatologists, proctologists etc etc through the medium of a different training programme as we inexplicably do with dentists. Not really a medical doctor/surgeon, but expected to behave exactly like one, and be a sort of specialist. This will inevitably change sooner or later to structure the correct emphasis on greater numbers of appropriately trained therapists (at last!) who will deliver the diminishing restorative care and who will form the bulk of the team under the overarching diagnostic and team leading role of the dentist.

The advances in the biosciences, which are moving at a staggering rate, have resulted in enormous leaps of understanding with regard to cellular biology, diagnosis, and the prevention and treatment of disease. How far into the future will we continue to row such a divisive boat?