Sir, I write with the future in mind, concerned that recently qualified dentists - keen to develop their competencies and skill-set re: their familiarity with surgical extractions or more complex treatment planning and its delivery in an NHS primary care setting vs a secondary care DCT pathway, private practice or equivalent 'wet-fingered' qualification - are at risk of being 'held back' by the pressures of a strained NHS system; a valuable but volume-heavy and often stressful first step in the career of most GDPs.

For example, where practices are under pressure to meet NHS commitments/UDAs - and where more senior members of the team are more likely to supplement their books with private income - recently qualified dentists are arguably more likely to take up this NHS 'burden' of 'extra patients'.

Finding time to provide routine and urgent general dentistry within an eight-hour day can be difficult enough - noting (though anecdotally) it is not unusual for patients to be waiting 2-3 months for active treatment following an NHS examination due to waiting times. Where does this leave young professionals who are keen to build their skills in NHS practice and invest in their professional development and job satisfaction?

Do you pick up the surgical handpiece in tackling a symptomatic molar requiring sectioning with a busy waiting room?

Take an extra 15 minutes to refine your crown preparation and provisional restoration?

Take that extra ten minutes to offer more tailored lifestyle advice? Do we sacrifice these actions and the time it takes to develop skills to run 'on time'?

Do we cancel patients at short notice, going against our want for effective time management and forward-planning?

Irritate those already in the waiting room as you invest time in developing your skills and the patient experience - running the risk of a 'that will do' attitude in a profession that demands the highest standards in patient care and personal integrity, and the personal medico-legal implications such an approach can precipitate?

Maybe a wider question to consider is - in its current form - how far is NHS dentistry geared to treat the individual patient vs stabilisation of the population - and if so population-focused, are we risking losing further GDPs to the private sector where time and resources are often more available and less of a premium than in the NHS - as young clinicians look for new opportunities in their self-development?

Thoughts on a postcard.