Sir, professional regulation is necessary and ideally should provide optimum protection to the public while imposing the lowest practical burden on dentists. Although there is a body of research on factors affecting the productivity of dentists,1 there appears to be a dearth of quantitative, financially-oriented research, unlike in medicine.2

A poll recently conducted on GDPUK.COM (membership includes UK and non-UK dental professionals) provides some insight into the extent to which regulatory burden impacts on clinical efficiency, and by implication dental care provision and the costs of care to patients. It is hoped that the results, reported below, will stimulate related research which benefits both patients and the profession.

When asked if they 'firmly believe current regulatory demands and their associated risks cause them a higher level of ongoing stress than would occur under a significantly lower, yet effective and fair level of regulation', 97.8% (n = 89) agreed, while only 2.2% of those who voted did not.

When asked if current regulatory demands and their associated risks have caused dentists 'to restrict the range of care I provide compared with that which I have been trained for and/or am capable of providing', 63.1% (n = 53) agreed, while 36.9% reported that the range of care they provide was unaffected. Had these circumstances made 'a higher number of referrals than I believe I would under a under a significantly lower, yet effective and fair level of regulation', 50% (n = 39) agreed, while 50% indicated their referral patterns were unaffected.

A fourth question sought to assess the extent to which those voting believed their clinical efficiency would increase under a significantly lower, yet effective and fair, level of regulation. Of those who voted, 10.8% believed that their clinical efficiency would increase by between 0% and <2.5%, 21.7% between 2.5% and <7.5%, 30.1% between 7.5% and <15%, while 37.3% (n = 31) believed it would be by more than 15%.

These responses suggest substantial health and defensive-dentistry costs associated with the current level of regulation over those which could otherwise be achieved. Their associated financial costs to patients are likely to be difficult to calculate accurately but are potentially substantial.

The data from the fourth question were used to try and gauge the full potential benefits to patients of a 'significantly lower, yet effective and fair level of regulation' (it is recognised that achievable gains would be lower). Using HSCIC3 figures for 2014, it is estimated that approximately 4 million additional courses of NHS dental treatment could be provided or the resources allocated to increasing still further the quality of care and dental health education. In the private dental care sector, it is estimated that the cost of care would reduce by 8.6%, an annual saving to patients of approximately £250 million. (With thanks to GDPUK members who voted.)