One key definition of a profession is that it has self-regulation. Dentistry no longer has this and it is a theme I have discussed previously.1

However, I would like to revisit it. Governments in their wisdom decided to assume the role of regulators, although overseen by various bureaucracies, primarily the Privy Council. In the process the Council of the General Dental Council (GDC) has gone from being directly elected by the dental profession from candidates nominated by them plus some few lay members appointed by the Privy Council to being wholly appointed by the latter. Previously there were the deans of all the UK dental schools, with their collective wisdom on dental undergraduate education. Now there are none. Previously there were the four chief dental officers of the constituent countries of the UK with their knowledge of government policy and devolved agendas, now there are none. Previously there was a broad cross section of general dental practitioners with their knowledge of how dental practice actually runs; now there virtually none. I am reliably informed that of current lay members of the GDC not less than three of them are lawyers. As far as I can ascertain there are no dentists appointed to the equivalent regulatory body for lawyers.

This means that the GDC is all but devoid of genuine, practical, day-to-day dental knowledge. I can only assume that whoever advises the Privy Council also has scant intelligence about the world of dentistry, else why would they reappoint for a second term a chairman whose resignation has been openly called for on numerous occasions by the BDA and others as a mark of no confidence?

All of this is a matter of public record, a set of facts. So where does this leave us? An external observer, by which I mean a person not appointed by anyone else to any regulatory body, might not unreasonably assume that the state of dentistry must indeed be in a terrible turmoil. To some extent they might be correct. Collectively and as individuals we have been battered by the vagaries of the GDC and their belligerent stance towards us. But in other respects, and tellingly, they are not correct. The Care Quality Commission, for example, has found dental practices way ahead of the field compared to other healthcare providers and establishments. Some disparity here then. This is not an outlier result or some statistical quirk. Crucially this is supported by our patients. Despite the GDC gleefully trumpeting that complaints have risen, so have they about doctors, about lawyers and about virtually every service and company you can name. Society has changed BUT society still has overwhelming confidence in the profession that 'was' dentistry.

I am so often struck, when I mention dentistry in non-dental circles, that the clichéd response is trotted out 'oh, I hate dentists' to be followed in the same breath by 'but I'm very lucky, I have a really great one.' This is the reaction that is familiar to us all, it is the reflection of what we all have, all see every day, trusting and loyal patients.

Do our younger colleagues not realise that they are no longer in a profession?

Sooner or later the disconnect will be spotted. I am only sorry that I unable to tell you when that will be. I hope it will be soon. I suspect it will not and that we will continue to plough our own furrow fending off the prevailing weather, pests and hardships. However, what does give me hope is the attitude of dental students and young dentists. They are bright, motivated, good-humoured people who variously have acute senses of entrepreneurism, community, fairness, awareness of the importance of continuing education and other very worthy, very, er, professional attributes and characteristics. They, like their mature colleagues, also express concerns about the GDC's disproportionate responses and similarly are driven as a consequence towards defensive practice but they accept that this is how life is. To be frank I find this both surprising but also heartening. Despite that, as associates, real income has fallen dramatically since early this century, dental school applications still outstrip places by several times and the dedication and enthusiasm seems to have few boundaries. Practice ownership is still a stated ambition for some and although doubtless it will be far harder than ever to achieve this in the future there is unquestionably a passion in many young colleagues that it is an obstacle to be overcome and not one by which to be downcast.

My question then is; do they realise that they are no longer about to join nor are in 'a profession?' And my answer is that I do not think they even consider it. Why? Because despite all of the nonsense to which we are subjected we do not cease to act professionally, we do not err from the path of being professional. For this we should be proud.