Last month, British Dental Association Northern Ireland held an event to launch their new oral health manifesto for the forthcoming Assembly elections, highlighting the crippling effects of the pandemic on top of pre-existing concerns long before COVID-19 was an issue.

Rebuilding and Reforming Dentistry is the plan to 'provide firm foundations for Health Service dentistry, and deliver better oral health for all', the manifesto front cover reads. The event itself was insightful, thought-provoking, and what could have been the continuation of cautious optimism between all parties involved.

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And then, the hammer dropped. On the very same day, the Department of Health announced that the Rebuilding Support Scheme (RSS) - intended to increase and incentivise activity by enhancing fees to mitigate the impact of COVID-19 - would see a 25% enhancement applied to dental fees, a figure that represented a downgrade on the previous offer of 35% that had been put forward.

Following the toughest two years in dental history, BDA had said hopes that the extra costs in dental practice had been grasped by the Minister and officials, and that an expected enhancement would enable practices under financial pressure to start to rebuild the service - were left shattered. Given the way the things panned out, were the entire negotiations nothing more than lip service? They either don't believe what the BDA had to say, or they did and didn't care about the capacity and cost conundrum. Whichever it is, it is patients who will suffer.

This sequence of events got me thinking about an exchange I had earlier in the day with the panellists. While the manifesto goes into great detail about the problems and the solutions, there remains that elusive question of how you get from A to B, and how the necessary pledges will be delivered. More specialists required? Firm foundations for ensuring the longevity of the service? Action on inequality?

Maybe it's because of public perception, but dentistry seemingly has a harder time than you'd expect of asking for more money. Yes, it is more nuanced than going cap-in-hand, but at the root of every problem identified and solution put forward in the manifesto, you'd find money. Maybe it shouldn't come as much of a surprise; the evidence points to money draining from the system and running on fumes, year after year. Without it, dentistry across all four corners of the UK will collapse. Examples like the RSS enhancement just goes to show how much there is to do in the upper echelons of the profession. The pandemic has brought dentistry closer to the fore than ever before - we've all read or heard the stories about patients in pain having to seek out urgent treatment centres and the ongoing Bilbo Baggins-esq quest to find an NHS dentist across various parts of the countries.

it just makes you wonder what governments and their relevant departments of health really think about dentistry? Is it a piñata they give a smack to every now and again when they need some spare change? Tooth decay is the largest, preventable NCD globally, the cost of which to remove and restore far outweighs that to prevent these problems from occurring. And yet, here we are, seemingly on an endless GIF loop identifying problems, requiring money to go about solving them and coming up short. It is inconceivable that asking for investment in a basic human right is turned away or, in this case, diluted and reduced.

Money truly is the root of all evil, but for this profession, it is both the root of all our problems, and unfortunately our solutions. â—†