Sir, nothing has so undermined the concept of the team working in high street dentistry so much as the present coronavirus crisis. The perception that the current management of business risk and anxiety is shared between practice owners, dental therapists, hygienists and nurses can now be finally put to rest.

Skill mix was a worthy aspiration. Any notion, however, that it can lead to an equitable sharing of responsibility between team members is now finished. The present closure of practices is difficult for employees, but it is nothing compared to the financial burdens faced by dentists with debt interest on borrowed capital. Unable to demonstrate any activity, NHS practitioners will find it difficult to be prioritised in any promised government handouts.

The notion of a dental team was always fraught. Employing a dental therapist so that a practitioner as a practice owner can carry out more complex procedures is the last thing a NHS provider is looking for. NASDAC are wary of advising clients to employ hygienists in non-mixed practices. Their contribution is only sustainable because of the ambiguities in providers' contracts. This does not apply to therapists in general practice which is the reason why the majority have to work as hygienists. The management and costs of employing dental nurses to carry out fluoride varnish application is not really a viable business model.

Granted that true skill mix, which by definition would require regulatory reform, could improve access. It might also control/or give better value to public expenditure. However, as the present public health crisis demonstrates the term 'skill mix' remains an egalitarian fantasy supported only by salaried academic elites. They know little of the high street.