Sir, those with long enough memories will recall the extremely negative effect on the mental wellbeing of some dental practitioners before the generous NHS pension was introduced in the latter part of the twentieth century (on the same basis as that of the doctor's pension, final salary based and index linked). Dentists by whom as retirement approached, it was realised that no strategy could build up a pension pot adequate to maintain the standard of living to which they and their families were accustomed.
At the time also, the sale of a flourishing practice for which the goodwill could be calculated would be counted on to provide a lump sum, but even there, illness - physical or mental - could make the value of a practice share vanish.
A dental surgery is expensive to establish and run, the NHS Dental Rates Study Group, and their Target Annual Net Income (TANI) never made a dentist working with (NOT 'for') the NHS rich, but once the initial heavy cost of starting off - by buying into an existing practice, or for the courageous few a 'cold start', it did provide a decent living. The workload and need was high, but the job satisfaction of providing a service in which maybe 30 or 40 people every day were better off because of their dental attention cannot be overstated.
Added to this were other positives, the fact of never having to send anyone away from the door because they could not afford treatment, of keeping patients in the practice solely on the basis of the reputation of the practitioner, of freedom to refer to a consultant who fitted the patient and the condition, and often for those given freely their dental training and career the opportunity to repay that gift, and it can be seen why a career as a dentist was vastly rewarding. And then - wonderfully - that pension.
Recent rapid change, on top of some years during which the relationship of practitioners to the NHS approached more that of employees rather than professionals, and the status of patients changed to that of 'consumers', together with the great success of fluoride and the profession (and hygienists!) and materials science in massively reducing the disease load of the population had cumulatively required a reassessment of the profession.
That is very obvious, and perhaps the past as described can look like a golden age, but it is the present that must be lived in - and the purpose of this letter is to remind today of the position of practitioners once more facing (eventually) a retirement for which they may not have made adequate provision, and to pre-empt, by paying attention to that essential activity, the sometimes distressing consequences seen in the 'bad old days' for those no longer cushioned by the benevolence of the NHS, benevolent as it indeed was for a while.
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Bishop, M. Making adequate pension provision. Br Dent J 235, 361 (2023). https://doi.org/10.1038/s41415-023-6342-3
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British Dental Journal (2023)