' The future of our profession is in good hands'

I was immensely honoured to be inducted as the president of the British Dental Association in May this year. In my inauguration address¹ I noted my concern that in a wealthy twenty-first century democracy, oral health inequalities persist - particularly in disadvantaged groups such as the homeless, refugees and asylum seekers.

One of the great pleasures of being president is being invited to attend meetings across the UK and I have met many colleagues at all stages of their careers. Conversations often turn to the future of our profession and a good number of people have expressed their anxiety that younger dentists are reluctant to become involved in the care of the most vulnerable in society. Those expressing this view feel that the allure of cosmetic dentistry and facial aesthetics might lead to increased health inequalities as those with active oral diseases are less able to access care.

My personal view is that as a profession we are uniquely able to both diagnose, treat and prevent the major diseases of caries and periodontal disease whilst at the same time being able to use our more cosmetic skills to enhance wellbeing and self-esteem. Balancing these often-competing demands on our time is a real challenge for our profession, not just here in the UK, but across the world.

I was blown away by the participation of so many FDs in programmes that addressed the needs of the most vulnerable in society.

I was privileged to be invited to the DFT [Dental Foundation Training] conference in Leeds earlier this year. It was fascinating to discuss with newly qualified dentists their hopes for the future at the beginning of their professional careers. This conference, though, was a celebration of the completion of DFT for the dentists from across the Yorkshire and Humber region.

I was blown away by the participation of so many Foundation Dentists (FDs) in programmes that addressed the needs of the most vulnerable in society. Colleagues participated in reaching out to provide dental examinations and onward referral for treatment to refugees and the homeless in contact with the inspiring GP practice at Bevan House in Bradford. One dentist working there said: 'My time working for Bevan was a real eye opener for me; looking after individuals who were refugees or homeless really highlighted to me their day-to-day struggle especially when it comes to accessing healthcare. The oral health of some of the people I met was quite poor with many of them needing emergency treatment. Whilst I was at Bevan, I was able to diagnose and reassure and then refer to secondary care and I really felt that I was making a difference for these people. My time there did highlight complete gaps and lack of funding within the system which is a real shame. Overall, I was grateful for the time I spent there as I felt I helped the individuals who came to the clinic and this experience really added a new dimension to my clinical ability especially with regards to history taking and talking to patients through interpreters.'

Other colleagues worked in a different scheme with the following aim: to assess dental care barriers and oral health needs of refugee/asylum/evacuee groups. This project looked at the risks of dental disease in this group and how anxiety was a feature of those presenting for care. It also looked at the urgent care needs and the outcomes of treatment.

Another group of FDs worked in a dental practice that offered to extend their opening times to enable the practice to see patients who could not access NHS care. This was mostly urgent and emergency care and they described their experience as follows:

• That it was daunting

• They felt very supported

• It was a really good experience in terms of clinical challenge and personal development

• They felt 'as though I could make a tangible difference to patients' lives'

• They gained experience with dental emergencies and extractions

• They appreciated the difficulties faced by patients accessing dental care

• They learnt about the management of dental anxiety

• They gained experience with triaging.

I left the conference inspired and uplifted that so many dentists had taken the opportunity to step out of their comfort zones and provide care for some of the most vulnerable in society. I am grateful to Jason Atkinson, Associate Postgraduate Dental Dean and Ian Wilson, Training Programme Director JDFCT Scheme, from NHS England - Directorate for Workforce, Training and Education (Yorkshire and Humber) for inviting me to hear these mostly young dentists share their experiences. I know that the impact of working with such disadvantaged groups will help inform and direct their professional lives in the years ahead.

The future of our profession is in good hands!