Sir, the Nuffield Report1 comes at a time when NHS dentistry is never far away from the news headlines, accompanied by constant headlines of the public being unable to access NHS dental services. Identifying the problems leading to the current crisis is key to finding solutions.

Whilst the report portrays NHS dentistry in England through a particular lens and highlights several important and recurring challenges in the provision of dental care, the Dental Professional Alliance is keen to understand why the largest registrable group of dental professionals was not involved in the discussions that resulted in the publication of the report.

The wider members of the dental team are key to the ongoing delivery of dental care and dental treatments. Dental hygienists and dental therapists have recently been identified as being part of the solutions to some of the so-called ‘wicked' problems. In England, dental hygienists and dental therapists can now open courses of NHS treatment, mirroring their way of working in the private sector.

Dental nurses have been identified as vital in the delivery of preventative practice. Of course, the demand for dental nurses is undoubtedly likely to rise, as we contemplate their role in further supporting dental hygienists and dental therapists.

Orthodontic therapists play a pivotal role in providing NHS orthodontic care, with NHS contracts financially reliant on this group to enable the number of patients being treated. Clinical dental technologists have also been identified as a group of clinicians who can be used to help with the provision of removable dental appliances (predominantly dentures). Dental technicians are not generally patient-facing; however, they play a vital role in both NHS and private settings. It is worth noting that there are currently more technicians leaving the register than registering each year, highlighting a growing problem.

The Dental Professional Alliance is at a loss to understand the rationale for not including the full representation of all professional bodies, as without this a balanced opinion is impossible. It is also a wasted opportunity for the NHS to fully utilise the skills and knowledge of these valuable professionals.