Sir, I read the thoughtful, well referenced article on manpower planning in periodontology (BDJ 2014; 217: 399–402) as someone with an interest in workforce planning in practice from Dentists with a Special Interest and at specialist level. The authors put the case very clearly based on the incidence of periodontal disease, this being the need for care, as to the number of specialists who might be required if all the disease is to be treated. From a workforce perspective this is only part of the equation as a needs-based model looks at maximum provision if all the need is to be met. Another part of the workforce equation to be considered is: which clinicians can deliver what aspects of the care required?

In addition there is the consideration of demand. How many patients want advanced periodontal therapy? How many will comply with regimes? My clinical experience over 30 years in general practice indicates that only a few of those with moderately severe periodontal disease wish to have the full gambit of therapies; most prefer to opt for a simpler therapy and accept the long-term outcome rather than go through regular treatments. The authors suggest that 14.3% might need specialist care. From a workforce perspective if demand for advanced therapy from a specialist is less than one third then the workforce plan would be very different. This is before one considers who can deliver the care.

Paul Batchelor (BDJ 2014; 217: 405–409) in the same edition notes that there is little evidence to support the use of routine scaling and polishing. I think all authors agree that regular review of oral hygiene (OH) and re-enforcement is of value to all patients. If a preventive approach is adopted and referral to intermediate and specialist is based on compliance with OH regimes then the workforce need may be considerably less. Sadly, the biggest challenge is gaining patient compliance with regular OH regimes and this perhaps requires the dental team to develop communication and motivational skills, and having the time to talk and more especially listen to patients.

1. Taunton