The gap between the 1970s and now seems more like a chasm. The extent of the divide was brought home to me recently on the 40th anniversary of the Apollo 13 mission when 'a young person' told me that he was amazed that it had actually happened as, although he'd seen the film he hasn't realised it was based on a true story. All at once I felt I had been round the moon with the astronauts, and on a bike. Yet on the bedrock of our profession there lurked then as now an acknowledged yet usually unspoken awkwardness about toothlessness.

When I was at dental school in the 1970s – oh dear, I had promised myself that I would never include in an Editorial the words 'when I was...', oh well – prosthetics was regarded as the Cinderella of dentistry (not even prosthodontics you'll note, which was far too lah-di-dah a term for the humble full-full). Yes, even then, when the ink was hardly dry on the 1968 Adult Dental Health Survey and when about one third of the adult UK population was edentulous, it was viewed as the department at the failed end of the corridor of dentistry; the acrylic cul-de-sac of calamity. We were told that from there the only way was up. It seemed a bit harsh to be honest, as cheap-day ticket clutching ladies of a certain age bussed themselves in from north and east London to have some really quite respectable complete dentures made for them by the students at University College Hospital Dental School, a very worthy establishment that had its doors closed later last century as there were too many dentists. A chasm of time indeed.

But what of this reminiscing that I promised myself not to indulge in? It has been stimulated by a research paper that we published in a recent BDJ on the state of prosthodontic teaching, and by Paul Wright's Editorial of two issues ago on national deficit fuelled funding cut backs in UK dental schools.1,2 Both pieces pose questions about the way in which we teach our students, what we expect from them on graduation and how we see the profession developing in the future.

Glass blowing, thatching and dentures

The line of thinking is that because the percentage of edentulous people has fallen so dramatically in the last 40 years, and looks set to continue to decline probably to about 6%, we need not pay so much attention to it in the curriculum. Hence the similarly declining number of cases required by today's graduates. However, 6% still represents some four million citizens and this does not include those people who are edentulous in one arch only, who provide a similar if not greater therapeutic challenge. Of course it will be fine because we now have Clinical Dental Technicians (CDTs) who are especially trained to do this work. The General Dental Council in their role of protecting the public have seen fit to register them and they are now regarded as part of the dental team.

We know too, because we have been beaten about the head with it for many a year now, that the future is in the dental team – and rightly so. Presumably then our dental schools are busy ensuring that tomorrow's dentists are team leaders, trained alongside their erstwhile team mates to learn to delegate and to be comfortable to lead them. Does this sound like the pattern that you have heard or experienced? Probably not.

Plus the problem becomes more complex yet. Even if undergraduates were trained alongside, in this case CDTs (which they are not) or taught how to refer, delegate and practice with them (which they are not) very few, if any, CDTs work now or will work in future in the NHS. So how many of the four million will be able to afford the private fees of whoever eventually has the residual skills to teach them? Will it be perhaps a case of seeing complete denture provision as one of a BBC2 documentary series on keeping heritage skills alive, together with glass blowing, thatching and blacksmithing?

We are also told that the undergraduate timetable is bursting at the seams with new subjects. Implants, behavioural sciences, communication, tooth whitening, tobacco cessation, the list is seemingly endless and expensive in terms of cash, of which there will be less in the short and medium term, and in terms of attracting skilled and willing teachers. The conundrum seems all but as complete as the dentures on which it is founded.

Cultural myth has it that 'in the old days' people saw the act of having all their teeth removed and dentures fitted as being the cure for any further tooth troubles. So I think it is a curious irony that as a profession we have been making very similar assumptions about there being a place in which we can offload complete denture treatment, conveniently out of the way in the bedside denture mug of destiny.