Presidential address

Fellow members of the Association, colleagues present and future, ladies and gentlemen, I am greatly honoured and delighted to have been elected and now installed as President of the British Dental Association. This highest honour of the Association is a pinnacle of my professional life. Thank you for this exceptional accolade, and for the confidence and trust in me to serve as the 129th President of the Association. I could not be more delighted and excited by the prospect of my term in office.

In accepting the office of President of the Association, I dedicate myself to serve the Association to the best of my ability. I very much hope that, following my time in office, I will be judged to have been a worthy President and to have made a meaningful and lasting contribution to the further strengthening and development of our internationally renowned Association – the professional body for dentistry in the UK.

I have been left in no doubt that we are better together...

One of my first acts as President is to acknowledge and express appreciation for the service of my predecessor, Alasdair Miller, the now Immediate-past President of the Association. Alasdair fulfilled his presidential role and responsibilities in his characteristic, statesmanlike fashion, with great diligence and commitment to the Association. In congratulating Alasdair on the success of his presidency, we must thank and applaud him for his unswerving service to the profession and the Association.

In the challenging, ever-changing world in which the profession seeks to deliver the best possible oral healthcare, there are many issues and uncertainties. At one and the same time, however, there are important opportunities which need to be realised. During my time as President, I hope, amongst other matters, to promote and emphasise the importance of good oral health to general health and wellbeing at all ages. In the process, I hope to have opportunities to encourage many more individuals to seek regular dental care and assume more personal and, where appropriate, parental responsibility for oral health. I would also like to promote more shared care of patients, with colleagues in other healthcare professions working with dental teams to improve quality of care and clinical outcomes. Dentistry, in my opinion, is best when provided as part of integrated healthcare – treating people, not just teeth, notably in the care of patients with chronic non-communicable diseases, such as diabetes, and those suffering, for example, from conditions ranging from childhood obesity to dementia in old age. In pursuing these aims, I hope to enhance the public image of dentistry. In my experience, dentists and dental teams are invariably hard working, publically spirited, highly motivated healthcare professionals who, despite many different pressures, practise to very high, laudable standards. This is in sharp contrast to the regrettable, now outdated way the profession tends to be portrayed in the media, and, in turn, continues to be viewed by many individuals. The inexcusable imagery used, for example, by the General Dental Council in 2014, when encouraging members of the public to make complaints about their dental care, highlights the pressing need to change public perception of the profession. Time to push back the endless, demoralising negativity, and replace it with evidence-based messages and statements on the many, different, typically remarkable achievements of dentistry.

In becoming increasingly involved in the work of the Association over the last three to four years, I have been hugely impressed, indeed humbled by the time and tireless efforts large numbers of colleagues put into serving the Association and, in turn, the profession. In applauding such commitment and dedication, I have been left in no doubt that we are 'better together', both in terms of membership of the Association and across all sectors of dentistry. I strongly believe that our individual and collective goals and aspirations are much more likely to be realised if an ever increasing number of colleagues take advantage of the benefits of membership of the Association. Many more members will, I hope, become engaged in Association activities and affairs, and we should seek to eliminate barriers to more efficient and effective, joined-up working across all sectors and branches of dentistry. In advocating a greater coming together of the considerable expertise, commitment and professionalism I see across dentistry, I would not wish any aspect of the illustrious history of dentistry in the UK, let alone individual colleagues' feelings of belonging to specific groups and organisations, to be eroded. Faced, however, with the many different challenges which the future will inevitably bring, I believe the profession can ill afford to spend precious time, resources and energy on sustaining an ever increasing plethora of organisations and professional groups, let alone perpetuating and pursuing differences between existing organisations and groups which are of little, if any real consequence to the future of the profession. It would be a tremendous legacy to kindle interest in developing such thinking or possibly even some positive actions on this front.

Good regulation needs the right people to apply it the right way at the right time...

A further aspiration as your President must be to leave no stone unturned in seeking to promote modern, 'right touch' regulation of the profession. I strongly believe, as I did when I was President of the General Dental Council between 1999 and 2003, that the current legislation dictating the regulation of dentistry is no longer fit for purpose and needs to be swept away. The Dentists Act in its present, amended form is terribly outdated, labyrinthine, inflexible and very difficult to reform. If the Law Commission's recommendations on the regulation of health and social care are ever revisited and become law, it will help; however, where we stand today, I believe that a complete overhaul of the regulation of the profession may be the only means to best protect the public and regain the support and confidence of the profession. That said, good regulation is not just about the right legislation, it needs the right people to apply it the right way, at the right time and with the right force, to achieve the right result.

In looking forward, I believe it is important to appreciate what has gone before. A hundred years ago, the country was gripped in the horrors of World War I. Despite repeated representations to the government of the day, the country was ill-prepared for the profound effects that dental disease had on its capacity to respond in its time of great need. Quoting the President of the Association at the time – William Dolamore: Diseased teeth mean illness causing unnecessary 'waste of time and the expense of treatment.'¹ Whatever 'time of need' may lie ahead for us, suitably resourced, professionally-led prevention of oral and dental disease will pay great dividends. Fifty years on, in 1965, the then newly installed President, James Smyth, used the occasion of his Presidential Address² to stress the importance of an appreciation of ethical standards, better understood at the time as 'moral consciousness'. Amongst his various comments on the challenges of upholding ethical standards, President Smyth identified episodic courses of treatment as a weakness of NHS dental care. Hopefully, new, long awaited contractual arrangements will at long last facilitate and encourage continuous, potentially lifelong care of patients, ideally applying state of the art preventatively orientated, minimum intervention techniques, with dentists and dental teams being rewarded for primarily saving rather than repairing, let alone removing teeth. Twenty-five years ago the main theme of Professor Roy Duckworth's Presidential Address³ was the 'challenge of quality' in resource limited circumstances – as much, if not more, of a challenge today as it was then. In meeting new demands when resources are under pressure, we must not sacrifice continuous quality improvement, nor forego the opportunity to apply new, treatment enhancing technologies. Last, but not least in this look back, ten years ago John Craig in his Presidential Address⁴ emphasised the relevance of, in his words, 'the Association's splendid motto' – Ars, Scientia, Mores (Art, Science and Ethics) – to the work and professionalism of members of the profession. Mottos, in particular Latin mottos, may be viewed as old fashioned, possibly irrelevant to modern day life; however, the Association motto does serve to remind us of our ethical responsibility to concurrently practise both the art and science of dentistry; an issue to reflect on with growing trends to consider guidance as rules, and the growth in cosmetic procedures to enhance dental attractiveness.

Inspired by those who have gone before me, and having set out my aspirations for my time as President of our Association, I return to thanking you for your confidence and trust in me. As ever, I am greatly indebted to the numerous people who continue to support, encourage and inspire me, notably my immediate family, not to forget my deceased father and 'uncle' Bobby (Richmond)⁵, both single-handed general dental practitioners who were proud to be career-long, active members of the Association. If they were here today, they would be first to tell me how fortunate I am to become President of the Association, and to use the opportunity to promote the profession and, in turn, enhance the care of the patients it serves.

I must also pay tribute to Sir John Tomes, the first President of the Association, on the 200th anniversary of his birth. Sir John remains an inspiration to all of us. Sir John, who, apart from his clinical expertise and acumen, was pre-eminent in his day in dental histology, describing Tomes processes, granular layer and fibrils. Amongst his many other achievements, Sir John inaugurated the Dentists Act in 1878 – a true visionary, innovator and man of vision. If Sir John were here today, it is to be hoped that he would be pleased and proud of the Association he led as its first President.

Finally, I return to the great honour you have bestowed on me, as the new President of the Association. The importance of this high office will be a driving force for me over the next twelve months. I hope I will have opportunity to meet and learn from as many existing and future members of the Association as possible during my term of office. I will greatly welcome all opportunities to support and serve you to the best of my ability as your President.