June marks the Diamond Jubilee of Her Highness Queen Elizabeth the Second. During her reign she has seen many changes in dentistry.
The first and most important development in this time is the aspiration of the population in relation to oral health. In the 1950s almost half of adults would lose their teeth during their life. The National Health Service had come in to being in 1947 in the post-war era and the expectations of the public were relatively low. During her 60 year reign things have changed. The patterns of dental disease have changed and the science of dentistry has moved with it. Most children born today can expect to keep their teeth for life and the level of knowledge is such that there is now no excuse for the ravages of dental caries and periodontal disease to take effect. Perhaps a failure is that these diseases are still essentially socio-economic in their distribution.
That is not to say that the influence of the dental profession is negligible. Patients have access to dental care at greater levels than in 1952 but there are so many potential causative factors in the improvements of oral health that it cannot claim all the credit. Fluoride toothpastes have had a huge influence and, along with improved diet, have helped. The advancement of knowledge in dental science has, however, allowed the profession to understand how to help patients achieve oral health and to understand the new challenges.
A second feature is the use of technology. We have had the development of high speed handpieces, implants, lasers, materials and adhesives and, of course, a greater understanding of infection control. Many of these technologies have helped us to treat patients although recently there has been much debate in the press about whether it is right to treat just because we have the technology. Porcelain does not replace enamel even if it makes a substitute for the lack of it.
The NHS system that existed in 1952 is still broken although it doesn't resemble the system as it is now. The dental professions are still arguing that it isn't working. The reality is that in 60 years the profession has adapted to the change and most dentists and other dental professionals believe they do a good job in difficult circumstances, even if those circumstances have changed regularly over this time. The key difference is the loss of mobility of the profession with the health department now effectively back in charge of the budget. In a sense this is a loss of autonomy for patients.
We have had many big names in dentistry over this time. Sadly many have passed on. However we have our own Queen who has reigned for much of this time, starting her dental pathway in 1954. She has held almost every top post in dentistry and was the first woman to hold many of them. Although technically a Dame she has reigned in dentistry for many years. There have not been too many Kings over that time and we don't have our own version of William and Kate. So I hope we will celebrate the Jubilee with the knowledge that anyone who offers service over 60 years deserves to be recognised for it.