What is a dentist for? That was the fundamental challenge Professor Jimmy Steele set himself to answer when giving the first BDA/BDJ Anniversary Lecture.
He described how historically an epidemic of caries followed the arrival of sugar with tea and coffee drinking in the 18th century and that sugar had literally fuelled the industrial revolution, providing a cheap source of calories especially for those in the industrial regions of the north. However it was only really in the first world war that those in power recognised the impact of poor oral health as soldiers were unfit to fight, resulting in the development and formal recognition of the profession.
Professor Steele went on to talk about oral epidemiology in more recent years, for example showing the dramatic fall in the number of people receiving treatment for dental disease from almost 100% in 1973 to around 40% in 2013. The rate of edentulousness has plummeted creating a dilemma for him as Head of a Dental School; should complete denture construction stay in the crowded undergraduate syllabus? Despite general improvements, social inequality remains with a core of people (for example children eligible for free school meals) whose oral health is not improving, a difference between the rich and poor which could not be ‘treated away’.
With rapid improvement in life expectancy, Professor Steele suggested that dentists now ‘had to attempt to bridge the gap between our evolutionary needs and nurse patients’ dentitions through a modern lifespan’. The dentist’s role is to improve health, although as a consequence of this redefined treatment need, their work is now ‘harder, more complex and more varied’.