Dental Lighthouse

Guy Laffan (GL): Where did you grow up?

David Thomas (DT): I grew up in Sparkbrook, in inner city Birmingham. Our house backed onto the BSA motorcycle factory

GL: What got you into Dentistry?

DT: I did sciences at A level and went to Birmingham Dental School on an open day. I liked the idea of working with people and in a healthcare environment.

GL: What’s your fondest memory of dental School?

DT: I think I valued the whole experience of learning something new, but most of all I valued my class mates many of whom have remained friends for 40 years.

GL: What’s your worst memory of dental school?

DT: Failing finals seemed like the end of the world, but I guess as thing turned out it wasn’t!

GL: How did you become CDO for Wales?

DT: I worked in the GDS for 10 years after qualification, however I decided working in practice wasn’t for me.

I pursued a career working in Dental Public Health over the next twenty years, firstly in Birmingham and then in Oxford.

These jobs gave me a great grounding about the bigger picture and about how to problem solve on a population basis. When my children left home we decided to move back to Wales, and I obtained another DPH job in SE Wales.

However, I was seconded into Welsh Government as Deputy CDO and then when Paul Langmaid retired, I applied for and got the job.

GL: What exactly did the role entail?

DT: As CDO you are the principal adviser to the Government on all things relating to oral health. You must support and implement government policy and advise the Minister on all issues relating to oral health.

In general, that means – that you do a number of things – develop advisory reports, attend lots of meetings and conferences, liaise with colleagues across the UK and answer innumerable emails every day.

GL: What goals did you have when you started the role and how did you achieve them?

DT: I had two goals -Firstly to ensure that oral health of the population of Wales improved and that we developed a better NHS dental contract that would be fair to patients and fair to dental teams operating it.

In order to achieve that I developed a National Oral Health Plan which was introduced in 2013. I think that we are starting to achieve some measurable improvement in oral health and the current CDO is certainly trying to introduce a new contract which will reward preventive interventions as well as treatment

GL: Where are you now?

DT: I am currently Director of Postgraduate Dental Education for Wales

GL: How do you see the future of UK dentistry?

DT: This is one of the most difficult questions to answer and something I have struggled with for many years. On the one hand technological and IT development has revolutionised the way that dental teams work, however the business model has been challenged by the squeeze on funding from Governments and the effect of national economic austerity.

The facts are clear. The cost of running a dental practice is going up not going down. The cost of salaries continue to increase, as do the cost of materials, technology, and premises, Dental Teams seem now to be in apposition where there is nowhere now to make large cost reductions and large reduction in your fixed costs over time. I don’t think there will be much change until:

1. A new NHS contract is developed – and we decide how the fixed sum of money that is available is best spent.
2. We see a greater involvement in the use of other members of the dental team to deliver some aspects of care

GL: What do you think will be the biggest change?

DT: I guess the further decline in the one surgery practice and a move to bigger more diverse practices co-located with other professions.

I hope that we develop a system which focuses more on health and prevention in a more integrated way using the skills of other professions in tandem with the dental team.

In addition, we need to utilise all members of the dental team to their full potential, allowing them to look after the patients well-being, by being their first contact at the practice, by advising patients about oral health through sessions that the dental practice is remunerated for.