Sir, as a newly qualified nurse, it would be naïve of me to forget how far dentistry has come over the past 80 years. Talking recently to a nonagenarian patient brought things into focus and made me think about the future of NHS dentistry. Back in 1940, the country was in the midst of a global crisis and the Lancet was reporting the spectacular success of animal testing of penicillin, a new wonder drug capable of curing previously life-threatening infections such as gas gangrene. It would be another eight years until the NHS was formed.

Our patient attended an urgent appointment, during which we talked about how much visiting the dentist has changed. She reflected about the similarities to 80 years ago when (aged 14) she started working as a dental nurse. With no training or mentoring, she worked chairside full time from day one. In those pre-NHS days, dental work was avoided by patients until absolutely necessary, treatment was generally limited to extractions and anaesthesia was generally inhalation sedation. Many patients were left with missing teeth and when the NHS (free at the point of use) was formed in 1948,1 she recalled a massive influx of patients seeking dentures to replace their missing teeth. The demand was so high, that she recalled of the dental team (and the lab technician who worked in a shed at the bottom of the garden), 'We just couldn't keep up!' Shaking her head and with a distant look in her eyes, she repeated it a number of times - it was clear it had a significant impact on her. And it made me wonder whether this is how we'll feel over the next few months as we play 'catch up' with patients once things start getting back to normal? And as for the NHS dental services more generally? Back in 1952, dental charges were introduced because the provision of dentures nearly bankrupted the newly formed NHS.2 What are the parallels for the future of NHS dentistry?