It's a desert out there. Even the tumbleweeds have left town. The only place you'll find a mirror and probe is in the local house of ill-repute, and unfortunately even that's empty.

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So, how do you get dentists to work for the NHS? And why would you? Well, saving the latter question for later, the former is answered out of Nye Bevan's playbook at the inception of the NHS. Pay them some money. At least that's the latest gimmick offered by the government and just in time for an election year.

Unfortunately, it's a paltry £20,000 to around 240 dentists for three years of NHS dentistry. I'm not sure if the sky is blue on their planet as well but that's about as much incentive as a gobstopper for eating a mountain of mulch. It won't even pay for new tumbleweeds. The government spent around £200 billion on healthcare last year but are offering a mere £200 million as part of a plan to boost dentistry. Now, I'm no mathematician but providing a golden hello to 1% of dentists out of 1% of the total health expenditure is barely worth spending at all.

They must believe dentists procure all their materials and equipment from the local civic recycling centre. I'm sure NHS dentists are forced to exercise tremendous thrift all the time but for some treatments, materials and equipment are so expensive they actually have to pay the patient to sit in their chair. The extra £50 offered per patient for more complex dental work, ie root canal treatment, barely covers the price of one rotary file. I realise it's a popular sport to resent dentists for making any living at all but I don't think they're registered as a charity. The material, energy and staffing costs of running a dental practice are enough to make your teeth (and other parts of your anatomy) clench.

So, that's the ‘how', such that it is. Let's think about the ‘why'.

Even newly trained dentists don't aspire to work within the NHS. They might tolerate it at the start of their career to gain a little more confidence and experience but at the first opportunity for private work they're out of there faster than you can ask ‘Are you taking on any new NHS patients?' And why would anyone want to work for a system that is so chronically underfunded, so endemically demonised for its subsequent absence, and that asks practitioners to compromise their quality of care just to make a quota? Does the government really believe dentists would be lured away from a much more rewarding private sector to work for such a system?

I'm not sure if the sky is blue on their planet as well but that's about as much incentive as a gobstopper for eating a mountain of mulch.

The dental profession keeps suggesting that the government needs to get serious about funding such an expensive form of healthcare against a Whitehall culture that clearly thinks teeth are expendable assets. But perhaps it was always a tall order to expect the state to cover such exorbitant costs. After all, doing so in the first place was a gimmick itself and when the eye-watering bills came in the charges to the patient were introduced.

So, the real conversation to be had is one about expectations. What does the dental profession realistically expect from the state in the long term, and are those expectations in keeping with the political aspirations of those that secure the funding? What does the government realistically expect from such poorly funded dental provision, other than an exodus from it, and is the occasional injection of cash worth the imaginary boost to their poll numbers? And once the aforementioned questions have been honestly answered, should the public really expect there to be an oasis in the desert?

No one should have to resort to pulling their own teeth out or supergluing their broken dentures together. But as a nation we have to be honest with ourselves about the cost of providing dental care (and healthcare generally, but one thing at a time). Unless a significantly greater chunk of the healthcare budget that we've all paid into is allocated to dentistry, the practitioners won't be able to offer a meaningful service. Perhaps individual contracts should be abolished altogether to fund more of the proposed regional dental centres in rural and coastal areas. Fewer venues, perhaps, but each with a greater share of 1% pie. Of course, they'll be oversubscribed in no time but it's better than no provision at all.

I'm no fan of state paternalism but nor do I want my fellow citizens to need a tetanus shot after they've inserted a pair of rusty pliers into their mouths. Alas, each political party is little more than a shiver looking for a spine to run up, and without the imagination and farsighted will to tackle this issue, simply trying to coax dentists back to the NHS with a paltry cash incentive is a fool's errand paid for with fool's gold.