Community Dental Health

cover art

Cover Date:
December 2007
Print ISSN:
0265 539X
Vol:
24
Issue:
4

BASCD Presidential Address

BASCD Presidential Address
BASCD SPRING SCIENTIFIC MEETING ‘Oral Health Inequalities, What matters, what works?’ 26-27 April 2007, Edinburgh, Scotland
Ladies and Gentleman, it gives me great pleasure to both address you today, and welcome you to Edinburgh. It is a great honour to be elected as president and to follow in the footsteps of the famous names in the history of UK dental public health that appear on this weighty badge of office. First, I would like to thank Sue Gregory for leading our association through another busy and demanding year. You may recall that it was in Cambridge, in March 2006, Sue stated that it was chance that her conference coincided with the biggest change in NHS dentistry since 1948. nGDS went live in England & Wales, and this happened just after we left the restful confines of Robinson College. Sue’s contribution to community dentistry, dental public health and her leadership of BASCD has been outstanding. Because of her leadership the Association is robust and healthy. From everyone, thank you Sue. I also have to thank the members of BASCD council who work hard on behalf of their members. Our council members do make a huge contribution to the association and both the benefit of their experience and the fruits of their hard work have made my time on BASCD Council so much easier. One of the many strengths of BASCD is our broad membership. All of you members, officers and council are drawn from a wide spectrum across dentistry. So that our meetings always have tremendous atmosphere which I think results from the many different perspectives that delegates bring to the meetings. I would encourage each one of you to introduce at least one suitable work colleague to BASCD to make sure we grow and continue to be the specialist society for community dentistry. I would also ask the younger members to consider standing for BASCD council. My experience is that you will not be disappointed. I enjoyed an excellent training in Dental Public Health; in fact I had a great time, I would recommend it to everyone. It was a privilege to study public health and widen my horizons. I’d like to take this opportunity to thank the two individuals who supervised my training and who shaped my whole career. The first, many of you will know, as the previous writer of the current affairs and comments section in Community Dental Health, the gossip columnist himself, Geoff Taylor. I can honestly say, “Geoff taught me everything I know.” Thank you Geoff. My second trainer was Keith Woods. BASCD has a superb dental epidemiological database, the school based BASCD surveys, which without doubt are the best in the world. Keith Woods helped in establishing, developing and embedding the BASCD surveys in the North West of England and working beside him you could not help but learn from his enthusiasm and the care he took and his attention to detail. Keith also had a great sense of fun and he regularly thrashed me when playing squash. Keith sadly died on 17th September 2005 not long after he retired. For someone who pursued so many keen interests, his death, to me, was unfair and unjust. Therefore, it is some consolation for me to introduce The Keith Woods memorial prize to BASCD. This is an annual prize for a written piece of original research work or good practice in dental health needs assessment or dental epidemiology. I hope that as an Association we can publicise it widely so it becomes an accepted part of dental training and education. The theme for my presidency is reducing inequalities in oral health. I believe that reducing health inequalities is the most important problem we have yet to address and I am glad to say that the governments, in both Holyrood and Westminster agree with me. Some of you will be too young to remember but throughout the eighties in this country we were unable to call them inequalities in health, referring to them euphemistically as health variations! Certainly when I started in Dental Public Health, running a conference around this theme would have been unthinkable. Today it is at the centre of government policy, even if there is little recent evidence that government policies are reducing inequalities. The eighties and nineties were a period of rediscovery of health inequalities and of clarification of their intractable, corrosive and ruthless relationship to poverty. In social class one the standardised death rate from oral cancer is about half of the national average, for males in social class four it is double the national rate or four times the rate of social class one. It is only a gap if you look at the extremes. If we look at the population as a whole there is a clear socioeconomic gradient. Please also note that these are death rates, so it includes both the incidence of the disease and the treatment received for the condition. We know from the work of Dr Julian Tudor Hart that there is an “inverse care law” in both medical and dental care, so the four-fold difference will result from first, a higher incidence and second, poorer survival in people at the foot of the social scale. So, why do we still have poverty, and if we got rid of poverty would we reduce inequalities and flatten the

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