Q&A: Dr Nigel Carter, British Dental Health Foundation

DR NIGEL CARTER has been Chief Executive of the British Dental Health Foundation since 1997 though he has been involved with the Foundation for the last 34 years, having joined the Midlands branch within a couple of years of qualification. He began his dental career in Birmingham in 1975 and has worked in both NHS and private practices, showing particular interest in dental implants, periodontology and the management of TMJ syndrome, having pioneered treatment in the UK.

Do you feel the work of the Foundation over the last 40 years has made a difference?

Absolutely. The Foundation was established by a group of far-sighted preventive dentists, supported by the dental trade, against a background of extremely poor dental health in the UK, with the expectation of total tooth loss and dentures by middle age being the norm. Our aim was to raise awareness that this tooth loss was not inevitable and that teeth could be for life.

The mission throughout has been to educate the public to improve dental health. During my time with the Foundation I have seen considerable improvements in levels of oral health. The development of water fluoridation, the advancement of technology and the accessibility of oral health information are but a few of the things that have changed quite significantly. Patients are constantly seeking answers, and having that information a couple of clicks away is a necessity.

What achievements are you most proud of?

Our range of activities has grown hugely over the last 14 years. I inherited an enthusiastic team of five but we now have a team of 13. We have a website visited by one and a half million people a year and we distribute over a million patient education leaflets each year. Our Dental Helpline has answered over a quarter of a million enquiries from members of the public in the last decade.

Extending our National Smile campaign from a week to a month has been very successful in helping to raise awareness of the key messages around oral health, and the Mouth Cancer Action Month each November is helping to raise awareness of a condition that remains a major killer with the fastest growing incidence among cancers.

Should more emphasis be placed on prevention in dental practice?

It is an issue both I and fellow dental professionals feel passionately about. The message of prevention is one that often gets lost in translation when it should be the highest priority. The focus is too heavily weighted on cure, as most people attend the dentist purely to correct poor oral health. If the message of ‘prevention better than cure’ played a prominent role in dentistry today, we would not be faced with some of the problems we see on a daily basis.

The new dental contract being proposed for England, with for the first time an emphasis on prevention and health outcomes, offers a real chance of a quantum change from the previous regime of professionals only being rewarded for carrying out restorative work and not for achieving better dental health for their populations. Much work is being done with children, particularly in areas of high experience of disease, to institute prevention at an early age. With time we can hopefully see future generations having an expectation of good oral health throughout their life.

If you were in charge of NHS dentistry in England, what would

The fiasco of the introduction of an untried and tested new contract in 2006 is now well behind us and following the Steele review and the adoption by the new coalition government of its principles, the new contract pilots do seem to be a step in the right direction. We are fortunate in having an opportunity to change the way dentistry is delivered and rewarded in the future, to remove perverse treatment incentives and to look at improving the oral health of the nation. This opportunity must not be squandered and it is important to get the new contract right and for the profession to embrace the new quality outcome measures based on improvements in oral health not volumes of treatment.

Describe a typical working week.

One of the things I love most about life at the Foundation is its variety. As a charity promoting oral health we will never be able to raise funds by rattling a box in the street or accosting passersby, so on the one hand I have to run a business that raises a million pounds a year and on the other hand then spend those funds to promote our aims of improving oral health.

A typical week can therefore involve meeting with some of our product accreditation clients, a key source of funding, developing new educational material for our leaflets or the web, developing the next major campaign and always looking for ways to promote the message of good oral health via the media. The Foundation issues some 150 press releases a year and these generate a huge amount of interest from journalists. Each week I will speak to a number of journalists about articles they are writing and also carry out radio interviews. Never a dull moment.

Interview by Joanne Curran, associate editor at MDDUS