The image of a dentist

When Gilbert and Sullivan penned their famous lyric in 1879 for the comic opera The Pirates of Penzance 'I am the very model of a modern Major-General' they established the slightly frenetic tempo for job descriptions thereafter. Behind the original lyric is the notion that to be worthy of holding an office, one has to be up to date on a whole range of knowledge and understanding; qualities which might not otherwise be immediately considered relevant to the main tasks involved in the day-to-day skills of the job. The Major-General in question even confesses to knowing what a mamelon is - a dental term with which many of us may not even be conversant. Without attempting to rewrite the entire song, the point is that as dentists we have to have an incredible range and depth of knowledge and experience on everything from Hertwig's sheath to capital gains tax in order to function as efficiently and effectively as possible in the care of our patients and support of our teams. Yet, how many individuals really appreciate our worth in this context? What is our image?

The question has been partly prompted by a paper in the previous issue of the BDJ.¹ Gierok et al. provided a very comprehensive overview and catalogue of the portrayal of dentists in USA films between the years 1913-2013 and analysed them in relation to the way in which that medium sought to place us in society. The danger is that any individual or group can take to heart what might be construed as a negative or demeaning representation of themselves. This is especially so when, in the wider context of what the world really thinks or knows, it is at odds with the way in which the motion picture industry or television production chooses to project it.

That said, the authors of the paper detected shifts in perceptions over the decades and grouped these into three eras: 'Although there is no consistent stereotype of a dentist, the figure of "Dr Awkward" can be attributed to the silent film era, "Dr Prosperous" to the 1960s/1970s and "Dr Evil" to the 1980s/1990s.' Importantly, they also note a gradual, if almost reluctant, swing towards portraying female dentists and note patients' desires for aesthetic perfection. These factors are a significant insight into the minds of the creative teams, which it is perhaps fair to say lag behind the situation in the real world of increasing numbers of women dentists and of major technological advances. Entertainment movies are, by their nature, not documentaries so while we should not get upset that the latest advances are not given screentime it should also be balanced by a pressure for creators to reflect modern situations. Do they not attend dentists themselves? Most certainly the performers do, hence the widely used adjective of Hollywood smiles which transcend tinsel town parlance into mainstream aspiration.

Our image is assessed by patients and by our local and national media, and increasingly social media.

All this is well and good, but whilst we might visit cinemas and stream content, we don't all live in a media enclave in Los Angeles. However, our image is assessed by patients and by our local and national media, and increasingly social media. So, what does that tell us about how we are regarded here in the UK, and possibly elsewhere in the world? Taking the authors' categorisation of the 1960s and 1970s era as 'Dr Prosperous' fits well with the type of publicity that plagued us in the late twentieth century. An infamous BBC Panorama television documentary on dentistry of that time set the mood by using the ABBA song Money, Money, Money as its backing track over footage of Rolls Royces.

Yet, as we have rolled into the current century, I detect that attitudes have changed and our image with them. The BDA helped the beginning of this process some years ago by pointing out to journalists and writers that dentists were not withdrawing from offering NHS dental care for reasons of wanting to profit from private practice but, conversely, that they could no longer provide NHS care economically. This situation has of course become more extreme since the introduction of the 2006 contract in England. The progressive effects of this stance have provided benefits and I think that now, above all else, the key attitude our patients have towards us is one of continuing trust.

This is the image we have rather than a fictional coating of former identities and personas. No one believes we inflict pain deliberately, no one believes we are purely comic characters. Increasingly, patients understand why we are motivated to move to systems that enable us to provide the care we believe will benefit them most. We might, accordingly, fit our own words into a D'Oyly Carte homage: 'we are the very models of a modern caring dental team'.