Dentistry is a profession at the crossroads, which is why patients in some areas may find it difficult to get NHS treatment.

The incidence of dental disease in the West has dramatically fallen since the Seventies but there are still isolated areas, such as Brighton and Hove, where the occurrence of dental disease, particularly in children, has not fallen as sharply, even though this aspect of dental treatment can easily be performed by hygienists and auxiliaries.

Where the elderly are concerned, they may need advanced treatment (for example, crowns or bridges), which call for the expertise of a dental surgeon.

We need to increase the number of dentists and we certainly need a more rational deployment of people working under the dentist's supervision.

There has been a tendency for over-regulation of the dental profession. Managers and administrators have, in some respects, subverted the role of the health professional.

The numerous regulations, couched in language which only lawyers can easily understand, are one of the reasons many dentists opt for patients under private contracts. With increasing NHS charges, the margin between private fees and NHS ones has increased.

More dentists are being recruited from Poland where they have been highly trained and where there is a high dentist-to-population ratio. Although they don't have to go through an English language test before they register in the UK, their standards are approved by the EU.

The recruitment of dentists from India is more of a problem, if only because the developing world needs all the specialists it can get.

The level of tooth decay in Brighton and Hove would no doubt be reduced to a large extent by the fluoridation of water supplies. The benefits considerably outweigh the risks and everyone, from children to the elderly, would benefit.

Ideally, the availability of NHS dental treatment should improve in parallel with a general improvement in oral health.

-Sam Barsam, Hove