1231

The Profession of Dentistry.

THE LANCET.

LONDON: SATURDAY. DECEMBER 9, 1922.

A person shall not be entitled to take or use the name or

title of " dentist " (either alone or in combination with anyother word or words) or of " dental practitioner " or anyname title addition or description whether expressed inwords or by letters or partly in one way and partly in theother implying that he is registered under the Act or thathe is a person specially qualified to practise dentistry unlesshe is registered under the Act.IN these words the Dentists Act of 1878, as amended

by the Medical Act of 1886, sought to make provisionfor the registration of person specially qualified topractise as dentists in the United Kingdom, and it wasthe hope of its promoters that the Act would result inthe creation of a profession of duly qualified men.Unfortunately the Act proved to be unskilfully worded,and in 1909 the House of Lords, in the case of Bellerbyv. Heyworth, decided that there was nothing in thewording to prevent anyone from doing dentist’s workand informing the public that he did so. Only he mightnot call himself dentist, dental surgeon, or surgeon-dentist. The description forbidden by the Act was apersonal description of the man as distinguished from adescription of his work. As an immediate consequenceof this decision, numbers of unregistered persons putup their names, adding such words as " dental surgery,"with the result that their clients believed that theywere being attended by a dental surgeon. These

persons being under no control in the matters of

advertising or canvassing for patients made it difficultfor registered men to hold their own, with the naturalresult that the numbers diminished of those willingto go through the curriculum and to obtain a diplomaor degree. The situation was made the subject of

inquiry by a Departmental Committee, appointed in1918 under the chairmanship of Mr. F. D. ACLAND,M.P., and as a result of the labours of this committeethe Dentists Act of 1921 was passed. By this Act an"interim period " was allowed during which all

persons then practising dentistry might, on applicationto the Board and on satisfying certain requirements,have their names entered on the Dentists Register.This period expired on Nov. 30th, and from now on,with the trifling concessions mentioned below, all

practice of dentistry by persons not on the DentistsRegister is illegal and no person can practise unless heenters the profession by the ordinary portal of thedental school curriculum and diploma.The only exceptions now valid to the practice of

dentistry by registered dentists are (1) in the case ofregistered medical practitioners, (2) the extraction ofa tooth without an anaesthetic by a registered pharma-- ceutical chemist or registered chemist and druggistwhere the case is urgent, and (3) minor dental work inany public service in accordance with conditionsapproved by the Ministry of Health. Registrationentitles the holder to take and use the description ofdentist or dental practitioner, but he is strictly for-bidden to take or use, or affix to or use in connexionwith his premises, any title or description reasonablycalculated to suggest that he possesses any professionalstatus or qualification other than a professional statusor qualification which he in fact possesses, and which is

indicated by particulars entered in the register inrespect of him. We are here quoting the exact

wording of the Act which is believed this time to affordno loophole for malpraxis. The scope of what isforbidden to the unregistered person is very wide ;for the purposes of the Dentists Act, the practice ofdentistry shall be deemed to include the performanceof any such operation and the giving of any suchtreatment, advice, or attendance as is usually performedor given by dentists, and any person who performsany operations or gives any treatment, advice, or

attendance on or to any person as preparatory to orfor the purpose of or in connexion with the fitting,insertion, or fixing of artificial teeth shall be deemedto have practised dentistry within the meaning of thisAct. The penalty for illegal practice is heavy, as anoffender is liable on summary conviction to a finenot exceeding £100 for each offence. The Act containsa number of detailed provisions as to the personswho may be registered under it, the principal classbeing those of good personal character and 23 yearsof age in July, 1921, who had been in practice for fiveof the seven years immediately before that date, orwho had been members of the Incorporated DentalSociety not less than a year before the same date.Special provision has also been made, by examination,for those who had not been in practice so long and fordental mechanics. Any registered pharmaceuticalchemist or chemist and druggist who at the date ofthe passing of the Act had had a substantial practicein dentistry was also registrable. The Board was givencertain powers for admitting ex-Service men to theRegister, provided it is satisfied that the publicinterest would not be prejudiced thereby. Provision

has been made for dental companies to carry on theirbusiness provided that the majority of the directorsand all the operating staff are registered dentists.

As a result of the Act it is expected that some 8000names will be added to the Register, the total numberon which has been for a decade between 5000 and 6000.Before the passing of the Act of 1921 discipline wasmaintained among registered dentists by the GeneralMedical Council who conducted the necessary inquiriesthrough a statutory committee appointed under theDentists Act of 1878. The Council had in seriouscases the power to erase a name ; the deterrent effectwas, however, much lessened by the fact that a man,even after erasure, might still continue to practise,although he might not call himself a dentist. TheCouncil still possesses the right of erasure, but the dutyof inquiring into cases has been transferred to theDental Board, who will make recommendations tothe Council. Now that practice by unregistered personsis forbidden altogether the penalty of erasure will befar more serious, amounting, indeed, to taking awaya man’s livelihood. On the other hand, the dentistwho practises in an ethical manner is protected by theAct from unscrupulous competition. The Dental Boardhad recently, with the approval of the General MedicalCouncil, drawn up for the warning of practitioners anotice, the substance of which appears on p. 1242.From this it will be seen that advertising and canvass-ing are altogether forbidden and that the standardwhich has always obtained among professional menwill be strictly maintained. The view of the DentalBoard is that the dental profession is likely to take afar higher position in the future than it has done inthe past. The importance of conservative work, asopposed to extractions and the use of dentures, is

being increasingly realised by the public, and therecan be little doubt that the coming into effective

operation of the Dentists Act marks the beginning ofa new era in the health of the nation.