New Zealand Dental Association

Thank you, Dr Isdale, Mr President, Mr Orthodontic President, Mr Australian President, other distinguished visitors, members of the Association, ladies and gentlemen.

Thank you for your welcome and for the invitation to open this, your 19^th Biennial Conference. May I, in my turn, extend a welcome to our visitors from overseas. I trust you enjoy not only this conference, but this capital city, and, hopefully, something of the New Zealand beyond it.

I should tell you at the outset that I was warned that you know all the dental jokes. Not, of course, that I would have been tempted to tell one. Because of course, these days the profession most often targeted by jokes about painful extractions is my own, the law.

And so instead of disregarding the warning, I would like to pay an opening tribute to the great advances in dental skill and technology, and hence patient comfort and well-being, that there have been in recent years. One consequence of your profession's extraordinary progress has been to enable a coward like me to come and face dentists en masse, as I do my own dentist now, with a considerable degree of equanimity. It was not always so. I still vividly remember my childhood years, when my dentist, who was really a very kindly man, had to hold me down while I screamed and squirmed, especially when he was trying to put a gas mask on me for some extraction or other. That was the painful, miserable era of seemingly interminable drilling and picking.

But today, how different it is with high speed drills, an understanding practitioner who always gives me a local ('needle for the injection coming up!'), and a youthful nurse wielding a mini hoover. The ultimate experience for me though, was an emergency visit in another town, when I was asked what kind of music I liked, and then dreamily listening to Bach while a root canal was plumbed painlessly and noiselessly.

Like all medical and related sciences and skills, dentistry has seen remarkable changes. At the same time, public attitudes to all the professions have changed quite remarkably too. No longer are clients or patients acquiescent. They have become questioning, even challenging. And much more knowledgeable.

Once, it would be fair to say, the opinion of the professional was absolutely final - only he (this is the old days we are talking about, after all), only he truly had what you could term the 'inside' information. But now, members of the professions are no longer the only people who have access to specialist knowledge and expertise. As a result, society as a whole no longer feels so dependent on many of those experts whose pre-eminent status could, in earlier times, never be scrutinised or challenged by outsiders. This is the age of professional accountability, when all are open to criticism and challenge, and to public scrutiny and, sometimes, vilification.

Crucial to accountability is communication. And so the theme of the Conference "Communication in Dentistry" is not only timely, but extremely important. I have to confess to a wry smile when I first read the theme, for it brought to mind images of the practitioner unburdening his mind to the patient while preventing any coherent response with wads of cotton wool and sundry metallic objects, so permitting only grunts of somewhat indeterminate meaning.

But of course that's not the sort of communication that the theme of this Conference is about. Nor is it just about the need to gain truly informed consent for any significant procedure. I suggest that effective communication requires as well that the professions strive to develop their capacities as educational institutions; institutions that foster learning partnerships: between the practitioners, in the sharing of knowledge and experience; between the professionals and their clients or patients; institutions that can, continuously, adapt to the needs and circumstances of the public they serve. When the only constant in professional life is change, the way a profession operates becomes about as important as its stated objectives. Its style has to be considered as well as its substance: its means seen as being as important as its ends, because its means shape its ends.

It is becoming less and less possible for anyone or any group in the modern world to command respect. Instead, it is becoming increasingly necessary to earn it, day in and day out. The patient is not quite like a customer, in that he or she will not always be right, but he or she will nevertheless always be entitled to make and take the ultimate decisions. Patients are, in other words, like the person mentioned in a limerick, which of course is not about a dentist:

There was a young man with a hernia
Who said to his doctor, "Goldernia!
When improving my middle
Be sure you don't fiddle
With matters that do not concernia."

And this change in professional orientation, from being unquestioned providers of expertise, to being partners in an on-going and on-demand educational relationship, seems to me to be perhaps the greatest challenge that faces every profession in the modern world; an even greater adaptation than those that have already been made to cope with the pace of scientific discovery and technical innovation.

Certainly, many traditional activities remain vital. As always, the professions must maintain their historical focus on such processes as peer-review; the development of professional standards; and the recognition of the excellence of individual practitioners.

But as well, these days, a truly responsible profession must also be consciously looking outwards, beyond its membership, to its clientle and to the community of which we are all a part. The imparting of information to patients is just one aspect of this requirement.

As well, a new facet of professionalism is necessary: one that provides an accurate context, both scientific and ethical, for the flood of new knowledge and capability that science brings forth, and which communications technology then makes universally available.

A professional body, amidst today's bountiful supply of un- or semi-qualified opinion, must now provide constant reminders of what its members truly stand for, the wisdom its members have accumulated, the sound judgements that its members can be relied upon to furnish. This sort of activity, this on-going establishment of professional bona fides, will consume a greater proportion of ever-scarcer professional time and resources, than used to be necessary. But that is really no bad thing. Given the theme of this Conference, it would also appear that the professionals here gathered, already agree.

I am sure you are going to have a productive Conference and I wish you a pleasant stay in Wellington and beyond. Again, my thanks for the invitation to be with you this evening. I am looking forward to meeting many more of you - and communicating with you - later in the evening. For now, though, it is my pleasure to declare this 19^th Biennial Conference of the New Zealand Dental Association officially open.