Changing a poor impression is like pulling teeth

They may still put the fear of God into many people, but the dentistry profession is trying hard to loose that Spanish Inquisition image.

"When I graduated in 1964 most of the work was in extractions and fitting dentures," says John Clarkson, professor of public health and dean of the school of dentistry at the Dublin Dental Hospital.

"We were fighting an uphill battle against decay. Visiting the dentist was generally painful and many people left without their own teeth."

Modern techniques have changed people's expectations of keeping their teeth, says Clarkson. Children see the dentist at a much earlier age before problems begin, so their initial experience is not too unpleasant. "Children's introduction to the dentist is generally for a check-up or a clean and polish, not for an extraction." Dentistry is a very precise, specialised health profession. Some dentists specialise in dealing with patients of particular ages, others go into specific areas such as orthodontics or periodontics (gum disease). Vast areas of research are opening up, says Clarkson. "We're currently doing a lot of research into titanium implants to replace bone lost form the jaw." The current emphasis is on promoting dentistry as one of the health professions. The symptoms of many illnesses dealt with in general medicine first appear in the mouth, says Clarkson. "We've gone beyond extract and replace," he says, "it's time to put the mouth back in the body."

Changing the image is a tough job he says. "Patients still tend to be nervous and can be very tentative about going to the dentist."

However in the Dublin Dental Hospital, the training ground for the TCD dentistry students, patient relations is an integral part of the course. "Students begin seeing patients at the end of their first year, allowing them to develop their communications and social skills."

In the Dental Hospital in Cork city, where the UCC dentistry students are trained, Dr Noel Ray also emphasises the importance of patient relations. "You need to be able to get on with people," he says. "If you can't stand people you'll be totally frustrated. It's not all about the points you got in the Leaving."

This is an important point, he says, but one which prospective students don't take on board. "Dentistry can be a stressful occupation, but it's as stressful as you make it, so for your own mental health you have to seriously consider why you're choosing the course." If you decide that dentistry is for you, it can be a very rewarding career, says Ray. "I don't know of any dentists who are unemployed, and with no internship year you can go into practice straight away." The UCC degree course is over five years with a "virtually zero" drop-out rate. Many of the 35 yearly graduates go to work in Britain for a couple of years and then return to set up their own practices. The TCD degree course also has a very low drop-out rate, according to Clarkson. It too is over five years and takes in 40 students each year. The course offers great opportunities for travel and students can do work-experience "electives" in countries as far away as Vietnam, Nepal and South Africa.

After graduation Irish dentists are free to work anywhere in the EU, but the job prospects here are currently very good, says Clarkson. "There are very good opportunities within the medical card scheme, especially on the east coast."

The vast majority of graduates go into general practice. Most don't have their own practice straight away because of the expense of setting them up, but go into joint practice or an associateship with more established dentists. Others work with the health boards on the GMS (General Medical Service) scheme. Some large companies employ a dentist for to look after their employees and a small number go into teaching in the dental hospitals.