By Raj Rattan MBE, Dental Director at Dental Protection
As we move into 2026, it is worth considering not only how dentistry is changing, but how those changes shape the way we see our work, our responsibilities, and ourselves. Some influences are obvious; others are quieter, like shadows, imperceptibly shaping how we view the world.
To explore this, it is helpful to revisit an old idea. More than 2,000 years ago, Plato illustrated how easily appearances can be mistaken for reality. In The Republic, he described prisoners chained in a cave, able to see only shadows cast on a wall by objects passing in front of a fire behind them. Having known nothing else, the prisoners believed the shadows were real. Plato’s insight was simple but enduring: our understanding is shaped – and limited – by the conditions in which we work.
Over time, entire generations of dentists have practised knowing only the present. For example, for many the shadow cast by the 2006 GDS contract is the only professional reality they have known. We are all influenced by the shadows of regulation, targets, payment systems, commercial pressures, corporate interests, technology, and digital platforms. These shadows influence what is measured, what is rewarded, and – from a dentolegal perspective – what is feared. As the saying goes, you get what you measure for.
These are not predictions, but five features of the 2026 landscape:
1. Social media
A typology of social media use among dentists has been described, including avoiders, secondary and occasional users, observers, seekers, active but cautious users, limited users, engaged users, and deleters1. Despite these differences, there is broad agreement that social media increasingly shapes how dentistry is perceived and judged. These platforms reward visibility, confidence, and certainty, often at the expense of clinical nuance or long-term outcomes. What gains attention is usually what looks good and is easy to share, creating shadows that can obscure the complexity of ethical clinical decision-making.
It is important to recognise that social media can also be a force for good. Used thoughtfully, it can support education, professional connection, patient engagement, and the sharing of good practice. The challenge lies not in its existence, but in how easily its shadows can go unnoticed.
Social media has also created a powerful arena for professional comparison, where clinicians measure their skills, careers, and even lifestyles against carefully curated portrayals of others’ success. Streams of flawless cases and “Instagram smiles” cast shadows over everyday dentistry, editing out the ordinary uncertainties and incremental progress that characterise real clinical practice. Over time, this can contribute to stress, low mood, and burnout, driven by a persistent sense of never quite measuring up despite demonstrable competence.
2. The NHS
The GDS contract has cast a twenty-year shadow that is difficult to shake off – a constant presence shaping how dentists work and how patients experience care. For many dentists who have practised since 2006, these shadows have come to define the new normal.
Recent changes to the NHS dental contract are welcome and may soften some of these shadows. However, they remain cast by familiar objects: limited funding, activity-based targets, and ongoing access pressures. Without more fundamental reform, the risk is that the shadow becomes the cave wall – no longer recognised as a limitation but accepted as the boundary of what is possible.
3. New puppeteers
Artificial intelligence and automated tools are the new puppeteers. Their outputs will increasingly influence diagnosis, treatment planning, record-keeping, and clinical risk assessment. These systems can highlight patterns in large datasets, but they may also embed bias or oversimplification.
Verification therefore remains critical. Conventional clinical methods – including examination, radiographic interpretation, patient history, and relevant investigations – must underpin the use of AI-generated outputs. Clinicians should adopt a process of triangulation, assessing whether algorithmic recommendations corroborate or conflict with clinical findings and the patient’s presenting concerns. This approach helps guard against automation bias – the tendency to over-rely on algorithmic outputs simply because they appear authoritative.
4. Commoditisation and commercialism
Dentistry must operate as a business, and commercial pressures are inevitable. As Holden observes, “the rise and persistence of a commercial model of healthcare and the potential shift towards the commodification of dental services, provided to consumers, should provoke thought about the nature and purpose of dentistry and whether this paradigm is cause for concern.”2
The ethical risk lies not in commercialism, but in commodification. When care is reduced to products and patients to consumers, vulnerable individuals may be steered towards profitable interventions while more conservative, preventive options are overlooked. As I have previously argued, minimal intervention dentistry rarely looks impressive on a spreadsheet, but it often delivers the greatest benefit for patients over time.
5. A global currency
Ultimately, trust is the universal currency of dentistry – a value that transcends borders and requires no conversion. There is no border control when it comes to trust; it is recognised instantly and understood everywhere. The relationship between clinician and patient is built on this foundation.
Rather than relying on caveat emptor – “let the buyer beware” – dentistry should look beyond the shadows and aspire to caveat fides: let trust be safeguarded. That is what every patient deserves and has a right to expect.
References
1Mondkar, A., Scambler, S. & Gallagher, J. Hashtag, like or tweet: a qualitative study on the use of social media among dentists in London. Br Dent J (2021)
2Holden ACL. Consumer-driven and commercialised practice in dentistry: an ethical and professional problem? Med Health Care Philos. 2018 Dec;21(4):583-589.
