Dentistry as a Career

Over the past half century a gradual reevaluation of both the philosophy and the practice of dentistry has taken place. Whereas around World War II it was estimated that half of all Americans over 65 had lost all their teeth, by the end of this century, this figure for the same age group will have been reduced dramatically. The reason for this is that there has been a profound improvement in the oral health of recent generations of Americans caused by water fluoridation and the associated change in the role of dentistry, from one of treatment to one of prevention of tooth decay and gum diseases.

In terms of dental practice, an arsenal of new tools, techniques, drugs, and restorative materials has been developed over the past 30 years. These have dramatically expanded and improved the dentist's capacity for providing care in all areas. Among these developments are: (1) the high-speed air drill that minimizes the pain, time, and noise associated with drilling; (2) a variety of materials, both metal and plastic, that can now make up crowns and bridges; (3) plastic sealants that can be applied as a coating film over children's teeth to prevent decay-causing bacteria from attacking them for up to two years; (4) an alternative to bridges and dentures whereby one or more teeth can be set over metal implants inserted into the jaw bone; (5) a new technique called bonding in which a composite material that is undetectable can be glued onto the tooth, enabling chipped teeth to be repaired, spaces between teeth to be filled, and worn-down teeth to be restored, all with aesthetically appealing results.

Advances have also been made in diagnostic techniques, and research is continuing with the focus on preventive dentistry. The prospects for better oral health, therefore, are much higher, provided that increasing numbers of people practice good oral hygiene and avail themselves regularly of competent dental care.

Another major change that may be in the offing is the way dental services will be delivered. The traditional approach since the development of modern dentistry has been to have services provided by the individual practitioner. During the last decade, groups of specialists in a particular specialty area have joined together to utilize a common facility on a rotation basis, thereby cutting down significantly on operating expenses. Thus group practices devoted exclusively to endodontics, for example, have developed.

Multipractitioner dental clinics, that is, clinics that offer primarily general but also specialty services, have sprung up in department stores and shopping centers. Their expansion from only a handful in 1978 has primarily been stimulated by legal decisions allowing dentists to advertise. Other contributing factors are the high cost of quality dental care at private offices and the unequal distribution of dentists in some areas.

In 1979 about 125 million Americans spent more than $13 billion for dental treatment, 90% of which was provided by individual practitioners. It is certain that the trend is away from private care and toward multipractitioner clinics. This will have enormous implications both for patients and for dentists already in practice and those planning careers in dentistry. The new approach to dental care delivery holds the promise of offering less expensive and more convenient care.