In a short article in the December 2011 issue of Dental Update, two dental students in the U.K. have prognosticated about their new profession. They identify some major trends over the next ten years in delivering dental care to an aging U.K. population.1
- The restorations in many older patients will need replacement.
- There will be a shift, subsequently, to maintaining new restorations until end of life.
- An increasingly acidic diet (attributed to austerity and the price of food) will increase caries increment and caries prevalence.
These trends will surely raise interest in more preventive care by both the adult patients, and under capitated reimbursement, by the dental provider.
But I see other broader developments which will further the movement to more preventive care and radically change dentistry over this coming decade:
- Health seeking behaviour. The older generations are no longer simply frail and sitting in their easy chairs with their slippers on. Nor are they passive about their health – including their oral health. Witness the yoga movement and the success of adult exercise programs. Lifestyles and underlying values are clearly changing, mainly because the older folks are so much more informed about their health and their choices to keep healthy.
- The growing connection between oral health and systemic health. Imagine the impact of a study which showed that root caries was more significant to heart health, than cholesterol! Wouldn’t that stir things up in the waiting room? Well, we already know this to be the case (witness data from the Atherosclerosis Risk in the Community Study), and we will surely know much more in the coming years. Many patients already know about the link between oral health and overall health, but more studies will feed this interest into a stream of inquiries about prevention. Many will ask what restoring a cavity will do to protect the tooth, and the heart.
- Austerity and creeping user-pay. The economy is unsettled not just because of almost insurmountable government debts, but also because wealth has shifted to the East, because technology permits new ways of doing things, and because the aging population has different consumption patterns. The days of subsidized dental care are waning fast, if not over. The patient will pay for his/her care more and more. And simply put, a patient paying the bill prefers prevention over restoration.
- New preventive technology. Imagine a topical, painless treatment which will prevent 70% of cavities over one year in the highest risk adult patient. That’s Prevora.
Dentistry in a decade will certainly be different.
Ross Perry
1. Kateb E-L, Heming M. 2011. Dentistry in a Decade: Recent lessions from the Adult Dental Health Survey. Dental Update, December, 658-659.