ADA.org: Future of Dentistry Full Report

148 FUTURE OFDENTISTRY

Dental and Craniofacial Research

This chapter has described selected research
efforts underway that hold much promise for oral
health and the future of dentistry in the United
States. The research points to four key issues and
strategies.
First, while the prevalence of dental caries and
periodontal diseases may be changing for the entire
population, these disorders are still common among
segments of the population, especially those who are
economically disadvantaged, and particularly racial
and ethnic minorities. Within the next decade, the
dental profession and the United States health care
delivery system should make primary dental treat-
ment available to these underserved populations.
Second, if a causal relationship can be established
between dental infections and severe, life-threaten-
ing medical conditions, primary physicians may
become active in diagnosing oral diseases and in
referring their patients for dental care. Thus, dental
and medical professionals should take a team
approach to the prevention and management of
dental diseases to limit their impact on overall
patient health.
Third, within the next 10 to 20 years, research
will lead to new biological therapies for use by den-
tal practitioners. Additionally, advances in molecu-
lar diagnostic and imaging technology will likely
enhance and facilitate the detection and monitoring
of dental diseases. Thus, the dentist of the future
will require a degree of facility with, and an under-
standing of, fundamental biology in order to pro-
vide optimum patient care as novel treatments
become available for dental caries, periodontal dis-
eases, and other oral disorders.
Fourth, researchers have seen an increasing fre-
quency of significant age-associated oral conditions.
These include salivary gland hypofunction, mucosal
lesions, and related tissue discomfort, dysphagia,
and chronic orofacial pain. Additionally, many
medical therapies have significant effects on oral tis-

sues and functions, ranging from conventional phar-

maceuticals that cause dry mouth to extensive mu-

cosal lesions in persons receiving cyctotoxic

chemotherapy, to mucosal candidiasis in immuno-

suppressed patients. Dental practitioners will re-

quire more advanced training in managing age- and

pharmaceutical-associated oral problems.

To establish a pathway toward achieving the

vision articulated at the outset of this discussion, the

following strategies are suggested:

ECONOMICS

The dental profession should consider:

u Exploring, in association with public and private

health care delivery agencies, plans by which routine

primary dental care can be provided to economical-

ly disadvantaged individuals.

u Advocating for third party medical insurance

coverage for oral health care for selected patients.

u Supporting the concept of medical insurance ben-

efits for medically necessary dental care as defined

by the Institute of Medicine in 1999.

DISEASE PATTERNS

The dental profession should consider:

uCoordinating programs whereby resources and

services are better provided to underserved populations.

uPromoting the concept of evidence-based re-

search as the predominant knowledge base that

defines dental training and the practice of dentistry.

Dental schools should serve as models for the evi-

dence-based practice of dentistry by requiring out-

comes assessment for dental care.

III. PATHWAYS AND STRATEGIES FOR DENTAL AND CRANIOFACIAL RESEARCH

IN THE FUTURE

research is the NIDCR, which has significantly
increased its support of TMD research in the past
decade. Recently a TMD Interagency Working
Group has been established to increase the scope
of activities related to TMD. This group includes
many institutes and offices of the NIH, the Food

and Drug Administration, the Agency for Health

Care Research and Quality, the Health Care

Financing Administration, and the Department of

Defense. This multidisciplinary effort should

promote a focused clinical and research agenda

for TMD.