FUTURE OFDENTISTRYstrong. Dental restorations have a finite life span.
Materials fail, caries recur, teeth fracture, dental
restorations wear, and esthetics change. The longevi-
ty of the new resin and resin-bonded restorations is yet
to be determined. Implant-supported restorations will
be used increasingly to replace lost teeth. Increased
use of periodontal surgeries for pre-prosthetic and pre-
implant treatment is anticipated as teeth retained into
older age fracture and wear. Thus, it is anticipated that
replacement of existing restorations will be a larger
proportion of the dental practice.
Preventive services will increase as adults seek to
maintain their oral health. This trend could increase
significantly if research on the relationship between
oral infections and systemic health strengthens.
New diagnostic and therapeutic tools to enhance
risk assessment may include:
u Assessment of salivary function and cariogenic
bacteria;
u Refined caries diagnosis utilizing digital radiog-
raphy, optical fluorescence, and possibly ultra-
sound and electrical impedance;
u Selection of appropriate antibacterial therapy; and,
u Development of "smart restorations" that incor-
porate the release of fluorides and antibacterial
agents over time.
Dental esthetic services will increase as the
demand for all types of cosmetic services increase
(American Society of Plastic Surgeons, 1999). An
increase in implant services is also expected.
Absent major increases in third party coverage, the
number of root-form dental implants placed each year
in the United States will increase approximately 4% per
year (about 610,000 in 2003). The much smaller num-
ber of non-root-form implants (for example, blades and
subperiosteal) will gradually decrease as the availability
of improved dental bone augmentation materials con-
tinues to expand care options for orofacial trauma. The
convenience-driven shift from two-stage tooth-form
implants to one-stage and immediate-loading designs
will continue (Medical Data International, Inc., 1999).
Future dental consumers will be more aware of the rela-
tionship of oral and systemic diseases, oral care prod-
ucts, technology, and oral health clinical services. Such
information will be widely available through electronic
media; and, oral health will become increasingly associ-
ated with overall health and success and achievement.
In addition to the changes in demographics and
disease trends, economic factors will affect the
demand for clinical services. If the economy
remains strong, demand for services should remain
strong as well. Even if costs increase, it is likely that
more educated, affluent individuals will continue to
avail themselves of both needed and elective dental
services. However, an economic downturn of sig-
nificance could create market force changes that
could decrease the demand for clinical services,
especially those of an elective nature. It is not clear
what the effect of such a downturn would have on
access to dental care for low income or other under-
served populations.TECHNOLOGICAL ADVANCES IN CLINICAL
PRACTICE MANAGEMENTAdvances in technology are quickly transforming
the dental workplace. New information manage-
ment technologies and advanced diagnostic and treat-
ment tools are improving diagnosis, patient care and
patient care management. A major challenge for den-
tal practice managers will be to achieve a coordinated,
systematic, and secure approach to the integration and
application of information technology. Many of the
issues in sharing data and setting up such systems are
not solely technical in nature, but rather involve legal,
economic, and political considerations (Schleyer,
1999; and Willis et al, 1997).
The infrastructure for communicating patient in-
formation will evolve to a point where the informa-
tion is readily available and where computers will
anticipate the need for information and will provide
it. Within the dental office, dentists will have access
to all patient charts, radiographs, and other perti-
nent data. Scheduling likewise can occur chair-side.
Computers will enhance communication between
dental offices, and also between dental offices and
other health care professionals.
Computers will become more effective tools for
patient education both within and outside of the
dental office. Scientific advances will require den-
tists to become increasingly techno-literate evalua-
tors and users of new and improved technologies.
More hours and a greater percentage of the typical
dentist's continuing education time will be devoted
to techno-literacy. This need will be partially
addressed by technology vendors. However, the
market for unbiased and accurate informationClinical Dental Practice and Management