FUTURE OFDENTISTRYulations, orthodontics, periodontal services, endodon-
tic services, and oral and maxillofacial surgery.
The demand for preventive dental services is
expected to continue to grow. Preventive dentistry
needs will be strengthened if it is clearly demon-
strated (by intervention studies) that improved
oral health leads to improved cardiovascular, res-
piratory, endocrine, and reproductive well-being.
Indeed, well-demonstrated oral-systemic links
could profoundly affect the traditional dental
delivery model in the United States (Loesche,
2000). If these studies result in significant increas-
es in third party dental coverage, this could pro-
duce a sudden, large, and disproportionate
increase in the percentage of dental users. Such a
scenario would further augment the demand for
oral preventive services.
Although caries rates have declined in children,
the need for dental services provided by pediatric
dentists will likely increase due to the higher
caries rates in young children (newborn to two
years), special needs patients and low- income
children (USDHHS, 2000a). This trend will be
amplified by an increased tendency of Americans
to avail themselves of the services of pediatric
dentists as consumer awareness and average
wealth increases.
The need for practitioners treating the under-
served and public health dentists will increase as the
numbers of underserved populations increase. Also,
the need for community-based preventive and serv-
ice programs will require increased numbers of
public health dentists and practitioners treating the
underserved.
Orthodontics for both children and adults will
continue to thrive. Combined surgical-orthodontic
protocols will continue to benefit patients with com-
plex needs. Pediatric dentists, general dentists, and
periodontists will continue to perform some adjunc-
tive orthodontic procedures.
The need for periodontal services will continue to
increase. New computer-based technologies will
likely make treatment more affordable.
A growing demand for regenerative and cosmetic
periodontal plastic surgery will also contribute to
this demand. Moreover, the increasingly well-
publicized link between oral infection and systemic
health will result in dentists assuming a larger role
in clinical oral medicine in collaboration with physi-
cians and other providers (McFall, 1989). Perio-
dontal services will be performed by periodontists,
general dentists, and to a limited degree, dental
hygienists. The growth of esthetic dentistry may
increase the need for more endodontic care.
Endodontists and general dentists will continue to
perform the bulk of endodontic procedures. The
demand for endodontic services will remain high as
many patients opt to maintain teeth rather than
accept extractions.
The percentage of the population that is com-
pletely edentulous will decline in the future, however,
the absolute number of individuals with at least one
edentulous arch will increase through 2020 suggesting
that the demand for traditional removable
prosthodontic services will not decrease in the short
term.
The demand for fixed prosthodontic services is
expected to remain strong. A major medical break-
through that significantly increases life span would
increase the aggregate demand for prosthodontic
services. The surgical placement of dental implants
will remain part of the specialties of both periodon-
tics and oral and maxillofacial surgery. Surgical
placement of implants by prosthodontists and gen-
eral dentists will continue to increase. Prosthodon-
tists and general dentists will continue to direct the
scope of implant restoration.
The scope of practice of oral and maxillofacial
surgery will continue to expand. With a number of
training programs offering a medical degree and
additional training in facial reconstructive and plas-
tic procedures, the boundaries between the special-
ties of oral and maxillofacial surgery, otolaryngolo-
gy, and plastic surgery will continue to blur.Dental Care DeliveryThe dominant dental delivery modes will con-
tinue to be solo practices and small group prac-
tices (Valachovic, 2000). Special needs popula-
tions, such as medically compromised patients
and nursing home residents, have access problems
that extend beyond funding. Models of care
delivery, such as school-based programs, hospital
dental programs, mobile dental service, and
portable dental practices will be needed to meet
the oral health needs of these individuals. Health
science centers with a critical mass of oral health
expertise will become repositories for meeting the
needs of complex patients.Clinical Dental Practice and Management