A peer-reviewed journal that offers evidence-based clinical information and continuing education for dentists.

Quo Vadis

One positive influence on clinical practice is the pace of technological advances, and a great example is the increasing use of “distance learning.”


The clinical practice of dentistry is changing. These changes are being driven by multiple issues that are shaping the future of dentistry. Let’s briefly examine some of the key drivers.

For starters, globalization has led to the diminution of the middle class. These individuals traditionally had dental treatment financed through insurance paid by the companies for whom they worked. Nowadays, however, many employers no longer offer dental insurance, and this has had a significant negative economic impact on many practices.

Generational changes are also affecting the face of dentistry. Gen Xers and millennials do not tend to join organizations to the same degree as previous generations. For example, fewer young dentists are joining the American Dental Association (ADA), and this is impacting dentistry on at least two fronts. The first is that ADA has long been viewed as a disseminator of credible information relative to clinical practice. By forgoing membership, nonmembers have fewer resources for unbiased clinical information. The second is that ADA has a legislative voice that has protected dentistry from negative changes proposed by federal, state and local governments. As membership declines, this voice for dentistry will have less influence on legislation affecting oral health care. And while some of these regulations are laudable, increasing governmental oversight tends to place greater economic burden on dental practices.


We’re also seeing a trend toward producing “superdentists.” These individuals are trained in dental school to perform multiple procedures that were once the bailiwick of specialists, thus reducing overall demand for specialists. At the same time, another trend is emerging, one in which dentists are contracting with specialists to come into their general practices on a rotating basis.

Another factor that’s impacting the dental landscape is the rising cost of dental education. The upshot is that most dentists are graduating with significant debt, and, in many cases, this means that starting a practice from scratch is an unattainable goal. Dental service organizations (DSO) and similar large group practices — often owned by nondentists — offer reasonable pay and benefits to new graduates. And in return, clinicians must operate within the dictums specified by their employers.

Facing economic pressure from DSOs and myriad other sources, solo practitioners are finding it increasingly difficult to survive. And this, too, is fueling the rise of corporate dentistry, as individuals forgo sole proprietorship and join group practices in an attempt to reduce overhead and maintain profit margins.

One positive influence on clinical practice is the pace of technological advances, and a great example is the increasing use of “distance learning.” More and more continuing education courses are available online, and this has helped dentists reduce many of the costs traditionally associated with continuing education — such as travel expenses or time out of the office.

Future editions of Decisions in Dentistry will explore many of these topics and how they will affect the future of dentistry in general, and in your practice specifically. We look forward to the process.

Thomas G. Wilson Jr., DDS
Editor in Chief

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