The unresolved issues that I find most important to our profession are almost all foundational, big picture, and global.

 

1. The integration of dental health issues into the inseparable health of the individual and also the bringing of systemic health issues into dentistry for improvements in the overall health of our patients, families, and ourselves. 

2. The movement toward a goal of preventing and minimizing dental disease instead of a primary focus of coming up with more complex and expensive treatment options that the majority of the population and our patients cannot afford.

3. Having a goal of improving the consistency of the quality of the new dentists that we are training and also being more efficient in that educational process.  Answering the question of how do we graduate dentists with the ability to do the right thing for their patient’s best long-term interests and still make a living?

4. Changing the dynamics that reward some of the worst in dentistry and also punishes those dentists and that dentistry that is most valuable to the public.

 

Overview of some of these dental issues:

Dentistry as a profession is built around the concept of a benefit to the public or society in general.  We seem to have lost our way in some meaningful or significant areas.

 

These fall in the two familiar categories of omission and commission.  What we are failing to do that we should be doing, and what are we should do better or not doing at all.

 

Poor education and skills sets in prevention

Poor understanding and execution of outcomes

 

It is in the public’s interest to prevent as much dental disease and it’s costly destruction before damage control is necessary.

 

This is primarily an educational mandate that equates to early reading skills. Illiterate parents and grandparents cannot teach reading skills they don’t have. Parents and grandparents who don’t know how to clean teeth or evaluate those preventive dental disease skills in themselves have no chance of breaking that cycle in the next generation.

 

Dental disease is a communicable bacterial disease that is transmitted early in the family by those members with disease. This reservoir and reseeding mechanism of transmission from family member to family member needs to be addressed.

 

Those bacterial organisms inside of teeth and leaking out from underneath unsealed and poorly done dental work have not been addressed adequately and are as important to address as those bacterial plaques and the periodontal disease on the outsides of teeth.

 

The level of standard treatment or quality of execution of work does not address this need to eliminate this recurrent and undiagnosed disease in other family members that is the source of transmission from parent to child.  

 

The importance of the connection of systemic conditions to oral health and the corresponding connections of oral health to the rest of the body has to be made a primary and shared objective.

 

This goal has to incorporate the importance of understanding the effect of gut health and its function, airway and sleep disruption, nutrition and supplements and the inflammatory entry point to the body that the insides of teeth represent.

 

Our dental educational system needs to understand and expect more out of our profession in terms of bacterial contamination of dentin, the insides of teeth, which are the foundations for stability and the durability of our restorative (reparative) dental work.