A few years ago a letter to the editor of the BDJ appeared. A young dentist asking for suggestions for what to study next for general career development. My immediate instinctive thought was - ‘Something else’.
This was not a statement about the desirability of Dentistry as a profession, or the ability to make a living as a dentist, but rather the very real and valid concern on how to strategise for a secure future in the long term.
Dentistry, as is the case for many professions, is on a path of progressively increasing rate of change - an exponential progression. The implication of this will become suddenly apparent when events will seemingly become overwhelming within a very short space of time. This is the nature of an exponential progression.
The justification for the above statement is clear from a number of easily observable changes.
When I was an undergraduate a cancer was typically described by its epidemiologic profile, its observed pathology and presenting symptoms, and responsiveness to the treatments of the day. Essentially very little was really known about the pathophysiology of the cancer. Currently cancers are typically described in genetic, microbiologic, chemical physiology , in general a surprisingly clear understanding of the true nature of the disease process is known or being teased out. The nature of dental disease is similar. Together with this understanding it takes only a small change to progress to a preventive intervention.
In my practice I find myself advising very receptive younger patients on how to avoid tooth brush abrasion and modify their diet to ensure dental health. There is a deeply embedded innate desire in younger generations to maintain their health and wellbeing. A couple of decades ago it was a case of ‘this is a toothbrush - try it - you may like it’.
Correct the diet and control plaque - the caries and inflammatory periodontal disease will drop precipitously. Millennials are becoming
Avoiding or treating that initial subtle lesion very conservatively avoids the , filling , crown , root treatment, extraction , implant down the line….
One may argue that Orthodontics, Cosmetic dentistry and Implants will ‘fill the gap’
Orthodontics is undergoing a revolution. The technologies of scanning and 3d printers will make orthodontic intervention for the majority of cases simple, achievable and cheap for the typical general dentist. A specialist sitting at a screen on some other continent will digitally ‘treat’ hundreds of cases a day - mostly with a programme using AI
Cosmetic milled cases will also be a matter of scan - send to china - and receive perfect colour matched veneers in something like peek within just a couple of days - again the case having been diagnosed and designed remotely.
The number of patients needing this sort of extensive treatment will be fast dwindling as the older generations with the worst cases of mutilated mouths pass on.
Implants. Currently there is a huge pool of patients with missing teeth. This will also disappear, granted at a somewhat slower pace. Where there will be massive demand will be for treating failed implant treatments by practitioners with poor training and very limited experience. But even this need will fade dramatically within a generation.
Get your head out of the sand - Think
The Grumpy Dentist
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