Forty years of research--its impact on dental practice

With the multiple use of fluorides the philosophical basis of dental practice shifted from the restoration of the dentition to the prevention of the initiation of dental disease. In the United States, the profound impact on caries in children, with 50 per cent of the 5-17 year olds caries-free, has changed the relative distribution of the various dental services and the pattern of dental care. The child orientation has been superceded by greater attention to the restorative and other needs of the middle-aged and geriatric population. The research-generated insights into the role of plaque in the periodontal diseases and the wide-scale efforts to improve oral hygiene via plaque control have resulted in a marked reduction in gingivitis and manageable levels of periodontis in the employed population below the age of 65. More advanced disease can be treated more effectively because of new diagnostic procedures and new technologies as well as the use of anti-bacterial and anti-inflammatory agents. Major research advances in oral biology, oral medicine and oral diagnosis have extended both the depth and breadth of preventive dental practice. The scope of preventive dentistry now goes well beyond caries and periodontal disease to include: (1) injury, oro-facial defects, malocclusion and temporomandibular joint dysfunction; (2) oral mucosal lesions; (3) systemic diseases with oral manifestations and (4) hazards associated with dental practice. Dentistry is now being practised with an ordered set of priorities.