Does dentistry as we know it have a future?

The American Dental Association's Strategic Plan for the Future of Dentistry is primarily a self-serving document in that it attempts to protect the dentist regardless of the changing oral health needs of the population. Marketing, even if initially successful, will not increase the absolute demand for dental services, because persons on maintenance care require less care per year than sporadic users. Higher use will be balanced by less need. Excess supply creates incentive to overtreat. Today's dentist, as the dominant provider, does not have major motivation toward prevention, either by training or economic self-interest. The paper proposes that a modified hygienist, with more diagnostic training, should become the primary dental provider, with a better trained dentist as a secondary provider, combining problem solving and "surgical" skills. These changes would function best under a system combining group practice with a national health service.