Clinical dentistry in the 21st century

What will oral health care be like in the 21st century? During the 20th century, American dental education evolved from freestanding and often proprietary schools to become an integral part of research-intensive university professional education. This evolution provided a formidable scientific basis for diagnosis, therapeutics, disease prevention, and health promotion. The development of clinical skills coupled with advanced dental materials and therapeutics has truly been remarkable. And now we approach the 21st century as a nation of changing demographics. By 2010, nearly 40 million Americans will be 65 years old or older. Expectations for "quality of life" now punctuate American values. In 1900, the human life span was 45 years, but today it approaches 80 years. Although in 1900, the primary causes of mortality and morbidity were acute infectious diseases, today our challenges include complex viral-infectious as well as neoplastic and chronic disabling diseases (e.g., chronic facial pain, musculoskeletal degeneration, osteoporosis, osteoarthritis, and cerebrovascular and coronary diseases and disorders). In fact, one American dies every hour from oral cancer. Changes in the practice of clinical dentistry in the 21st century will: (1) integrate dental practice into comprehensive health care; (2) become increasingly proactive for health promotion; (3) represent an increased knowledge-base and computer-assisted technology approach for diagnostics and therapeutics; and (4) use novel strategies for oral health care ranging from gene-mediated therapeutics to community-based health promotion.