Challenges of modern dentistry
MODERN dentistry provides many challenges for the dental practitioner. Some of these involve the acquisition of technical skills, such as the ability to use new materials and provide new treatment options. While such skills form the foundation of dental care, technical expertise is always provided in a social context. Not only is there the relationship between the dentist and patient, but also the interface between the dentist and the community. Notwithstanding, this author, as a member of the American Dental Association ( ADA) recently returned from Orlando, Florida where the ADA’s Annual Session exposes dentists worldwide to the cutting-edge technology in dentistry. There are both opportunities and barriers to the achievement of oral health. First, there are changing trends in levels of oral disease. Overall, there has been a substantial improvement in the oral health of young people in the industrialized countries of the world, and many developing countries such as Guyana have been making valiant progress in the service to their populations within their economic constraints. But one important challenge involves the maintenance of these improvements into adulthood. This general improvement can, however, mask variations, due to geographic region and social class background.
But not everyone has benefited to the same extent, and people from non-Western cultural backgrounds can be at particular risk. The challenge of worsening levels of oral disease in parts of non-industrialized countries has to be faced. Can the dental profession help to improve the oral health of all members of all societies?  We in the dental community have seen proof that as the demographic profile of industrialized countries changes to reflect the growing number of older people, new demands for different types of expertise in dentistry are being created. Will the need for the care of the common oral diseases by dentists diminish in some parts of the world? And could dentists be replaced by dental auxiliaries in many instances?
The extent to which improvements in oral health are due to clinical practice is debatable. Some argue that oral health is improving because of changes in society, rather than being due to improved professional care. Perhaps a reduction in the number of trained dentists will have relatively little impact on oral health. There are also debates as to whether the provision of information to patients about the prevention of dental disease can be effective in helping them to change their behaviour. Those involved in health promotion recognize that providing clinical services is only one part of a more broad-based exercise which will include working with schools, community groups, industry and supermarkets. Health promotion will involve arguing policies that involve preventative measures for achieving oral health, such as water fluoridation. These obviously take place beyond the surgery. Does the dentist have a part in these activities? And if so, what should it be?
There are many interpersonal challenges. To treat disease successfully requires the development of special communication skills, such as an ability to provide reassurance, personal care and comfort. Successful care offers an opportunity to improve the quality of life of individuals using high-quality restorative materials. In all of these instances, patient satisfaction with treatment is a crucial aspect of care. My own view is that improved oral health status of a nation should  involve components such as more pro-action of private dentists as a body, as well as increased input on a sustained way  of national education programmes  in schools by government.
The public is being encouraged to have a voice in the planning of local services, and to make its views known as consumers of health care. The need to overcome barriers to the receipt of dental care and to reduce anxiety and discomfort to an acceptable level remains.
Making a realistic response to these different challenges means that the members of a dental team need to develop a wide range of knowledge, skills and ways of thinking.
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