As we enter the second quarter of the 21st century, it is nice to reflect on what the first quarter brought us, lessons learned, and what the future has in store.
I celebrated the 25-year reunion with my U of T classmates last year. Most of us are still practicing—some as principal owners facing various challenges; others, like myself, are wrapping up their clinical careers by selling their practices privately or to a DSO and becoming associates again, with no responsibilities for supplies, compliance with various regulations, or staff shortages. Some of us are ready to give back by getting involved with volunteering and academia.
So, what are some concepts that changed in the last 25 years?
- Implants are better and stronger than teeth and cannot be affected by periodontal disease. WRONG. Peri-implantitis exists and it is harder to manage than periodontal disease. Implants are NOT forever; it is better to save natural dentition whenever possible
- Fluoride in the water will eliminate dental decay and dentists will have no work. FALSE. The baby boomer generation continues to demand service; they have money, they grew up without fluoride, and they want to keep all their teeth that are restorable and replace those lost over the years. Some cities are planning to reduce or remove fluoride from municipal water supplies which could lead to resurgence of rampant decay in children and teenagers.
- Gold and PFM restorations as the standard of care is no longer the first choice in prosthetics due to high cost of materials and labor. Lithium disilicate (Emax) and Zirconia restorations are now the first choice for most dentists due to lower costs and ease of manufacturing as a part of digital workflow. Gold will still outlast anything, but the cost and unesthetic appearance makes it undesirable to the patients seeking looks over longevity.
- In office labs, pouring models, fume hoods for PMMA custom trays, alginate, and PVS impressions are slowing leaving the modern dental office and are being replaced by scanners, CAD/CAM milling machines, and 3D printers.
It is both fun and scary to look into the future at what is coming in the next 25 years.
- Are we still going to have a human receptionist greet patients as they come in? Or will Dentina.AI or some other virtual service hosted in India or China replace human interaction? It will definitely save money from payroll account—AI doesn’t get sick, ask for a raise every 3 months, threaten to quit, make mistakes in data entries or math, or steal or misplace receipts or invoices.
- AI in diagnostics, like Overjet, Diagnocat, and Pearl, will help diagnose, write reports, and reduce human error factor because we can all have a bad day, feel tired or under the weather, but AI does not.
- Just like in medicine, there is a huge spike in autoimmune diseases and conditions that defy explanation, diagnosis and treatment—dentistry is no different. Conditions like invasive cervical resorption (ICR), burning mouth syndrome (BMT), lichen planus, and molar incisor hypo-mineralization (MIH) are becoming more prevalent, and we do not have conventional means to treat them. Some emerging technologies that do not rely on pharmaceuticals may offer treatment options in the future, but our dental school curriculums are so full of outdated information, it does not leave time to introduce what is new and exciting. For example, laser technology has been dismissed due to lack of conclusive research, RCT’s, and only through more and more case reports by pioneers in the field, the research is starting to catch up.
I would like to be cautiously optimistic about the future of dentistry in the next 25 years, as long as we learn from our mistakes and keep an open mind.
About the author
Marina Polonsky, DDS, MSc is a gold medal University of Toronto ’99 graduate, she maintains private general practice in Ottawa, Ontario with focus on multi-disciplinary treatment utilizing lasers of different wavelengths. She holds a Mastership from World Clinical Laser Institute (WCLI), Master of Science in Lasers in Dentistry from RWTH University in Aachen, Germany. She is the founder of the Canadian Dental Laser Institute (CDLI), the only study club affiliated with the Academy of Laser Dentistry. She serves on the Executive Committee for Oral Health and is the editor of the Laser Dentistry issue.