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Future growth areas for dentistry
6th Dec 2005
Amarjit Gill assesses the viability of future growth areas for dentistry. Dentists who are no longer dependent on working in the NHS have a fantastic opportunity to redefine dentistry in the future. My vision of a high-tech dental practice is one where prevention is a continuous theme throughout the delivery of our service, and where we work happily with gadgets that make us smile. There will be an improved emphasis on diagnosis and communication, furnishing patients with more evidence-based treatment planning and tracking changes in oral health. Some examples include: • Using lasers for caries diagnosis – eg. DiagnoPen • Using salivary diagnosis to assess for buffering capability and volume produced • Bacterial assays to check levels of organisms related to sugar consumption and acid production • Digital radiographs • Intraoral photos and imaging. More comfortable and convenient restorative dentistry Once caries has been detected, the armamentarium at our disposal would include: • Ozone therapy and remineralising mouthwashes, enabling restorations to be bonded with no invasive techniques, or needles • Ultrasonics • Laser • Carisolv. The US is investigating implant placement that doesn’t require extensive training, so making the procedure affordable to more of the public. Cosmetic dentistry The US trends show that in the last five years: • Tooth whitening/bleaching has increased by over 300% • Direct bonding has increased by over 100% • Veneers have increased by over 250%. The study also shows that the cosmetic procedures in the highest demand from patients under 20 years old are; whitening, orthodontics and composites.Cosmetic procedures that are in the highest demand from patients over 20 years old are; whitening, veneers and composites. I believe that, with new, productive methods for restorations and using CAD / CAM machinery, we will see the advent of ‘while –u-wait’ services for veneers, or porcelain inlays for posterior teeth. Innovative regenerative techniques Biotechnology is now enabling us to create new gold standard materials to match the tissue being replaced. Such materials are: • Bone • Teeth with stem cell research • Periodontal tissues – simple treatments involving skin cell injections. Fibroblasts taken from the dermal layer of the skin are extracted, multiplied and then injected into the affected area. Periodontal therapy With an increasing desire to maintain teeth, periodontology will come to the fore. Most adults lose their teeth through this largely preventable disease. Historically, poor fees have led to under-diagnosis and consequently, under- treatment. This is rectifiable on a direct contractual basis with private patients. As the demand increases the market will respond with innovative answers to patients’ problems. Niche markets Recognising the benefits of a limited practice, many dentists now offer restrictive but lucrative services, including fresh breath clinics, a sports mouthguard service and hygiene clinics. Innovations Placing audio tooth implants, within a Class 2 restorative space, enables the ultimate in private and convenient mobile telephony. (BDJ 10/8/02) Summary A fixed budget system like the NHS is inconsistent with innovation in dentistry, as it does not reward the risk in sourcing and providing new services for our patients. As the private market develops, dentists will operate in a free market that rewards those who offer superior service or innovation that benefits the consumer. Increased prices for dentistry will filter their way to those who also support the profession but have been squeezed to the limit, under the legacy of a state system. This might see the following trends: • Technicians might find it rewarding to come back to their creative and valuable trade • Dental nurses would could be tempted away from checkouts offering greater salary levels than NHS dentistry permits • Only one in three of our dental trade companies are financially healthy. As the private sector enlarges, this proportion will grow and in turn, they will develop products and services for us that the patients want to buy. For the profession, private dentistry is the easiest route to getting off the treadmill. Dentists can then determine the direction of their practice to ultimately benefit the patient, providing the service that they would buy, with their insider knowledge. It is the future. Some have made it a reality, for others it is an aspiration that is achievable, if the focus is on the good of the patient. ‘Take the first step in faith. You don't have to see the whole staircase, just take the first step’ Dr Martin Luther King Jr - Let’s enjoy a long walk
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