Journal of the American College of Dentists

2011 ACD Annual Meeting
6
I challenge you to
step outside of your
practices and represent
our profession in the
eyes of the public.
To emphasize the significance of
our unprecedented challenges, I draw on
history, as it is said that “past is prologue.”
Looking back at the history of our country,
I believe there are certain parallels.
One example, in 1803, President Thomas
Jefferson knew that if the nascent democracy
was to survive, America would
have to take responsibility to control
its destiny. He knew there would be
challenges to this effort from many
outside influences and with ongoing
threats to our self-proclaimed autonomy
as a nation. Jefferson intuitively understood
that America would have to
continually fight for self-control and
that that responsibility would fall to all
Americans. In short, Americans would
be stakeholders in the future of America
and, likewise, Americans would be the
beneficiaries of those efforts at stewardship
of the fledgling nation.
We can take lessons from Jefferson
as our profession, our practices, and
healthcare delivery in general face new
frontiers and an uncertain future. We
must accept that our autonomy is not
assured. We must accept that it is dentists
who will and should have the greatest
impact on the future of the profession.
And we dentists must assume our
responsibility as stakeholders if dentistry
is to be the profession we would want
for Americans in the future. In short, we
must accept, as noted by Alexander the
Great, that “upon the conduct of each
lies the fate of all.”
Now fast-forward to the twenty-first
century. It has opened with all the
promise of a new beginning, with
advances in technology and informatics
that have the potential to change all that
had gone before. Just as the demand for
evidence-based outcomes has replaced
the empiricism of the past, the profession
of dentistry continues to evolve. I was
taught “extension for prevention” and
now I subscribe to “restriction with
conviction.” Clearly, these changes have
led us into the modern era of unforeseen
advantages, and yet, an era in which
we find ourselves with perhaps unanticipated
and certainly unprecedented
challenges. Among these challenges I
would note: (a) increasing disparities
among the legitimate needs for patients;
(b) available resources to meet those
needs; (c) increasing dependence on
market forces to transform healthcare
systems; and (d) temptation for dentists
to forsake their traditional commitment
to the primacy of patient interests.
Most dentists would agree that we
must craft the future we seek for the
profession. They would further say that
care should inherently be safe and
patient-centered and that there is no
real health without oral health.
But to be successful in our quest, as
we promote these basic premises on
behalf of the profession, we stakeholders
must face and address precisely those
questions that place us at a “tipping
point.” I see those questions as including:
1. How will oral health care be
delivered in 2025 and beyond?
2. Who will deliver it?
2011 Volume 78, Number 4