Dr. Richard H. Nagelberg uses the subway as an analogy to illustrate the changes occurring in dentistry—from practice models to new technology and scientific advancements, such as salivary diagnostics, that can be used to offer personalized treatment for patients. He offers his view of the direction the profession is headed with regard to integrated oral-systemic treatment.
FROM MY PERSPECTIVE, the dental profession looks like a long, heterogeneous mass—envision a subway—moving forward with gradually increasing speed. Its length stretches from the early adopters of new technology and information up front, all the way back to those who are slow to accept and implement these new concepts bringing up the rear.
The only constant is the changing nature of dentistry in every regard, including such basics as our various practice settings. The solo practitioner is moving steadily rearward due to the six-figure anchors around the new grad's neck in the form of student loan debts, the cost of opening a new dental office, and more. The dental service organization practice model is galloping forward, collectively accounting for thousands of practices and adding hundreds more every month. It looks as if this subway isn't stopping.
The machines inside most dental offices are changing constantly, too, but the pace does not compare to the advancements in research that enhance our knowledge and ability to improve patient care. Stem cells, gene therapy, and salivary diagnostics will move personalized treatments to the forefront of dentistry. One-size-fits-all thinking and treatment planning will one day be relegated to the back. Integrated oral-systemic treatment philosophies are gaining momentum, but not as quickly as they should.
All in all, the dental profession is moving forward, although not in unison. But it is advancing in the right direction nonetheless, and that's a good thing.
