Global Health Nexus, Fall 2000

Message from the Dean

Michael C. Alfano, DMD, PhD
New York University College of Dentistry

What is the future of dentistry? For this issue of Global Health NEXUS, we asked some of the most progressive thinkers and recognized leaders in the profession to look into their crystal balls, project 30 or more years into the future, and come up with a series of predictions about oral health and dental practice. There are many common themes, of course, but hold on to your hats for some of the predictions!

In the short run, anyone attempting to discern the directions that dentistry will take in the future can take heart from the prospect that, over the next 30 years, dentists will confront a tremendous increase in the need for clinical services as the “baby boomer” generation grows older and the ratio of dentists to population shrinks. Since there is strength in demographics, it seems safe to predict that the flow of patients into dental offices will increase substantially. In particular, the willingness of this population to invest large sums of money to maintain health, vitality, function, and a natural, youthful self-image bodes well for the profession.

But while this new environment will include a growing need for clinical care, especially aesthetic services, it will also require that dentists be able to implement the fruits of research advances and to adapt their practices to new technologies and approaches to managing patients. Indeed, with the completion of the Human Genome Project, it is likely that in the foreseeable future dentists will be called upon to intercept dental and craniofacial problems using functional genomics, gene therapy, biomimetics, and targeted pharmacoprevention.

How will these developments impact the practice of dentistry? Recently I was challenged to develop a dozen predictions for the next century for a time capsule at NYU. I also serve on the ADA’s Future of Dentistry Committee, and I think about the future all the time. But who could have predicted MRIs, the Internet, or gene therapy a century ago? So I’ll just offer five—hopefully provocative—predictions about technology and the future of dentistry.

What I See When I Look into My Crystal Ball

Let’s start with my own specialty and see what the future has in store for periodontists:

  • Scaling and root planing of teeth, the sine qua non of periodontal therapy today, will no longer be required, as periodontal disease will be controlled by both pharmacotherapy and gene therapy. This gene therapy will not alter the host, but rather the bacteria to make them non-pathogenic.
  • It will be possible to clone human teeth, and there will be much fanfare about it, but the technique will not be adopted because synthetic materials will prove to be faster, better, and cheaper.
  • Orthodontic therapy will be accelerated by growth factors and inhibitors. Bands and wires will be replaced with removable appliances worn at night, which generate fields to effect the changes. A computer will monitor progress and determine the proper sequencing and positioning of the growth factors and fields.
  • The predominant oral cancer, squamous cell carcinoma, will be detected and eliminated in a single visit very early in the disease process using optical diagnostic and extirpation therapy. Susceptible individuals will be easy to identify genetically, but it will be more difficult than expected to control the disease genetically.
  • The dental profession will bifurcate into one which focuses exclusively on appearance, to include implants, orthodontics, “smile engineering,” and esthetic restorative procedures, and one derived from or linked to medicine, which will be focused on disease prevention, diagnosis, and treatment utilizing genetic predictors and therapy as well as highly targeted pharmacotherapy.

You’ll learn what other prognosticators have to say in our cover story, “Seeing the Future.”

A Pluralism of Strengths

In dedicating this issue of Global Health NEXUS to considerations of the future, we also celebrate both the arrival of new, exceptional faculty and the promotion of remarkable scholars already here. In combining their strengths, NYU Dentistry is building a world-class faculty whose members will pool their talents in the service of investigation and discovery, and who will revise NYU Dentistry’s educational model to address a future shaped by awesome technology. Read about them in “Recruiting the Best” and “Promoting Our Own.”

NYU Dentistry's future will also depend upon raising the major funds needed for vital capital enhancements of our facilities and programs. So, in the new year, look for the unveiling of “Transformations: A Building, A College, A Profession”—NYU Dentistry's campaign to create the resources to fulfill our vision of becoming the dental institution in the world with the greatest impact on the health of society.

Key to the success of our campaign will be increased support from alumni and friends, and recent developments in that area are cause for optimism. Last year we experienced a 73- percent increase in alumni giving over the previous year. Our Honor Roll of Donors in this issue pays tribute to men and women who, when they forecast the future, predict a strong NYU Dentistry.

When you envision the future of dentistry, what do you see? I would like to know. Please E-mail your predictions to me at Selected predictions will appear in a future issue of Global Health NEXUS. Now, as you begin your journey into the future in the following pages, please join us in dreaming boldly!