The future of preventive dentistry

The recent sharp fall in the prevalence of the two main dental diseases in industrialised countries calls for a radical revision of preventive dentistry. Dental disease is readily preventable without dentists: the falls have occurred for reasons external to dentistry, with dentists playing only an insignificant part. We need to reconsider what dentists should be doing. I shall use dental caries for illustration, but similar considerations apply to the other main dental disease, periodontal disease.

Dental caries has undergone a striking reduction in most industrialised countries over a relatively short period. In England and Wales in 1973, 65% of 8 year old children had experienced caries; by 1993 this proportion had dropped to 17%. In 15 year olds the mean number of decayed, missing, and filled teeth fell from 5.9 in 1983 to 2.5 in 1993.1 The proportion of 16-24 year olds with 18 or more sound, untreated teeth increased from 44% …