Dentistry has a long history. It traces its root to the early civilizations and moving along with time until it reached its present state.
And the branch of medicine concerned with the health of our oral cavity continues to transform and shift. In the Critical Trends Affecting the Future of Dentistry: Assessing the Shifting Landscape prepared for the American Dental Association, Diringer and Associates conducted an environmental scan of the emerging trends affecting the future of dentistry.
Although technically outdated due to its publication about five years ago, the report is the most recent environment scan conducted, alongside A Profession in Transition: Key Forces Reshaping the Dental Landscape by the ADA. Still, the findings remain relevant.
In the report by the California-based health policy consulting firm, five themes were highlighted — people, providers, payments, policies, and practice implications — which must be viewed collectively due to their interrelation.
These key themes were captured to identify and understand the vital forces affecting the destiny of the industry and to chart a course for the dental profession and oral health in the United States.
In this article, the focus will dwell on the future landscape of dentistry with regards to the changes and characteristics of the country’s population, which is aging and more diverse.
Baby Boomers, Millennials, and the Shift in Dental Landscape
About nine months following the end of World War II, a period marked by a remarkable surge in the birth rate commonly referred to as the baby boom took place in Western countries, including the US.
This period from the mid-1940s to mid-1960s saw the birth of more than 76 million baby boomers in the country. Thus, they make up about 40 percent of the US population.
By 2030, all baby boomers will join the ranks of the older population. Because of this, it will shift the age structure of the elderly from 13 percent to 19 percent.
The shift in the age of the population will affect the different disease patterns. Also, it will also affect the care-seeking behavior, and the ability to pay of patients regarding dental care. Baby boomers, compared to preceding elderly people, are expected to retain their teeth. They will also remain active consumers of dental care with payments usually made out-of-pocket due to lack of dental coverage and limit of Medicare.
However, in an article in peer-reviewed journal Decisions in Dentistry published June 2017, Dr. Thomas G. Wilson, Jr. differed saying that baby boomers are at risk of running out of money in retirement as they have fewer traditional pension plans and rely mainly on Social Security and savings for retirement. Because of the reduction in their income, baby boomers may turn to careful budgeting of health care expenses to stretch a thinning income. Such will lead to cutting back or skipping of dental services.
Generations X who were born from 1965 to 1980 and the Millennials who were born from 1981 to 2000 are expected to have less dental disease. Therefore, they may need less for restorative dental care. These succeeding generations following the baby boomers will more likely seek lower costs for dental care. However, they will have higher rates of dental coverage compared to older populations due to employer supplied insurance.
Generation Z, also known as the post-millennials are expected to have less oral-related problems. They will also demand less for restorative dental service as they age partly due to dental coverages such as Medicaid and CHIP and dental benefit in the Affordable Care Act they enjoy as children.
Aside from an aging population, the country will also experience a dramatic shift in its ethnic make-up. According to the report, those in the younger age brackets will be composed of more diverse make-up, while the older population will be mainly non-Hispanic white.
The Hispanic population will more likely grow faster than other ethnic groups by more than double, reaching more than 128 million in 2060. In 2016, the Hispanic people in the country were at about 58 million.
According to Pew Research Center, the growth of the racial group has slowed but remains the second largest ethnic group, accounting for 18 percent of the country’s population in 2016.
According to a study by the Hispanic Dental Association, Hispanics are more likely to have public coverage than private. Moreover, they are less likely to visit a dentist and have less literacy about oral hygiene and prevention. In addition, they prefer Spanish-speaking dentists, and are more reliant on community dental clinics.
Hispanics also generally have poor oral health, are more susceptible to tooth decay, and have lower levels of tooth retention.
Also, an essential racial group is the Asian population. The Asian population grew at 72 percent from 2000 to 2015, making it the fastest-growing primary ethnic group. Among countries of origin of the Asian population in the US, Chinese, Indian, and Filipino origins comprise the largest groups.
This racial group, according to the Diringer and Associates, are more affluent, well-educated, geographically concentrated, and technologically savvy than the overall US adults.
Despite the increase in their population, Asian-Americans are not expected to have a dramatic effect on dentistry.
The shift from rural to more urban or suburban areas will also have implications for the distribution of dentists. Meanwhile, the utilization of dental care will also change following the drop of dental visits by adults, increase in dental visits by children, and the decline of the prevalence and severity of dental decay.
Dental services are also expected to shift from traditional restorative care to cosmetic and preventive dental treatments. The change in dental care patterns will bring down overall dental spending.