Oral Health Group

“The Future Is Not What It Used To Be”, Or Is It?

October 16, 2018
by Dr. Peter Birek

Iran this line by ten colleagues. All – with the exception of one – interpreted it in a negative way. They felt that it referred to a gloomy future; when things have gotten worse rather than get better. In their view, the future will be darker than their memory of the past. Yet, the statement can be interpreted equally in the positive.

The future of dentistry has been subject to an ongoing debate. When I started my practice, I spent a quarter of a million dollars on setting it up, and it took seven years to break even. The prevailing thought I often heard at the time was that I missed the “Golden Era” of dentistry. A well-respected and dear colleague of mine, of about the same age, who interpreted the quote somewhat in the negative, did say that we did live in the “Golden Era” and that he was grateful to have had the experience. But he was still ambivalent about the future of our profession. Today, when I look at our new graduates and wish them luck, I often wonder what the future really holds for them? Are the skies as dark and menacing as they say it is?


The following are not “alternative facts” and they indeed support the gloomy outlook:

  • Accumulated student debts are obscenely high.
  • The cost of setting up a practice is prohibitive for most.
  • The regulations thrown at us of late are painfully costly and not necessarily for the protection of the public.
  • Corporatization of dentistry, a new kid on the block for some time, is getting older and wiser in charting an unclear future.

All of these clearly bring clouds on our horizon. It is also true that dentists are reluctant to go to underserviced areas, places with less desirable geography, yet where the demand for our services is high. Equally true is that some grads are prone to hang their shingle in places where the need is low and competition is high. Indeed, these undisputable “true facts” conjure somewhat of a “dark future”.

In contrast, there are notions of variance and could be chalked up into the “bright future” column; and in my view, they balance the negative predictors. Even more so, some of the parameters of success are controllable by us individually as practicing dentists and collectively as a profession. As Andre Agassi noted in his captivating autobiography, Open, “control what you can control” and don’t fret about what you cannot control. Indeed, once he understood this concept, his second half of his career proved to be stellar in an equally competitive environment.

Let just see what the positives are:

The widened scope of dentistry allows us to offer more life-improving treatments.

  • We have increased our efficiency in treatment that lead to reduced prevalence and burden of disease. This may not translate as a gain to a bottom line but can clearly resonate on the personal accomplishment/pride scale.
  • We are better-trained and the population’s perception for the need for our services has constantly increased over the decades.
  • With the use of social media and alike we are better in spreading knowledge to potential patients about the importance of dental care, thereby raising the level of dental IQ in our target population.

Although these notions are rather new and promising, I feel that the basis for a brighter future belongs to a list of long-proven attributes of the successful health care professional, if we choose to remain one.

Here is the list of DO’s AND DON’Ts that kept us dentists able to make a living and flourish:

  • Don’t sell dentistry. What we provide is a response to patients’ needs and wants. We get to learn about our patients by listening (taking a history) and asking the right questions. Listening to the marketing gurus may not do. “Selling dentistry” is likely to cause problems (an understatement perhaps).
  • “Never treat a stranger” – meaning that you need to learn what patients need and want to ensure a level of confidence in the service we dentist provide.
  • Never say Never, Never say Always – things change quickly and so does our approach to various dental issues.
  • Don’t say or write down (as in dental records or communications with others) anything that you may regret or would not say directly to your patient. Adhering to this notion means that you won’t have to invoking Yogi’s line by saying “I really didn’t say everything I said”2 or a more recent one we all heard “I misspoke, ….”.
  • “When money is “no object” in relation to quoted fees, money may in fact be a problem.
  • Retain civility and respect, and don’t take example from certain politicians of late who display no such attributes.
  • Saying “I’m Sorry” is cheaper than responding to a complaint or going to court – also it is an attribute of an honest health care provider. This is well-supported in the literature.

Patients often have trouble deciding which treatment option to choose and ask, “What would you do if you were in my shoes, doc?”. Akin to that, when talk is about the future of dentistry, people ask me if I would encourage my children to become dentists? Well, my answer is that “I just did”, as my daughter is at the beginning of her carrier as a dentist; a great pride to her parents and her community.

Putting it all together, I very much hope that the future is not what it used to be; perhaps, it will be better and brighter for our profession – if we do things right, individually and collectively. There will always be a need for an honest, ethical dentist with a healthy business acumen, realistic expectations and an astute sense of judging the needs for our patients rather than creating them.

A certain age-old religion that was subject to severe persecution throughout the ages, always taught its adherents that, no matter how dim the apparent future seems, they must always conduct themselves as if the redemption was coming, and ACT AS IF. Perhaps we might take inspiration from this. The future of dentistry could become our field of dreams, if only we act as if.

Yes, the future may just prove to be better, and you heard it from me!


  1. First used in French in 1937 by the poet and philosopher Paul Valéry. Since then, often used with some variance by many, including Yogi Berra
  2. I really didn’t say everything I said. Yogi Berra, 1986, Long Island, New York newspaper OH

About the Editor
Dr. Peter Birek is an Associate Professor in the Department of Periodontics and a staff surgeon with the Oral Reconstruction Unit at the University of Toronto. He maintains a private practice in Periodontics and Implant Surgery in Toronto. Dr. Peter Birek is the Periodontology editor for Oral Health.

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1 Comment » for “The Future Is Not What It Used To Be”, Or Is It?
  1. Derek Townsend says:

    Thank you Dr Birek for some needed wise advice as well as pointing our profession to a hopeful future.
    This is the kind of writing we need more of.

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