I don't for one minute suggest that dentists are motivated exclusively or even primarily by the profit motive, either in treating individual patients or adopting new techniques. It cannot be denied, however, that when money can be saved, new findings are more rapidly disseminated and adopted. For example, a report presented at the 2012 meeting of the American Association for Dental Research showed that when periodontal treatment was delivered in patients with both diabetes and periodontal disease, a significant savings was realized in total (medical plus dental) healthcare costs. Although the researchers were careful to include caveats and conditions and are still trying to work out the mechanisms behind this finding, a major insurance company moved forward to introduce a wellness plan that includes dentistry.
Never forget that dentists in the United States are still, by and large, self-employed entrepreneurs, who collect their fees directly from their patients. So, it should be no surprise that they aren't quick to adopt a new instrument or diagnostic test without plenty of evidence that it will actually improve treatment or outcomes. A $20 "just in case" test kit that would be lost in the fine print of a hospital's explanation of charges would have to be justified to the dental patient face to face, or else absorbed as overhead. Dentists don't blindly reject innovations, but they do set a high threshold for clinical utility before they accept them.
The game changer here is the simple fact that anyone setting policy on a grand scale (governments and insurers) must understand this truth and will allocate costs and benefits accordingly. Whatever measures are taken, from subtle incentives to the most draconian mandates, will necessarily involve some rearrangement of the cost burden, whether we like it or not.
The Gradual Pace of Change
The dental game continues to change as we enter 2013, in its usual small, tentative way. This gradual pace is probably good, overall. In a headlong rush to rewrite the rule book, we risk causing unanticipated upsets -- which are sometimes very damaging to the public -- when change is occasioned by hasty decisions and premature conclusions.
My purpose here was merely to report what I see happening, not to advocate for one position or another. It's just one person's opinion, and I welcome yours.
Happy New Year!
Medscape Dental & Oral Health © 2012 WebMD, LLC
Cite this: Marjorie Jeffcoat. Game Changers in Dentistry: 2013 and Beyond - Medscape - Dec 17, 2012.