title: From repairing the consequences of disease to managed wellness: lessons from 20 years of managing dental care.
abstract: As the 21st century approaches, dentistry will be challenged by multiple pressures. The demographic trends of a growing population are outpacing the supply of dental manpower. Economic trends, including fewer family wage jobs, less full-time employment, and more single-parent families, create pressure on the ability to afford dental care. Competitive and reform pressures continue in the health-care field and are gaining momentum in dental care. Even without these pressures, traditional dental approaches have not been able to address the bulk of the needs of the population, as indicated by published assessments of the dental health of various segments or the overall use of dental services in the country. The challenge created by these demographic, economic, and competitive pressures on the KPDCP and the dental profession as a whole is to shift away from the individual patient, disease-model repair and improve management of dental wellness as the means of improving access to dental services for an even greater number of people. This challenge can be met by implementing the currently neglected clinical knowledge contained in our dental literature, taking action to find answers for the things we do not know, and by applying our knowledge to preventing the onset and/or progression of dental disease, decreasing unneeded and/or ineffective treatments, and avoiding premature entrance into the cycle of rerestoration.
authors.affiliation: Kaiser Permanente Dental Care Program Portland, Oregon, USA.
authors.forename: J R
authors.initials: JR
authors.lastname: Leben
mesh_terms: D003729:Dental Care / Q000592:standards*; D003812:Dentist-Patient Relations; D006279:Health Maintenance Organizations; D006301:Health Services Needs and Demand; D006801:Humans; D008329:Managed Care Programs / Q000592:standards; D011313:Preventive Dentistry / Q000458:organization & administration*; D011320:Primary Health Care / Q000592:standards; D011787:Quality of Health Care; D014481:United States