A look at the (near) future based on the (recent) past - how our patients have changed and how they will change.

Remedies for dental diseases have been in use for as long as 4,000 years, and various materials and methods have been used over the millennia. Dentistry continues to change in response to changes in the age distribution, origins, financial means and health of the population, as well as to changes within the profession itself. The Canadian population is very unevenly distributed geographically and ethnically. Furthermore, it is aging rapidly and life expectancy is increasing. Although the average income of Canadians has increased, the increase was unevenly distributed, and the gap between rich and poor continues to expand. There has been a steady rise in the number of Canadians with dental insurance, although the proportion of the population with insurance varies from one province to another. Not surprisingly, people with dental insurance compared to those without are more frequent users of dental services. The rate of caries attack has diminished in industrialized countries, but people are keeping their teeth longer, so caries will remain a significant public health problem, particularly among elderly people. In addition, smoking tobacco is strongly associated with periodontal disease; thus, there should be more action within the dental community in support of smoking cessation programs. The composition of the dental care community is also changing. The ratios of dentists and dental hygienists to the population have increased, the services offered by dental technicians have expanded greatly, and the services offered by denturists have also increased as these services gain more widespread acceptance. Use of dental services in Canada remains reasonably broad; however, denture-wearers continue to regard uncomfortable dentures as a normal part of aging. The pattern of uneven distribution of disease and access to service remains the major challenge facing the dental profession.