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The 1999 House of Delegates approved the plan and com- missioned preparation of a new Future of Dentistry report discount 150mg lithium visa. Assessing the sheer enormity of the project before it effective lithium 300mg, the committee decided to separate the task into log- ical parts. Panelists were to pinpoint trends; to separate what is known from pure speculation; and to offer reasonable, logical predictions for the future, defined as the next 5 to 15 years, depending on the area of interest. Finally, each panel was to forge recommendations aimed at helping the profession meet future challenges. The report was written by several authors and reflects the style of those authors. During the editing process, some standardization of format was developed, but no attempt was made to develop a uniform style. This final report, almost two years in the making, is meant to serve the entire dental community and the public. Thus, the insights and recommendations are directed to assist any individual or organization which seeks to ensure and protect the oral health of the public. Throughout the preparation of this report, the creative effort was conducted with great inde- pendence. The demand that the report be honest, objective and unresponsive to exter- nal pressures was scrupulously observed. This project could not have succeeded without the selfless dedication, talent, and extensive knowledge of those who participated. Heartfelt thanks are also offered to the entire range of communities of interest (both dental and non-dental) that provided their wisdom and constructive comments. Following is a list of individuals who participated in the development of the 2001 Future of Dentistry report. Caveney Teran Gall Trustee, American Association of Director, Special Projects, California Dental Orthodontists, St. Springborn Paul Luepke President-Elect, Wisconsin Dental Association, Head of Periodontistry, U. Scott Litch President, World Federation of Orthodontists, Deputy Executive Director, General Trustee-Elect, American Association of Counsel, American Academy of Pediatric Orthodontists, St. This visibility is seen in recent national and state legislation, federal reports and the media. The United States Surgeon General gave national and inter- national visibility to oral health and its relationship to general health and well being in: "Oral Health in America: A Report of the Surgeon General," published in May 2000. It provides an assessment of the status of oral health in America, how oral health is promoted and what needs to be done. The report finds, for example, that oral diseases and disorders affect health and well being throughout life. These dis- eases and disorders are complex, often are not self-limiting, compromise daily functions such as eating, speaking, swallowing, and school and work performance. The report notes that the mouth mirrors general health and well being, providing a diagnostic window to other, less visible parts of the body. The goal of the 2001 Future of Dentistry report is to help the dental profession cope with inevitable change, both at home and on the world stage. The findings and recommendations it contains were prepared by experts who came together in a mutual desire to improve oral health by improving oral health care. The report addresses all issues that touch the profession––no matter how sensitive they may be––and insists that all parochial views be set aside. Success will require collaboration, a will to break down barriers of isolation and pooling of resources for a common good. Such coalitions must cross all boundaries and involve groups both inside and outside the profession. The trends and issues identified by the expert panels will not come as a surprise to most, and the recom- mendations will not require radical changes in direction. A roadmap to the future is presented that will ben- efit the profession and the public it serves. Most important is that the journey be undertaken and the direction traveled be determined by a dental profession which acknowledges its responsibilities and enthusiastically undertakes to reach its goals. Its mission is to guard the oral health of the ulation with increased life expectancy. The American Dental Association defines its tality rates in the United States, however, still lag role more specifically as fostering "the improvement behind those of other developed countries. The percentage of Dentistry is known and celebrated for its high eth- children and adolescents aged 5 to 17 years who ical standards and an awareness of its social respon- have never experienced dental caries in their perma- sibilities and public trust.

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J Am Dent Assoc 2000 Jun; tive efforts by the appropriate arms of the dental 131:Suppl 1:35-75 discount lithium 300mg without prescription. Trends in dental care among long-range strategy for increasing the diversity of insured Americans order 150 mg lithium with amex, 1980-1985. J Am Dent Assoc demographics will require assessment and evaluation 1999 Dec;130:1707-12. Systematic errors in References estimating prevalence and severity of periodontal dis- ease. Periodontal Disease: Link to cardiovascular dis- Albander J, Brunelle J, Kingman A. Gingival recession, gingival bleeding, Chicago: The American Academy of Periodontology; and dental calculus in adults 30 years of age and older 1989 Jan 23-24. Chicago: American Dental Department of Health and Human Services, Public Association; 2000. Summary results of the Kentucky dentists in the United States by region and state (vari- dental practice demonstration: a cooperative project ous years). J Am Dental Association dental workforce model: 1999- Dent Assoc 1979 Apr;98:572-77. A computerized business simu- Resources and Services Administration, Bureau of lation for dental practice management. The inflation rate for dental services has been moderate, and dental care accounts for a smaller proportion of overall economic resources compared to previous generations. However, dental care has not reached every corner of American soci- ety to the extent it has reached the majority of Americans. Millions of children and adults from low-income families, people with disabilities, and the low- and fixed- income elderly––especially those in nursing homes––among others, have difficulty obtaining dental care. This is especially unfortunate because most oral disease is easily and economically prevented and treated. Providing basic preventive and restorative care to these groups is achievable, provided that law- and policy- makers at the state and federal levels are willing to work with the dental profession, other members of the health community and other stakeholders toward that goal. The overall performance of the general economy influences dentistry just as it does other sectors. Market conditions within and outside den- tistry affect the amount and types of services provided, the geographical distribution of dentists, average income levels of dentists and auxiliary personnel, the financial strength of dental practices, and the number of applicants to and graduates from dental schools. For the purposes of this discussion, access is viewed as the means of approaching and entering into the use of dental services. Rather, access occurs when care is available and people are able and willing to utilize it. Not surprisingly, people in middle and high-income groups, those with extended education, and those who live in areas with abundant dental personnel have greater access to care. For individuals with meager incomes, especially those who live in areas with few dental personnel, access is more difficult. For individuals who have disabilities and other special problems, access to care can be exceedingly difficult. This chapter discusses the trends in dentistry, the status of dental health in America and identifies future challenges for the financing of and access to dental care, including: x Status of oral health in the United States; x Unmet needs for dental services and the major barriers that prevent some people from receiving the dental services that they need and want, and how these barriers can be reduced or eliminated; x Demand for dental services, changes in demand in recent years, and future patterns of demand; and, x How people pay for dental services, important trends in the demand for dental prepayment, and how changes in dental prepayment may impact use of dental services and access to dental services. As fewer Americans experience dental dis- decreases of 75-80% were achieved in all main cat- ease, and as the severity of the disease declines among egories of age, gender, poverty and race. Department of White children in the number of untreated dental Health and Human Services, 2000). Children have fewer dental caries than dramatic improvement both in the percent without ever before. Comparisons of findings from four caries, the average number of untreated carious per- national probability surveys demonstrate that the num- manent teeth, and in the extent of untreated caries ber of dental caries has declined substantially. As illustrated in first time, recent analysis shows reductions in caries also Figure 4. The number of poverty level compared to those above 300% of the untreated carious lesions has been reduced by almost poverty level narrowed substantially between one half since the early 1970s. Caries is the dental disease that historically has Although the condition of carious permanent engaged the most dental personnel and resources. A major purpose of this survey is to measure and monitor indicators of the nutrition and health status of the United States’ civilian, noninstitutionalized population. Among Children 6 to 18 Years Old at or Below the Poverty Level However, the extent and scope of Compared with Those with Income Above 300% of the Poverty Level the improvements are somewhat 2. This improvement occurred in both the group two to five Adults of all age groups are retaining more teeth. Despite the significant ments of two to ten year old children (African decrease in complete edentulism, almost 30% of the American and White, male and female). However, population over 65 years old are edentulous and the reduction in untreated decay among children aged will require substantial care. Nevertheless, treated and untreated caries) and the percent of important barriers impede access for too many people.

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