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Dentists are healthcare professionals who are at high risk of infection and transmission of the coronavirus disease-19 (COVID-19). The primary objective of the present study was to evaluate the changes in clinical practice made by Brazilian dentists during the COVID-19 pandemic. From June 22 to July 13, 2020, an online questionnaire was sent to dentists using Google Forms. After providing consent, 1,178 dentists answered questions regarding their knowledge and clinical experiences related to COVID-19. Data were analyzed using Chi-square, Fisher's exact, or Kruskal-Wallis tests, with a significance level of 5%. Brazilian dentists significantly changed their routine dental practices. Biosafety measures were added in their offices by 98% of the dentists, increasing operating costs for 88.3% of dentists. Greater discomfort due to the increase in personal protection equipment (PPE) worn during the pandemic was reported by 58.6%. Furthermore, 84.2% reduced heir hours of service. It was found that the dentists decreased their workload, used additional PPE, and took additional biosafety measures.

We examine the effect of commercial dental insurance concentration on the size of dental practices, the decision of dentists to own a practice, and the choice of dentists to work at a dental management service organization-a type of corporate group practice that has become more prevalent in the United States in recent years. Using 2013-2015 dentist-level data from the American Dental Association, county-level data on firms and employment from the United States Census, and commercial dental insurance market concentration data from FAIR Health ® , we find a modest effect of dental insurance market concentration on the size of dental practices. We also find that a higher level of commercial dental insurance market concentration is associated with a dentist's decision not to own a practice. There is inconclusive evidence that higher levels of dental insurance market concentration impact a dentist's decision to affiliate with a dental management service organization. Overall, our findings imply that dentists consolidate in response to increases in concentration among commercial dental insurers.

Five background articles in Section 2 of the "Advancing Dental Education in the 21 st Century" project examined some of the factors likely to impact the number of dentists needed in 2040: 1) the oral health of the population, 2) changes in the utilization of dental services, 3) new technologies, 4) the growth of large capitated dental group practices, and 5) the demand for dental care. With this information, a sixth background article estimated the number of dentists needed in 2040 compared to the number expected if current trends continue. This executive summary provides an overview of findings from these six articles. The data indicate major improvements in oral health, especially in upper income groups that account for 65% of practice revenues. At the same time, per capita utilization of restorative and prosthetic services has declined dramatically. No major new technologies are likely to impact the need for dentists by 2040. In a large capitated group practice, full-time general dentists treated an average of 2,100 patients per year; solo general dentists averaged 1,350. Based on the examined factors, growth in demand for traditional forms of care may slow substantially, raising the potential for a surplus of dentists in 2040. If these trends continue, the key national policy issue then would be: should schools reduce the number of graduates before market forces require them to downsize or close, or are other alternatives available?

To be able to meet the demands for care in 2040, dental graduates will need to address challenges resulting from the rapidly changing health care environment with knowledge and sets of skills to build on current standards and adapt to the future. The purposes of this article are to 1) analyze key challenges likely to evolve considerably between now and 2040 that will impact dental education and practice and 2) propose several sets of skills and educational outcomes necessary to address these challenges. The challenges discussed include changes in prevalence of oral diseases, dental practice patterns, materials and technologies, integrated medical-dental care, role of electronic health records, cultural competence, integrated curricula, interprofessional education, specialty-general balance, and web/cloud-based collaborations. To meet these challenges, the dental graduate will need skills such as core knowledge in basic and clinical dentistry, technical proficiency, critical thinking skills for lifelong learning, ethical and professional values, ability to manage a practice, social responsibility, and ability to function in a collegial intra- and interprofessional setting. Beyond the skills of the individual dentist will be the need for leadership in academia and the practice community. Academic and professional leaders will need to engage key constituencies to develop strategic directions and agendas with all parties pointed toward high standards for individual patients and the public at large. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

The "Advancing Dental Education in the 21 st Century" project assesses current status and trends to prepare for the future. Section 3 of the project asks what knowledge and skills should dental and advanced dental education learners have to provide dental care in 2040 and how should educators be preparing them. This executive summary of five background articles in this section focuses on predoctoral education, advanced dental education, the provision of medical services within dental practice, the incorporation of oral health services into primary care and medical practice, and interprofessional education and practice. The changing environment and external forces are presented along with their implications for advancing dental education. These forces include changes in population characteristics (e.g., demographics, disease prevalence, health disparities, consumerism), treatment needs and modalities, care delivery, science and technology, educational methods, and medical and dental integration. Future oral health professionals (OHPs) will care for more diverse patient populations, older patients with complex medical and dental needs, and relatively dentally healthy younger cohorts who require fewer complex restorative and prosthodontic treatments. Increasing integration of medical and oral health education and patient care will require OHPs to have more medical knowledge and to practice in intra- and interprofessional teams. OHPs increasingly will be providing patient-centered care as employees in large group practices, health care settings, and safety net clinics with expanded types of OHPs and improved materials and technology. Educators need to implement innovative curricula and educational methods to prepare for and adapt to the disruptive changes that lie ahead.

There are a number of factors fueling the growth of large group practices managed by corporations across the U.S., including California. These evolving trends are shaping the dental profession and practice models in a variety of ways.

A generation ago, attracting new patients to an orthodontic practice was often done simply by cultivating a few good referral sources. General dentists, including some who might have provided orthodontic treatment out of necessity, were generally glad to have a trusted specialist they could recommend to their patients. Although general dentists remain an important source of new patients today, many consumers now turn to the Internet for help selecting their own specialists. As orthodontists face more competition from various sources, successful clinicians will make it easy for search engines--and patients--to find their Web sites on the Internet., (Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Until the 1960s, the value of a practice upon the retirement of the dentist was considered to be nil. In the next several decades, the value of a practice as a going business concern was recognized and formulas based on productivity were used to establish the sales price of "walkaway" practice transitions. Increasingly creative means, such as pre-sale, deferred pre-sale, shareholder process, incremental practice sale, and practice mergers have been created to make practice transitions more flexible, thereby maximizing the financial value of transitions. Dentists at the beginning of their careers will have an increasing range of opportunities in the future, with various combinations of financial security, freedom from manage- ment concerns, control over the practice, and accumulation of equity. Those in the 45- to 55-year age range should be planning in detail for their transition. Those older than 55 should begin exercising their plans since the future will involve much longer transitions.

The aim of this study was to explicate and describe the qualitative meaning of successful clinical and organizational change in endodontic practice, following a comprehensive implementation program, including the integration of the nickel-titanium-rotary-technique. After an educational intervention in the Public Dental Service in a Swedish county, thematic in-depth interviews were conducted, with special reference to the participants' experience of the successful change. Interviews with four participants, were purposively selected on the basis of occupation (dentist, dental assistant, receptionist, clinical manager), for a phenomenological human scientific analysis. Four constituents were identified as necessary for the invariant, general structure of the phenomenon: 1) disclosed motivation, 2) allowance for individual learning processes, 3) continuous professional collaboration, and 4) a facilitating educator. The perceived requirements for achieving successful clinical and organizational change in endodontic practice were clinical relevance, an atmosphere which facilitated discussion and allowance for individual learning patterns. The qualities required in the educator were acknowledged competence with respect to scientific knowledge and clinical expertise, as well as familiarity with conditions at the dental clinics. The results indicate a complex interelationship among various aspects of the successful change process., (© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

In this study, the authors examined recent trends in the growth of dental establishments and dental firms, including geographic location. In this article, they also present information about the demographic characteristics of dentists who work in a dental practice that is part of a larger company that delivers dental care in multiple locations. The number of dental establishments (single locations) and the average size of these establishments grew from 1992 to 2007. Large multi-unit dental firms grew in terms of number of establishments and the percentage of total receipts. Large multi-unit dental firms represent a small but growing segment of the dental market. Dentists less than thirty-five years old were most likely to work in a practice that was part of a larger company, and females were more likely than males to work in such a setting. The percentage of dentists working in these settings was also found to vary by region and state. The authors present a typology of dental group practice and suggest that future research should take into account the differences so that appropriate conclusions can be drawn and generalizations across categories are not made.

This paper explores the entrepreneurial role of dentists in primary care dentistry. It reviews the changing context of dentistry, not least the reforms being introduced by the health and social care bill. It suggests that this new context will reinforce the need to consider the business side of dental practice, in particular, the importance of quality, creativity and innovation, alongside the importance of meeting the needs of patients. An entrepreneurial approach will be required in order to sustain dental practice in an increasingly competitive environment.

Various internal and external factors are beginning to influence the delivery of dental care in North Carolina. This article reviews some of the current trends that have led to a shift toward new practice models-some of which are in stark contrast to solo private practice.

The role of computers in dental practice has dramatically changed over the past 30 years. We have witnessed the progression from administrative roles to complete integration leading to chartless offices. As the dental community gradually adopts this contemporary development, the move to electronic health records is imminent because of upcoming changes in the health care system. The past, present, and future of dental office computer systems is explored in this article. An understanding of the benefits and current challenges of contemporary dental practice software is also reviewed., (Copyright © 2011 Elsevier Inc. All rights reserved.)

There are new ways and new places to practice the ultimately unchanging profession of addressing the oral health needs of Americans. New approaches may be needed to achieve traditional values. The rural poor cannot be put aside, corporate business models cannot be allowed to diminish the personal relationship between dentist and patient, and the social values of younger generations of practitioners do matter. They may be listening on Facebook, but they are still listening for the core values of serving patients.

Predicting the future is always chancy, but when a young practitioner begins a career in dentistry, it is worthwhile to have some well-reasoned expectations. The critical dimensions in the next several decades in dentistry will include technology, marketing, and society.