General Dentistry on Life Support: The Overspecialization of the Profession

Issue: General dentists are trained to identify and treat the most common oral conditions and their complications, including dental caries lesions, by restoring tooth structure and function and replacing missing teeth, as well as by treating gingival diseases. However, many senior undergraduate students and junior dentists believe they lack confidence to practice comprehensive clinical dentistry; they may avoid surgical endodontic procedures, orthodontic care, and implant-related cases, for example. The answer, they believe, lies in the imminent need to pursue a specialization to have a successful career. Approach: General dentists must remain the backbone of the profession if we aim to improve access to basic dental care and address inequities. This perspective explores the values of a general dentist in meeting the majority of the care needs of society at large by recognizing the importance of training students to graduate as clinically well-rounded providers. It discusses the issues pertaining to overspecialization in dentistry, while acknowledging that specialized care is needed when general dentistry falls short. Impact: We argue that oral health inequities may only widen if the profession focuses on specialization over general practice, as this might inadvertently take the focus off prevention and not fully address general oral health-care needs of the population. Overspecialization, and the resulting fragmentation of responsibilities, may undermine patient's basic care needs. Training a broad-spectrum dentist is paramount while acknowledging the value of specialization to deliver specific—and complex—clinical care that does not come at the expense of general practice.