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Change is the New Normal


Change and uncertainty are two of the most accurate descriptors for 2020 for all of us. The same can be said about dentistry as offices were shut down for two months and many new requirements followed. I’m asked at least once a day if I think the changes will be the new normal. Time will tell, but some of the changes are a good thing and need to stay. Change is normal and often an advancement in the quality of care. I’ve been reflecting on during October as it was my 20th anniversary of practicing dentistry in

Orange City. I plan to use this article to highlight the positive changes in dentistry over the past 20 years that allow for better dental care and oral health.


The backbone to oral health is what you do at home. The dentist and dental hygienist only get to affect your oral health 2 to 4 times per year beyond education, so thankfully the tools available for home care have advanced significantly. The biggest change is the use of electric toothbrushes of which there are now several effective brands available. A manual brush can be effective if used properly, but studies have consistently shown that electric brushes are superior. Although toothpaste and mouthwash companies make many claims of greatly improving as they tweak and change, the fact is the main ingredients have been consistent for decades, minimizing what actual improvements have come from the changes.

In the dental office we have seen many changes in the past 20 years. Computerization has allowed dental offices to better manage patient information and improve care. We use computers for diagnosis with digital xrays that use minimal amounts of radiation compared to traditional xrays. We also now have three dimensional conebeam images that allow us to diagnose problems where previously we could only make educated guesses by the process of elimination.


Though periodontal disease, also known as gum disease, isn’t new, the importance and focus on it in dentistry and medicine has emerged in the past 20 years. Previously the concern of periodontal disease was mostly related to the loss of teeth. Of course, that is still a major concern, but over the years the correlation of periodontal disease to many systemic diseases such as heart disease and diabetes among others has become evident.


Technology has allowed for many changes. Same day crowns have become more the norm than the exception with computerized impressions and in office CadCam milling machines. We are now using 3D printed aligners instead of braces in an ever-growing percentage of orthodontic cases. Lasers have come on the scene, though they still have limited use. Technology has also allowed dental implants to move from a specialist procedure to having the majority being placed in general dental offices today.

Behind the scenes improvement that patients probably don’t even realize have changed include anesthetics that are much quicker and stronger and effective. Twenty years ago, the majority of fillings were amalgams that many refer to as silver fillings. Today, less than 50 % of dental offices even have silver fillings as an option and the material isn’t available in many countries and some states. Other materials have also improved in strength and cosmetic appearance as our crowns and tooth color materials get better every year.


Finally, and most directly tied to the year 2020, is the change in infection control. It was well over 20 years ago when the AIDS epidemic led to much needed improvements in dentistry with wearing gloves, masks, and sterilizing instruments better. Today we are doubling up on masks and wearing face shields due to Covid. We don’t know if this will continue but most likely our mask requirements will not be the same after. In the past 20 years we have had many other improvements including better testing protocols for sterilization and water quality, latex free options, disposable barriers and many other enhanced protections for employees and patients.


This article telling of all these changes may not directly give you something to use to stay healthy. But I hope it does give you a sense of the many positive changes in dentistry and oral health over the years and give you confidence that you are able to have better care now versus any other time in history. With all the negativity on social media and division in our country right now, it is good to remember that we really do have it good in a historical perspective.

Written by Dr. Joiner for publication in the Capital Democrat Staying Healthy Column

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Joiner and Zwart Dentistry   |   708 Lincoln Ave SE, Orange City, IA 51041

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