tion, research, and patient care. The march of science and technology in fields such as molecular biology, immunology, and genetics will continue to forge links between dentistry and medicine, as will the needs of an aging population with more complex health problems. The financial strains on universities and academic health centers will likewise encourage consolidation and coordination. Pressures from government and private purchasers of health services will maintain the movement toward integrated systems of care that stress cost containment, primary care, and services provided by teams of professional and allied personnel.

Second, to prepare their students and their schools for change, dental educators will need to teach and display desirable models of clinical practice. Using excellent practice in the community as a model, dental school clinics should seek to be more patient-friendly and efficient and to provide students with a greater volume and breadth of clinical experience. All dental graduates should have the opportunity for a year of postgraduate education with an emphasis on advanced education in general dentistry.

Third, securing the resources essential for educational improvement and, indeed, survival will require that dental schools demonstrate their contributions to their parent universities, academic health centers, and communities. These contributions include achievements not only in education but also in research, technology transfer, and community and patient service. Said differently, dentistry cannot afford isolation.

Fourth, dental leaders should cooperate to reform accreditation and licensing practices so that they support rather than obstruct the profession's evolution. Priorities include greater uniformity in licensing, reduced legal barriers to professional mobility, and revision of laws that limit dentists from working more productively with allied dental personnel. A uniform national clinical examination should be developed for acceptance by all states. Voluntary accreditation should focus on dental schools with significant deficiencies and reduce administrative burdens on other schools.

Fifth, continued testing of alternative models of education, practice, and performance assessment for dentists and allied dental professionals is necessary to prepare the dental community—educators, practitioners, regulators, and policymakers—for an uncertain future. In particular, experimentation and learning will help dentistry face one major uncertainty, namely, whether the future supply of dental practitioners and services will match, exceed, or fall below population requirements for dental care. The committee found no compelling evidence to predict with confidence a future



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