Introduction and guide to the special issue on economic and workforce issues facing dentistry and dental education in the twenty-first century.

This August 2012 issue of the Journal of Dental Education (JDE) is devoted to the economic and workforce issues that face the dental profession in the twenty-first century. Many of the issues it addresses are enduring and have occupied our profession for a long time. Previous reports have addressed these issues as they were expressed in the environment of the time. Other issues are more recent. Whether enduring or recent, these issues must be addressed within the environment that we will face in the twenty-first century. I suspect that it will be as different from that of the twentieth century as the environment of the twentieth century was from that of the nineteenth. This special issue is not intended to present a consensus of opinion, and readers will not find one in these pages. We sought the most qualified individuals to contribute articles and are content to let the chips fall where they may. We believe that is a strength of the issue. Readers will be exposed to a variety of viewpoints from a multidisciplinary group of authors. We are confident that our readers will be able to sort it all out. We expect some disagreement among readers; there was some disagreement among authors. Our effort would have been too cautious and sterile if that did not happen. We want you to think, debate, disagree, propose, and design new studies. This issue is not the final word, but we do hope that it is a new beginning. In reading the articles, you will encounter a broad array of opinions among the authors; you will also discern a certain commonality among them on broad questions confronting our profession. We will be delighted if these articles inform the journal’s readership and help all to be more enlightened consumers of the information that economics and policy analyses can provide. Many changes are occurring in the financing and organization of health care in the United States. Dentistry has not yet been profoundly affected by national public policy. The class size of dental education has been expanding since the early 1990s. Now, new schools are being opened and others are planned. Total real expenditures for dental services have not increased for nearly a decade. Real per capita dental expenditures are at approximately the same level they were in 1988. Many dental schools are examining potential changes in their business models. New schools are trying innovative business models. Private group practice organizations are increasing, albeit they still represent only a small proportion of dental practice. With all of these changes, members of the profession will need to become more conversant with the issues presented in the following articles to participate effectively in the ongoing debate. This initial article is intended to function as a rationale, guide, and interpretation of the articles that follow.