Dentistry in the United States is in a period of transformation. There is a shift among the American population from wanting to be regarded as "patients," to one in which they view themselves as health care "consumers" with differing behaviors, expectations and needs.  Dentists can choose to either embrace this paradigm shift or be left behind.

A 2012 Deloitte Survey of Health Care Consumers finds indications that "consumers are ready to become more active, informed decision‐makers."  According to the Deloitte survey, consumers are ready to customize and shop for dentistry to seek the best value.  Discriminating dental consumers are becoming more astute purchasers of health care and seeking value for their spending. Value in dentistry comes in many forms: price; reviews; experience; education; technology; location and more. As a result, it is becoming imperative that dentists recognize this changing environment and provide dental consumers with a level of transparency that will provide prospective patients with the information they desire.

This emerging "consumerism" is more salient in the younger populations, who are more apt to prefer "high tech" interactions where they can comparison shop through social media and other online forums. However, although social media is increasing as a source of referrals, it is not used by a significant portion of the population for that purpose.  Younger people are now accustomed to utilizing the internet to evaluate their purchasing decisions.  Dentists with a strong online presence will reap the benefits.

Older consumers generally prefer "high touch" interactions, which include personal experiences with providers. However, Baby Boomers may become more price‐conscious as they join the ranks of the elderly, with less coverage and more out of pocket costs for their care. Since 57 percent of those who have not visited a dentist in the past year cite lack of insurance and cost of care as the primary reason for not visiting a dentist, the Baby Boomers may become more astute shoppers of care and demand more value for the money.  

The population is getting older and more diverse, leading to different disease patterns, care‐seeking behavior and ability to pay.  Payment for dental services is shifting from commercial dental insurance to public coverage and personal out of pocket payments.  Health coverage is changing as employers are becoming less likely to provide health insurance, and the public programs provide coverage to more Americans.

The health care delivery system is also changing rapidly with the implementation of the Affordable Care Act. Consumer habits are shifting with Americans increasingly relying on technology and seeking greater value from their spending. The nature of oral disease and the financing of dental care are in a state of flux.

Many challenges are confronting dentistry and the status quo is unsustainable. The changing nature of dental consumers and their providers, along with altering patterns of demographics and government policies, will have significant effects on dental practice in the United States.   This is a critical moment for the profession. Changes in medical practice and the health coverage system are harbingers of forthcoming changes in dentistry. Since many of the changes have been slow in coming to dentistry, the profession has an opportunity to proactively chart a course to influence their directions. To ignore the shifting landscape is to lose control and allow others to determine the future of dentistry.