The authors

This initiative arose out of concerns about the future of the dental profession: A proud past, a questionable present and a challenging future. Several participants were invited to contribute papers to address this issue. Unfortunately, during the preparatory period, a few individuals fell seriously ill and were therefore unable to participate. More devastatingly, several died before the meeting was convened. These included Bernie Guggenheim, Per Brandtzaeg and Aubrey Sheiham.

This book is dedicated to their memory and to the immense contributions they each made to critical thinking about health.

Eventually six of us met: Lois Cohen (USA), Gunnar Dahlen (Sweden), Alfonso Escobar (Colombia), Ole Fejerskov (Denmark), Newell Johnson (Australia) and Firoze Manji (Kenya).

To set the context for the views expressed by each of the contributors, we asked each to prepare papers in which to describe their backgrounds and the development of their careers, including identifying those people who had made an impact on their own way of thinking. We asked each to provide an overview of the oral health situation over the past 50 years in their country or region. We also asked participants how their own research work had influenced the way in which they viewed the development of the oral health profession and reflect on the future of the profession.

The papers were circulated in advance of the meeting at La Cascada and were discussed in detail during the 3-day meeting. The La Cascada Declaration was a product of these discussions.

Here we present the La Cascada Declaration together with each of the papers. These papers were produced to stimulate discussions within the group and are shared here in this publication. These papers are not intended to provide the documentary evidence that backs up the Declaration as extensive reviews are already available in the literature. The main purpose of this Declaration is to open a public debate on the state of dentistry rather than merely an academic debate amongst the dental profession.

We invite you to share your thoughts and comments in reaction to each paper and to the publication. You will be able to do so online as well as by writing to us.


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8 Responses to Preface

  1. Jamie Arthur on April 26, 2017 at 1:14 am says:

    I applaud your observations and comments about the state of the dental profession and I cannot find a single sentence with which to disagree.
    As a London-trained and Australian-practicing dentist of nearly 40 years experience I am so disappointed to see the road which my profession has chosen to travel.
    I look forward to reading your completed text.
    With my sincere thanks,
    Jamie Arthur
    Gold Coast, Australia

  2. Allen Hindin, DDS, MPH on May 20, 2017 at 10:01 am says:

    Thank you all for your effort. A long tie faculty member and friend commented, not long ago, that dental students selected dentistry because of autonomy and lifestyle. After 46 years, I must concur.

    I believe it is time to question the very existence of dental schools. From such a narrow foundation, it is impossible to produce oral health professionals. Insulation and isolation of dentistry must end.

  3. Francois Chimoun, DDS, MPH on August 4, 2017 at 7:51 pm says:

    Thank you for opening the door for a debate on the future of dentistry.

    After 7 years of practice in West Africa (Senegal and Ghana), I realized that my work was just a tiny drop in the ocean. I focused on drilling, filling and building approach forgetting the core essence of my profession: prevention. This can be explain by the type of training i received at the University of Dakar Dental School where the curricula put less emphasis on prevention during the 6 years of study.
    Today my perception of dentistry has completely changed and i totally agree with the authors. Listening to Prof. Johnson during the 2nd Africa Regional Congress of Oral Pathology/Medicine held in Ghana, I believe that it is not but training more dentists that we are going to solve the problem in Africa but we should seriously consider prevention at the individual and community level.

    Thank you

  4. Russell O’ on October 26, 2017 at 6:16 am says:

    Thank you so much for drawing the dental profession’s attention to an ever growing problem. In our western lifestyle, I have been so disappointed and embarrassed by the Dental Community’s effort to draw the public’s attention to the massive sugary drink problem. They have been deathly quiet. You are right about some the dental specialties being cash cows but providing little benefit to the patients.
    Thank you for hopefully open up an intelligent debate and discussion.
    Russell O’Sullivan, retired dentist of 30 years

  5. Sergio Uribe on May 15, 2019 at 1:03 pm says:

    Thank you very much for sharing these profound and revealing reflections on the dental profession. It is a great contribution to the profession and hopefully many colleagues and students will be able to read this at the beginning of their professional lives.

    • firoze on May 17, 2019 at 12:02 pm says:

      Thank you for your comments. We appreciate your taking time to leave your thoughts. Please do feel free to share the declaration with others.
      Best wishes

      Firoze Manji

  6. Martin l MACINTYRE on August 25, 2019 at 2:52 pm says:

    The website belongs to Dr. Steven Duffin, founder and dental director of NoDK, LLC. I have had a 58 year career in dentistry including general and public health dentistry in the US and Saudi Arabia. I have prepared two applications for the MacArthur Foundation’s $100 million grant in 2016 and now in 2019. It proposed to have a global demonstration project that would meet the needs of the 90% of the world’s population that has no access to dental care and for whom a simple procedures performed by easily-trained local personnel could prevent 90% of toothaches and tooth loss at less than 10% of the cost of conventional surgical and repair treatments. I have contacted Dr. Cohen, who is a former colleague, Dr. Fejerskov and Dr. Johnson. I would like to hear from the other La Casada team to get feedback on this proposal that we call SMART dental care.

  7. Martin l MACINTYRE on August 25, 2019 at 8:16 pm says:

    In my preceding comment, I presumed that my email would be published and/or the Website. and

    I just completed reading the papers presented by the six authors prior to their meeting to discuss and then prepare the Declaration. I was impressed by all of them and found that each author had experiences similar to mine. It has encouraged me to write a paper as if I had been invited to be “one of them” prior to attending the meeting. However, I’m a practicing preventive dentist and therefore my focus is in applying what we know to meeting the basic needs of individuals, which I summarize as
    1. avoiding pain, especially toothaches and
    2. avoiding the loss of a tooth.

    I will be glad to provide the MacArthur Foundation grant application to anyone interested.
    There is no way to provide a URL but I’m going to have it added to the website.

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