Revolutionizing Oral Care: The McDonaldization of General Dentistry DALTON NEWMAN

What is Rationalization

George Ritzer, born in 1940, is an esteemed American sociologist renowned for his groundbreaking concept of "McDonaldization," as outlined in his works (George Ritzer 2024). Central to his theory are four key components of rationalization: efficiency, calculability, predictability, and control. Efficiency focuses on streamlining tasks to reduce time consumption. Calculability pertains to quantifying various aspects. Predictability emphasizes enhanced uniformity, while control involves standardization and heightened regulation.

Origins of Modern Dentistry

General dentistry has evolved significantly over the years, shaped by pioneering figures like Pierre Fauchard, often called the Father of Modern Dentistry. Fauchard, a French surgeon, published "The Surgeon Dentist, a Treatise on Teeth," in 1723, a groundbreaking work that introduced a systematic approach to dental care. Ahead of its time, Fauchard's publication introduced revolutionary concepts such as dental fillings and the recognition of sugar's acidic role in tooth decay.

Rationalization of Dental Education

In 1840, the Baltimore College of Dental Surgery opened, shaping dental education. Alabama enacted the first Dental Practice Act in 1841, setting standards. Harvard University established the first university-affiliated dental school in 1867, standardizing education and licensing. These milestones emphasized control and predictability in dentistry. Dentists had to meet specific criteria for licensing, leading to more regulated practice. Patients enjoyed consistent treatment experiences across dental offices, as these developments standardized dentistry, enhancing control and predictability.

Rationalization of Dental Technology

In the 1800s, significant technological advancements revolutionized general dentistry. The mass production of porcelain teeth in 1825 standardized dental technology, fostering greater control and predictability. Innovations like the dental drill, the reclining dental chair, gold crowns, and the introduction of X-rays in 1896 furthered efficiency and control. Together, these reshaped dentistry profoundly, rationalizing the field. The invention of Novocain in 1905 facilitated advanced procedures, leading to breakthroughs like the first dental implant in 1937. In addition, these advances led to the establishment of the first dental hygienist school in 1913 refined dental practices.


CAD/CAM technology revolutionized dentistry since Dr. Duret introduced it in 1971. With around 30,000 machines globally, 30% in North America, it creates 3-D models from mouth scans for rapid custom-fit crown production, enabling same-day service. By reducing human error through AI and computer programming, CAD/CAM ensures reliability, freeing dentists' time and enhancing customer experience. Overall, it boosts efficiency, predictability, and control, minimizing errors and standardizing practices. As technology advances, further improvements in dentistry are expected.

Incorporation of AI

AI's integration into dentistry drives rationalization, enhancing predictability, control, efficiency, and calculability. It improves diagnostics, minimizes errors, and automates tasks like scheduling and billing. While its full impact is uncertain, AI promises greater efficiency and focus on patient care, speeding up operations and enhancing predictability. However, it may reduce human interaction, presenting new challenges.


Lack of Authenticity

Rationalization in dentistry erodes authenticity, a notion seen as an irrationality by Ritzer. Patients expect predictable procedures, shaping the dentist-patient dynamic. Advanced technologies like 3-D scanners may undermine the unique craftsmanship of dentistry, causing concern. A BMC Oral Health study highlights worries among dental technicians about AI's benefits in efficiency and precision, but also its impact on job security, professional identity, ethics, and the need for proper training. These concerns underscore the ethical and professional dilemmas surrounding AI's integration into dentistry.


Dentistry's rationalization breeds professional disillusionment as technology replaces traditional roles, risking the loss of prestige. Automation of once intricate tasks diminishes dentistry's perceived exclusivity. The reduction of human error also erodes dentistry's individuality and craftsmanship, impacting dentists' mental well-being. Disenchantment is a significant contributor to the high prevalence of negative mental states among practitioners.


Rationalization has significantly transformed general dentistry, with its influence continually expanding. Examining Ritzer's key points—efficiency, calculability, control, and predictability—reveals the extent of this evolution. From Pierre Fauchard's pioneering work to modern innovations, dentistry has undergone dramatic changes, notably in education and technology. The rise of AI adds further uncertainty to the profession's future. While we can reflect on past developments, the changes ahead remain to be fully anticipated.


Chat GPT4 was used to summarize and rephrase the paragraphs above from my original paper.


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