The Elephant in the Room: Age Discrimination

I have NEVER (nor will I EVER) think of myself as old.  I am 72 years old.  At 72, I am still practicing dentistry.  I’m writing my third book—a textbook on full coverage restorative dentistry.  I’m creating courses and blogs (like this one) for my teaching website: www.theONWARDprogram.com.  My CV is 20 pages long (and growing); and the list of continuing education courses that I have taken since 1989 is 54 pages long (and growing).  Contrary to the stereotype about older individuals, I am extremely adept at using a computer, and I have even taken them apart.  Oh-and lest you think I am physically decrepit–I’m an avid gym rat who can perform bench presses with two 50lb dumbbells. My average time for the 800 meter row on the Concept Rower is 3:30.

Recently  I had to experience the unpleasantness of age discrimination, aka “ageism.” The term “ageism,” was coined in 1969 by Robert Neil Butler, founding director of the National Institute on Aging¹. Kirsten Weir, of the American Psychological Association, defines ageism as negative and inaccurate stereotypes that are “so ingrained in our culture that we don’t even notice.²”  Joann Montepare, PhD, Director of the RoseMary B. Fuss Center for Research on Aging and Intergenerational Studies at Lasell University, reports that ageism is the last ‘-ism’ that still remains socially acceptable, even though other “isms” have gone by the wayside.

Ageism is often confused with “ablism.”  “While it is true,” says Kirsten Weir, “that the risk of some chronic diseases and dementia increases with age, most older adults maintain quite good health and cognitive functioning.²”  In fact, Brainhealth University maintains that “adults in their 40s, 60s, and beyond often show increased depth, better long-term memory, and more strategic thinking” than younger individuals.³ The authors at this university explain that there are two sides to intelligence:

• Fluid intelligence: the ability to solve novel problems, reason quickly, and adapt. This peaks in early adulthood and may decline gradually with age.
• Crystallized intelligence: accumulated knowledge, vocabulary, wisdom, and life experience. This continues to grow through middle age and often into later life.

What this means is that a younger adult may be quicker at solving a logic puzzle, but a 60-year-old offers a more nuanced solution as a result of  deeper knowledge and emotional maturity.  Neuroplasticity—the brain’s ability to form new connections—actually continues throughout life.  Brainhealth University reports that “older learners often make stronger long-term memories because they connect new information to deeper life context. They may learn a new language more slowly, but they retain vocabulary better by linking it to real-world experience or established concepts.”

In a recent book, Becca Levy, PhD, a professor of epidemiology at Yale School of Public Health, repudiated all the stereotypes associated with aging. “In every case,” she explained, “I found information that not only contradicted the negative stereotype but also highlighted a strength that comes with aging.” Levy pointed out a host of artists and musicians who defied conventional “wisdom” by becoming more creative and more generative later in life.⁴

Unfortunately, culturally engrained stereotypes are very difficult to change.  The AARP reports that among working adults ages 45 to 74, 72% of women and 57% of men have experienced age discrimination in the workplace. Beth Castle, Managing Editor of InHerSight, reports that of the 72,675 charges of workplace discrimination that the EEOC dealt with in 2019, 15,573 of them were linked to age. “That number should be zero,” she snaps.⁵

One of the problems with ageism is that it is seldom overt, and often difficult to substantiate.  A snide remark may seem harmless, but it is stigmatizing. Ageism often manifests as a snub, a dismissal without cause, or  the closing of doors that should always be open to talent and ability.

It is my observation that younger generations of today exhibit more bias toward older generations than my generation did when we were the younger generation. I am a social media junkie, and I love to frequent the dental social media groups on Facebook.  One day a younger dentist actually posted this question:

“Why would a dentist over the age of retirement want to continue to practice dentistry?”

The comments in response to this question were quite disturbing.  While some dentists explained that they practice dentistry because they love the profession, others actually believed that dentistry was only a means to accumulate income and retirement accounts.  Some viewed older dentists as a “competition” that should be retired at age 65 in order to increase the patient pool for younger dentists. The reality is that there is no competition. There are more than enough patients “out there” for all dentists.

The real cause of ageism is narrow-minded thinking. Narrow-minded thinking is in vogue these days because critical thinking skills are no longer taught by the educational system.  What do I mean by that?  Here is an example:

I have enormous clinical experience in full mouth reconstruction and crown and bridge dentistry.  I was trained by a master, and I spent a lifetime studying and building skills and knowledge in this area of clinical practice. My father and I have accumulated 70 years of documented evidence for the basic principles and techniques that were applied to all of the cases.  I can show cases that I personally created lasting in health for over 40 years WITH X-Rays.  I don’t know a single practitioner anywhere in this country who can match this level of documentation.

Whereas my generation of dentists were eager for this kind of knowledge when I was young, today’s generation of dentists are not even interested in acquiring sound crown and bridge skills that have a real track record. Young practitioners, who often profess to have greater knowledge than I do, view me as “old fashioned” or (I hate to say it) “old.” They have no interest whatsoever in my perspectives.  I can’t even give away my enormous storehouse of clinical knowledge—and believe me—I would if I could. It seems to me that science no longer matters.  Neither does evidence and certainly not merit.  All that seems to matter these days is economics and “workflow.”

It pains me to see so many of my younger colleagues having difficulties with crown and bridgework—problems that were actually solved in the 1930s! It is no wonder that most young practitioners would rather extract perfectly restorable teeth and place implants.

This month’s issue of Dentistry Today showcases an article where all of the upper teeth on a patient were extracted to place an “all-on-x” implant supported framework.  The before X-Rays show that the patient had a great foundation for dentistry: long, curved roots with sound periodontal bone. The prognosis for saving the patient’s teeth with crown and bridgework (and NO implants) was excellent.  I know that I could easily have saved this patient’s teeth with crown and bridgework, since I have documented successful cases that were far worse. But here’s the real kicker: no one ever objects to this kind of travesty that patients are being subjected to on a regular basis.

Is it ethical for a magazine to publish a case that should have been dismissed for “poor case selection?”

I cannot stand to watch patients like the one in the magazine receive overly invasive treatments that actually have less prognosis for success simply because younger practitioners only know how to place and restore implants. Even the majority of their implant cases fail to adhere to the basic principles of sound engineering. Implantology expert Dr. Carl Misch’s research emphasizes the importance of designing implant cases around the management of biomechanical stress. Nevertheless, implant fixtures in articles and lectures are commonly overloaded with large superstructures they are clearly not designed to support from an engineering standpoint.  Worse, the restorations are often designed in such a manner that they are impossible to clean!

After 40 years of experience with implants (I started with implants in the early 1980s when Dr. Brånemark first brought them to this country), I can safely say that implants are not panaceas. Yet they are being applied by today’s young practitioners as if they were.  It doesn’t take a rocket scientist to predict that implant failure rates are going to skyrocket.

I believe that treatment planning should incorporate an armamentarium that includes crown and bridge skills as well as implant skills so that the best treatment option can be applied for each individual patient. In addition to clinical expertise, critical thinking skills are required for treatment planning, along with a sense of ethics to do right by patients.  A good ethical yardstick  dentists should always consider is this:

What treatment would you choose for yourself if you were sitting in the patient chair?

Lack of critical thinking ability and ageism go hand in hand.  They are both symptoms of “Narrow Mindset.”  The onceinabluemoon.ca website offers an appropriate list of symptoms associated with narrow-minded thinking⁶:

1. 1. 1. 1. 1. 1. 1. 1. 1. Resistance to New Ideas
                        2. Difficulty with Perspective-Taking
                        3. Reliance on Stereotypes and Generalizations
                        4. Discomfort with Complexity
                        5. Lack of Intellectual Curiosity
                        6. Defensive Reactions to Criticism.

It should be clear to everyone that ageism has no place in a profession supposedly dedicated to lifelong learning.

According to the United Nations, about 1 in 11(9%) people are over the age of 65.  This figure is projected to increase to 1 in 6 people (16%) by 2050.⁷  According to Manjula Klamath of IMMpress Magazine (the magazine of the University of Toronto’s Department of Immunology), “this shift demands more conversations around how the process of aging is viewed in our society.”  Manjula points out that in many Asian cultures, ageing is “synonymous with gaining wisdom.” Older individuals are valued and treated with reverence and respect in these cultures. Not so in western cultures. Older individuals are commonly cast off as worthless burdens of society rather than revered as productive contributors.

The younger generation would do well to embrace the idea that aging is not decline, but transformative–an important part of the personal growth experience. The unspoken narrative of bias that is so deeply embedded in societal institutions must be obliterated in order to break the vicious cycle of perpetuating stereotypes.  In a flash today’s “younger” generation will be the new “older” generation, and justice will be served on a silver platter.

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¹ https://en.wikipedia.org/wiki/Ageism

²Weir, Kirsten; “Ageism is one of the last socially acceptable prejudices. Psychologists are working to change that;” American Psychological Association; March 1, 2023; Vol 54 No. 2; p. 36 print version; https://www.apa.org/monitor/2023/03/cover-new-concept-of-aging

³Brainhealth University authors; “Only Young People Learn Fast? Here’s What Neuroscience Says About Aging and Intelligence; July 29^th, 2025; https://brainhealthuniversity.com/brain-health-insights/only-young-people-learn-fast-heres-what-neuroscience-says-about-aging-and-intelligence/

⁴Weir, Kirsten; “Ageism is one of the last socially acceptable prejudices. Psychologists are working to change that;” American Psychological Association; March 1, 2023; Vol 54 No. 2; p. 36 print version; https://www.apa.org/monitor/2023/03/cover-new-concept-of-aging

⁵Castle, Beth; “Age Discrimination: What It Looks Like & What to Do When It Happens; https://www.inhersight.com/blog/guide/age-discrimination

⁶https://onceinabluemoon.ca/understanding-limited-thinking-signs-of-a-narrow-mindset/

⁷Kamath, Manjula; “Aging Through the Lens of Culture: How Societies Shape the Way We Age;” IMMPress Magazine (Magazine of the Department of Immunology, University of Toronto); January 20, 2025; https://www.immpressmagazine.com/aging-through-the-lens-of-culture-how-societies-shape-the-way-we-age/