My last editorial was about the changes in implant surfaces over the years, and it started me thinking. Why did the person who discovered an implant that actually worked and the company that he helped to found, not make a few changes to the design early on? I used Brånemark implants when they were first introduced to the US. The course I took was one of the two that changed my professional life (the other being Mort Amsterdam's and D. Walter Cohen's Periodontal Prosthesis course) What a revolutionary concept! One that has improved the lives of millions of people all over the world. When they first started, the company had the market virtually to itself. But now there are numerous implants and implant companies. Why? Because they were not market driven, and the market demanded stronger implants and improved prosthetic connections. The original providers found it difficult to provide these modifications. This is not meant as a criticism. Their reasons were very valid. They wanted to wait until they had long-term studies before bringing new products to the market. Good idea, but the market could not wait. The same situation has happened to other people, other institutions, and other companies. Look at Kodak. Once a worldwide leader in photographic film, it now must lay off people as a result of the rapid transition to digital. I see the same thing happening in my field. For years we periodontists have felt that we should be the leaders, the final authority, and the main provider of periodontal therapy. That all started to change in the 1960s when forward-looking men like Barkley and Arnum went around the country teaching people the joys of flossing. It took a major turn when Procter and Gamble discovered that there was money to be made from people with pyorrhea, and raised the public's awareness to degrees not possible by professionals or their associations. We began to lose the educational side when companies started giving presentations on "nonsurgical" therapy to general dentists and dental hygienists. We didn't help by refusing to officially sponsor courses like this through our official body. We lost when the "dental hygiene department" became a "profit center." And now in many schools, periodontics is taught to dental students by dental hygienists. So why did all these people, companies, and professional organizations not change? I am not sure that I know all the answers about why, but I think I know a few. They were afraid of losing their livelihoods, their companies, or control of their profession. It is comfortable to maintain the status quo. It is difficult to change. As a result, we are all afraid of change, and therefore, in spite of all the warnings, we often lose what we most want to keep. I am a firm believer in the concept that the only constant is change and that change, while painful, is necessary for growth. Get over it-change will happen. You can make it happen, or you can have it happen to you and suffer the consequences. I just opened my new computer; I am in for some pain. Thomas G. Wilson, DDS Editor-in-Chief