Facing a major reform of the medical care system, the status of social security in Japan does not have an optimistic outlook. Among the wide-ranging components of the social security system, the medical care system faces serious problems. The national government is beginning to propose legislation to reform Medical Service Laws, review the economic situation relating to medical insurance, and establish comprehensive steps for support through taxation and public financing. Pressing issues specific to the dental community include the supply of and demand for dentists, a reduction in dental health care expenditures, and the reservation of a revised source of funds. Individual dental clinics currently face problems such as reducing the number of patients, and maintaining a balance between revenue and expenditure. Fundamental solutions to these problems can be found only by radical self-reform of the dental system and the dental community. In the future, dentists will need to establish their significance as consulting doctors providing consultations on a regular basis, rather than the present situation in which patients visit the clinic for the first time after experiencing deterioration in their oral condition. To foster a dental health care community that takes the lead in the medical care system of the 21^st century, it is necessary to maintain the favorable, though tense, relationship with administrative and political figures, while gaining the consensus of the public.