Sustainability refers to the capacity to continue. For the most part, United States dental schools have shown an amazing ability to endure over the past century. Dental schools have continued through fluctuations in application cycles and through persistent faculty shortages. Today, dental schools, particularly public institutions, find themselves faced with draconian budget cuts as states slash funding to higher education. While dental schools face threats, they also enjoy unprecedented opportunities. Scientific advances, particularly in genetics and molecular biology, presage the emergence of new modalities of patient care. The desirability of the dental profession as evidenced by the demand for dental services and the rising income of dentists is at an all time high. Public awareness about the importance of oral health care continues to grow.