As stated at the outset, the review of the two systems was not intended to determine which approach to provide dental services is better. Rather it has provided an opportunity for both systems to learn from the activities of the other. Thus, the continuing decrease in dental caries rates in the United States, no doubt associated with the extensive fluoridation programs, provides direction for efforts in England and Wales. Similarly, the pronounced changing attitudes to extractions and "wedding present dentures" in England and Wales offer our country some understanding of the needs to change general population attitudes if we are to expand dental services in this country to increasing segments of the nation.