President John F. Kennedy, in a memorable 1961 address to Congress, challenged the nation to put a man on the moon (and bring him back) by the end of the decade. It was an audacious goal, especially given the dismal history of U.S. satellite launch efforts up to that time. Yet, extraordinary levels of organization, engineering, investment and personal courage came together to make the dream a reality, with time to spare. Along the way, the space program left its mark in countless large and small contributions to technology, medicine, management and just about every other aspect of modern life.

A more dubious legacy is the now commonplace phrase, "If we could send a man to the moon, why can’t we ... ?" Fill in the blank with any difficult challenge—"cure AIDS," "eliminate tooth loss," "eradicate poverty," "build a foolproof voting machine"—and you raise a valid question of public policy. Why not, indeed?

Before answering, turn back the clock to the 17th century. Young Isaac Newton, on enforced holiday from his teaching job (Cambridge was closed on account of plague), supposedly got to thinking about an apple he saw falling in his family’s orchard. Why did it fall down and not up? One thing led to another, culminating in 1687 with a comprehensive theory of gravity in the monumental Principia Mathematica.

When the space program came along three centuries later, it may have lacked reliable rockets and miniature electronics and an organizational home, but at least it had Newton’s laws ready to go. And they were equal to the challenge. Every space launch, from the first Explorer satellite to today’s deep-space probes, has been planned and controlled exclusively according to Newton. As far as NASA’s supercomputers know, Einstein might never have existed.

So did we send a man to the moon in 10 years or 300 years? Yes, and yes. Any bold mission requires three ingredients: a goal, the will to reach the goal and the science to make it possible. Back in 1961, Kennedy laid out the goal, Newton and his fellows provided the science and the American public (rather amazingly) supplied the will and the funding to match. But if the science hadn’t been there, no amount of money, effort, enthusiasm or good intentions would have taken us one inch closer to the lunar surface.

The otherwise hostile vacuum of space is, paradoxically, the perfect environment for Newtonian dynamics. Out there, every action really does have an equal and opposite reaction, right down to the proverbial gnat’s eyelash. But back here on Earth, things aren’t quite so predictable. Human beings obey a whole different set of mostly unfathomable laws. Apply a known force to people, and they may move back, or sideways, or not at all. Hence the "law of unintended consequences" that seems to thwart so many well-intended programs. Getting results on Earth is not merely difficult, it’s messy and unpredictable as well.

In comparison, the race to the moon had a wonderful clarity about it. The finish line was there in the sky for all to see, and crossing it was the sole measure of success. But life is, for the most part, an incremental business. We help one patient at a time. Scientific advances come in almost undetectably small steps, and product advances, though important, are rarely as revolutionary as we are led to believe. So it is understandable that our patients, and we ourselves, sometimes grow impatient with the pace of progress. Perhaps an occasional grand mission would help bring this gradual process into sharper focus.

If dentistry were to undertake its equivalent of a moon mission, what would it look like? Starting today, we might declare "no unintended tooth loss after 2015." While that’s not everything we care about, it certainly is a worthwhile, ambitious goal. Equally important, much of the requisite science and technology are in place, from fluoridation to restorative techniques to protective mouthgear. The challenges are tremendous—education, funding, access, compliance—but nobody said it would be easy.

Now that’s just an example. Other objectives might be equally worthy and equally achievable. And there are plenty of good arguments against articulating any bold mission, not the least of which is the risk of very public embarrassment if we fall short of the goal. But whatever we promise had better be based on proven facts rather than speculation and wishful thinking.

In giant leaps and small steps, the state of oral health has improved profoundly in our lifetime. It will continue to advance as long as the profession both recognizes the value of open-ended scientific discovery, and actively seeks out ways to apply research to patient needs. Look on the space program with awe, and learn from it. Just remember to give Newton his share of the credit.