Dentistry’s social contract is at risk

Moeller, Jamie; Quiñonez, Carlos

doi:10.1016/j.adaj.2020.01.022

Cited by 18 publications

(20 citation statements)

References 16 publications

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“…Expanding the scope of practice for OHCPs to screen for flags that a patient may be in the early stages of experiencing physical health issues aligns with recent claims that dentistry holds a potentially important role in facilitating change and in supporting greater equity in health. One way in which dentistry could support greater equity is by helping to identify childhood adversity [ 89 ].…”

Section: Discussionmentioning

confidence: 99%

Protocol for a Case Control Study to Evaluate Oral Health as a Biomarker of Child Exposure to Adverse Psychosocial Experiences

Durbin

Abrams

Mandelis

et al. 2022

IJERPH

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Background: The early identification of children who have experienced adversity is critical for the timely delivery of interventions to improve coping and reduce negative consequences. Self-report is the usual practice for identifying children with exposure to adversity. However, physiological characteristics that signal the presence of disease or other exposures may provide a more objective identification strategy. This protocol describes a case–control study that assesses whether exposure to adversity is more common in children with tooth enamel anomalies compared to children without such anomalies. Methods: For 150 mother–child pairs from a pediatric dental clinic in Toronto, Canada, maternal interviews will assess the child’s adverse and resilience-building experiences. Per child, one (exfoliated or extracted) tooth will be assessed for suspected enamel anomalies. If anomalies are present, the child is a case, and if absent, the child is a control. Tooth assessment modalities will include usual practice for dental exams (visual assessment) and modalities with greater sensitivity to identify anomalies. Conclusion: If structural changes in children’s teeth are associated with exposure to adversity, routine dental exams could provide an opportunity to screen children for experiences of adversity. Affected children could be referred for follow-up.

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Section: Discussionmentioning

confidence: 99%

Protocol for a Case Control Study to Evaluate Oral Health as a Biomarker of Child Exposure to Adverse Psychosocial Experiences

Durbin

Abrams

Mandelis

et al. 2022

IJERPH

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“…While some might argue that the evolution of regulatory boards in Australia has made the self‐regulation of the dental profession a great deal less in evidence, 25 it is likely that only dentists and other trained dental professionals can judge when overtreatment has occurred. Indeed, sincere engagement with self‐regulation is a key component of the dental profession’s social contract with society and failure to meet this obligation is a threat to dentistry’s professional status 26‐28 . Commercialism in dentistry means that an appropriate engagement with self‐regulation is as important now as it has been in the past.…”

Section: Discussionmentioning

confidence: 99%

Overtreatment as an ethical dilemma in Australian private dentistry: A qualitative exploration

Holden

Adam

Thomson

2020

Comm Dent Oral Epid

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Background The phenomenon of overtreatment in dentistry is under‐explored and has not been the subject of much research inquiry. Most dental care in Australia is provided by practitioners in private dental practice. This research expands understanding of how the nexus between professionalism and commercialism in dentistry is impacted by the phenomenon of overtreatment. Methods Data were collected through recorded interviews and written reflections from private dentists working in the Australian context. The data were then examined using thematic analysis to understand common themes and reveal deeper insights. Results A total of 20 participants were recruited for this study. Participants spoke of their experiences in practice where financial targets and pressure from practice owners to provide high‐cost treatments presented challenges to their professionalism. The participants expressed that the way in which dentistry is remunerated based on activity was a motivation towards engaging in overtreatment. The participants also spoke of finding a balance between commercialism and professionalism within private dental practice. Conclusions Participants’ reports provided insights into how the mismanagement of the commercial elements of private dental practice led to a transactional (‘buyer beware’) relationship between the consumers and providers of dental services, rather than a relationship founded upon professional altruism and trust. Consumer empowerment through the commercialization of dentistry has potential to be a positive influence on the patient experience in accessing dental care. However, this research has shown that the shift of power through consumerism also risks attenuating professional appreciation of the imbalanced nature of the patient‐clinician relationship in dentistry.

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“…That is, many of the members of the largest professional association representing American dentists may oppose coverage, delivery, and workforce reform. Some experts argue that the ADA, as an organization representing the dental profession, has the strongest ethical mandate to advance oral health, 72 particularly given the recent social unrest and increasing disparities during the COVID-19 pandemic. The ADA could also engage in state and national debates about workforce models, benefits, and training.…”

Section: Lessons From the Acamentioning

confidence: 99%

Oral Health Stakeholders: A Time for Alignment and Action

et al. 2021

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Since the Surgeon General’s report in 2000, multiple stakeholder groups have engaged in advocacy to expand access to oral health coverage, integrate medicine and dentistry, and to improve the dental workforce. Using a stakeholder map across these three policy priorities, we describe how stakeholder groups are shaping the oral health policy landscape in this century. While the stakeholders are numerous, policy has changed little despite invested efforts and resources. To achieve change, multiple movements must coalesce around common goals and messages and a champion must emerge to lead the way. The ongoing COVID‐19 pandemic and political changes due to the 2020 elections can open a window of opportunity to unite stakeholders to achieve comprehensive policy change.

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Dentistry’s social contract is at risk

Cited by 18 publications

References 16 publications

Protocol for a Case Control Study to Evaluate Oral Health as a Biomarker of Child Exposure to Adverse Psychosocial Experiences

Protocol for a Case Control Study to Evaluate Oral Health as a Biomarker of Child Exposure to Adverse Psychosocial Experiences

Overtreatment as an ethical dilemma in Australian private dentistry: A qualitative exploration

Oral Health Stakeholders: A Time for Alignment and Action

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