THEMATIC ARTICLE

 

Joseph P. Graskemper

Dental Ethics with a New Emphasis: Reflections on the Curriculum

 

Over the past few years additional emphasis has been allocated in dental schools to the education of future dentists in the importance of dental ethics.  Most of the allocated time has been directed to the dentist- patient relationship and the dentist-society relationship.  These are both very important aspects in the education of future ethical dentists.  There is, however, a third area of concern that should be addressed more fully. 

 

The dentist-dentist relationship is becoming a more ethically challenged area.  With the downturn in busyness, the increase in advanced costly materials, and increased competitiveness, dentists through advertising and the use of disparaging language in relation to the patient's former dentist, are being tempted to ethically contort proper patient care for increased income.

 

There is nothing wrong with the pursuit of financial success; but, it should not come at the expense of an unknowing, dependant public.

 

Dental student are taught dental ethics as it relates to the patient and the public in general.  Most, if not all, codes of ethics deeply discuss the ethical concepts that affect the patient and society; namely, Autonomy, Beneficence, Nonmaleficence, Justice, and Veracity.  But with the increased competition for patients willing to pay for higher profitable dental procedures such as implant and cosmetic dentistry, there has been an increase in unethical promotion (advertising) of the dentist's abilities. On the other hand, dentists should be able to inform the public of advanced training or knowledge they have achieved throughout their career.

 

To properly prepare future dentists to succeed in their careers without turning to promotion or advertising that may be questionably unethical, they must be taught how to communicate their advanced education, skills, knowledge and/or talents ethically.  Some states have codes of ethics that prohibit advertising of advanced education, fellowships or degrees earned from a non-traditional academic setting. Nonetheless, many dentists promote and advertise their advanced education as earned fellowships from various organizations.  Many of these organizations are nationwide, have rigorous examinations, and require multiple case presentations to be awarded a fellowship.  There are also the continuing dental education institutions that are not university grounded and promote that their graduates are better than the rest.

 

Dental students must learn while in dental school through dental ethics courses how to ethically inform the public of such achievements. This should be given more emphasis since future dentists will, more likely than not, advertise.  It is well known that advertising affects the public's image of those who are advertising; and it is through those dental advertisements that the whole dental community is affected.  By just saying "don't do it", is merely closing one's eyes to the reality of what the new dental graduate must face. Ethical advertising/promotion is possible and must be taught to dental students in the effort to maintain a public positive image and a healthy social contract with society.

 

Many states have laws and dental codes of ethics that prohibit disparaging remarks.  However, many times unhappy, questioning patients seek a second opinion from another dentist, who, in the privacy of their own office, will inform the patient how the prior dentist did it all wrong and that he or she could or would have done it differently or better.  Sometimes the patient is even told to seek legal action to help pay for the allegedly needed re-treatment.

 

Another ethical situation arises when patients are guided, after specialty treatment has been rendered, to a friend or relative to complete the needed treatment because they are the only ones that "really do it right" or "that is who I work with all the time"; giving the impression that if the patient does not follow through with what the specialist is saying they may not get it done right or even jeopardize the treatment the specialist has just completed.

 

Dental students must be taught by all faculty that there is more than one way to treat the patient's dental problems.  Just because one dentist prefers a different manner of treatment does not in and of itself mean that the dentist did it wrong.  This tolerance for other manners of treatment has slowly eroded away by dental gurus who self promote that their way is the best and only way to treat the patient. It has also been infringed upon by the dental supply companies the idea that if not using their new improved more costly product the dentist is not providing the best for the patient.  Advanced materials are most definitely a plus in patient care.  But to supplant the notion that one product must be used if you truly care for your patient goes a bit far.  The newly graduated dentist is highly impressionable and subject to such promotion.

 

There are many occasions that the dentist-dentist relationship makes an impact on patient autonomy.  I hope this has brought more attention and hopefully bring about more discussion on the dentist-dentist relationship such that the dentist-patient and dentist-society relationships are better supported by ethical professional dentists.  

About the Author

Dr. Joseph Graskemper is a private practice dentist as well as an Associate Clinical Professor at SUNY Stonybrook School of Dental Medicine, New York

Correspondence

The author can be reached via email at: jpgraskemperdds@optonline.net

Note

Graskemper, J. P. (2009). Dental Ethics with a New Emphasis: Reflections on the Curriculum. Bulletin of the International Dental Ethics and Law Society 9(2) 38-40