Dentists as Individuals Specializing in Oral Health - Term Paper Example

Name: University: Instructor: Date: Dentists 1.0 Reason for Choosing Dentists The main reason for choosing this profession is to allow the readers understand how dentists promote good oral health, and positively lead to social, mental and physical well-being. Dentists are very important because they help people live a healthy life. Scores of Canadians are today enjoying improved oral health and dentists are helping them to keep their natural teeth all through their lives. Still, this is not the case for every person considering that cavities are still prevalent amongst children. Dentists are described as individuals specializing in oral health with varying responsibilities such as diagnosing oral diseases, performing surgical procedures, and so forth. Dentists are important for ensuring effective and safe oral care. 2.0 Brief Historical Background of Dentistry in Canada In 1867, change in Canada was constant in every field, including dentistry. In early 20th century, dentists became worried about the welfare the public, and identified the need to regulate the dentistry practice. The need for regulation brought together a group of committed dentists such as Barnabas Day, the founder of Ontario Dental Association. This resulted in passing of Act Respecting Dentistry into the Ontario Legislature, whereby the Royal College of Dental Surgeons of Ontario were given powers to regulate and licence dentists. In the mid-19th century, dental apprenticeships had increased, but since the dentistry training was not standard, the apprentices depended on the willingness of the trainers to share experiences.  The dental education and dental organizations disseminated widely in Canada, and in 1935, the Journal of the Canadian Dental Association replaced other literature materials on dentistry. In 1892, the Dental College of the Province of Quebec, the first dental school in Canada was established. In 1902, approximately 350 dentists met in Montreal to form the Canadian Dental Association as well as to create the Code of Ethics that could help bring showman 'dentists' to an end. 3.0 How Dentistry Relates to the Economy 3.1 Government Support In Canada, the oral health care is not covered by the Canada Health Act (CHA); therefore, the majority of Canadians get dental care through dental clinics that are privately operated. Most Canadians pay for dental services using their own money or insurance. Dental care in Canada is considered as a service that is publicly uninsured. Still, in a number of cases, if the patient gets dental care is in the hospital or belongs to a vulnerable population, dental care is publicly insured. Dental services funded by the government can only be accessed by federal prisoners, veterans, refugees, aboriginal population, military personnel, individuals with developmental disabilities, and recipients of social assistance together with their dependents. Oral health programs in Canada are mainly supported by territorial and provincial jurisdiction at municipal and regional level and through universities. At the territorial and provincial level, the public oral health programs is directed to targeted adult and child populations such as institutionalized and disabled persons and also in provincial prisons 3.2 Providing Dentistry services as a business In Canada, more than half of all private expenditures on dental care are from private insurance while the rest comes from the patient’s pocket. That proves that most Canadians rely on private health insurance to pursue dental care. Besides that, almost 17 per cent of Canadians are reluctant to seek dental care due to the cost (CDA).  Furthermore, more than 30 per cent of Canadians do not have dental insurance, and this issue is growing in significance (CDA). The increasing per-capita pool of dentistry professionals in Canada has resulted in price wars as well as discount offers. In places like Toronto, dentistry is considered a hyper-competitive market. Some decades ago, dentists considered themselves professionals, but nowadays they are considered business people. More than ever, dentists have offered the patients more purchasing power. 3.3 Dentistry Contribution to Economy Dentistry has an effect on the economy because for an economy to be successful, it needs a healthy population. Oral health is considered important for overall health, but millions of Canadians go without dental care, simply because it is expensive. Besides that, the ethnic and racial minorities with low incomes as well as older adults are experiencing challenges to access routine as well as preventive dental care. Presently, dentists in Canada are ‘over- saturated’, and their per-capita pool is growing, especially in large urban centers such as Vancouver, Montreal and Toronto. Because dentists are ‘over-concentrated’ in urban centers, competition for customers is exceedingly high. The dentistry tightening market shows that dentists are forced to efficiently run their practices by collaborating with colleagues so as to reduce practice related expenses such as high equipment cost. The economic impact of evident is evident considering that approximately 4.15 million working days as well as 2.26 million school days are lost yearly because of dental sick-days or dental visits. Moreover, approximately 40.36 million normal activities hours are lost because of dental check-ups. All these hours lost because of dental care and check-ups have a negative effect on the Canadian economy (Canadian Dental Association 5). 4.0 Power Struggles between Dentists and other Professions In Canada, there is an enduring struggle between bodies representing dental hygiene and dentistry with regard to issue of expertise, professional autonomy and status, and particularly over who is the primary provider of oral health care. According to Adams (2243), this struggle has been exacerbated by the ever-changing dental services market, regulation changes of health professions, and independence. Regrettably, the conflict between dental hygiene as well as dentistry is happening on the government and professional level with both professions seeking the government support and trying to win the public backing. Besides that, scores of professionals in the past were dominated mainly by men as evidenced by their competitiveness, decisiveness as well as action. Therefore, women in such professions were considered subservient and relied on the male employer. Until now, the position status in the organization in addition to the work division and quality has been demarcated clearly by gender (Freeman, Gorter and Braam 161). Some decades ago, women desiring to be part of the dental profession were recruited as reception staff, dental therapists, dental hygienists and dental nurses. In clinical practice and professional legislation, professional demarcations have been defined clearly. Therefore, female dentists often feel that they have lower professional status. Gender-related conflicts are prevalent in dentistry. 4.2 Equity and Social Class in Dentistry Even though dental conditions are hardly fatal, Grignon, Hurley and Wang (4) posit that oral health has an enormous impact on quality-of-life. Failure to access the required dental treatment may impede a person’s ability to have a normal life. There is a great relationship between oral and the general health; therefore, challenges endured by Canadians to access dental care are largely associated with affordability issues. Insurance and income in Canada are recognized as the main predictors of access to and the use of dental care, especially due to their ability of mitigating care costs. Still, as observed by Ramraj, Sadeghi and Lawrence (1) plans for dental insurance have dramatically changed in the last two decades and have declined both in terms of their availability and quality. After the 1990s recessions, for instance, dental insurance plans reduced because firms in Canadian devised ways of cutting cost by changing the benefit plans through expansion or introduction of deductibles or by means of co-payments or co-insurance (Quiñonez and Grootendorst 4). Concurrently, the accessibility of dental insurance for employees has reduced since most Canadian firms are changing the nature of employment by increasing temporary as well as part-time positions, therefore, preventing emergency of unionization. Lack of equity in accessing dental care is an indicator of the growing inequalities within the Canadian society. The population of elderly and minorities is increasing progressively while the population having dental insurance is reducing; therefore, accessing dental care will become more difficult unless the government start to act now (Thompson 724). 4.3 Statistical Analysis The number of licensed dentists in Canada as of 2010 was 19,563 with almost 89 per cent taking part in the general practice while the remaining 11 per cent being specialist dentists (Canadian Dental Association 2). The 2009 statistics shows that male dentists in Canada were almost 72 per cent and 28 per cent being women. Hitherto, there has been a dramatic shift in the gender composition of the dentists with majority of female dentists being aged below 30 years. 5.0 The Regulatory Body for Dentists There are a number of regulatory bodies for dentists in Canada, but the main one is the Canadian Dental Association (CDA). According to its website (www.cda-adc.ca), CDA mission is to act as a national voice for dentists so as to promote the best oral health, which is a crucial component of general health. The objective of CDA is to serve as a knowledge negotiator so as to promote consensus concerning issues that affect dentistry professions. Imperatively, CDA seeks to influence the outcomes, which advance, promote and protect dentists. Another regulatory body is the Canadian Dental Assistants’ Association (CDAA), which according to its website (www.cdaa.ca/) seeks to serve the interests of the dental assistants by trying to solve issues like workplace safety, occupational analysis as well as labor mobility.  The CDAA mission is to offer leadership for the dental assistants at national level and advancing their member interests. CDAA seeks not just to advance the dental assisting professionals, but also to advocate for them through core values: knowledge and research, policy influence and advocacy, and capacity building. The Royal College of Dental Surgeons of Ontario (www.rcdso.org) is another regulatory body for Ontario based dentists. Its mission is protecting the public’s right to access quality dental services by offering education as well as leadership to dentists. RCDSO core purpose is setting the qualification for people seeking to become dentists and developing programs that enable dentists to advance their knowledge and skills. Besides that, RCDSO ensures that the dentistry professional standards are developed continuously and that dentists adhere to the set ethical principles. Imperatively, RCDSO ensures the safety and protection of the public by means of effective self-regulation. Its main goal is developing and maintaining knowledge and skill standards as well as programs for promoting enduring competence amongst its members. 6.0 People Served by Dentists Dentists’ customers include people with toothache, dental caries, dental abscess, periodontal disease, gingivitis, herpetic gingivostomatitis, and acute necrotising gingivitis. Other customers include those who go for normal check-up as well as those suffering from periodontitis, aggressive periodontitis, those seeking to undergo periodontal surgery, and those having systemic diseases that affect the gingiva and teeth. Some customers visit dentists not to get medical care, but to know how they can maintain a bright smile, how they can prevent periodontal disease, as well as how to improve your self-esteem and confidence. 6.1 Dentists Vulnerabilities According to Puriene, Janulyte and Musteikyte (10), dentist normally suffer different psychological and physical ailments caused or worsened by the work setting, and this the health of other dental professionals. Puriene, Janulyte and Musteikyte (10) posit that the musculoskeletal complaints are prevalent amongst dentists, with majority of the dentists experiencing at least one musculoskeletal disease symptom annually. Dentists’ physical load appears to increase the likelihood of getting musculoskeletal disorders. As observed by Puriene, Janulyte and Musteikyte (11), the dentistry normally create fairly high muscular load on both extensor- carpi-radialis and trapezius muscle. This results in cumulative loads, which in the long run, affects the dentists’ physical health. Puriene, Janulyte and Musteikyte (13) assert that there is much stress in dental practice since dentists are expected to handle numerous significant stressors in both their professional as well as personal lives. Empirical evidence as cited by Puriene, Janulyte and Musteikyte (13) shows that dentists often experience high level of job-related stress, with most of them perceiving dentistry as being ‘exceedingly stressful’. The stress is normally brought about by heavy workloads, anxious and late patients and running late on the set schedule. Besides the human condition vulnerabilities, dentists also experience psychiatric illnesses, addictive disorders, relationship as well as family problems, and other vulnerabilities that bring about misery (Robinson, Acquah and Gibson 223). 6.2 Responsibilities of dentists Dentists have a number of responsibilities such as examining, diagnosing as well as treating oral diseases, performing an oral treatment, which includes removing prosthetics, extractions, root canals, as well as teeth fixing (Burket, Greenberg and Glick 8). Other responsibilities include working with other health professionals so as to offer the patients quality treatments; educating patients on how they can prevent oral illnesses; treating gum injuries, teeth malformations as well as other oral abnormalities. They are expected to use dental equipment safely so as to avoid accidents; examine teeth and gums using diagnostic equipment and x-rays; making sure the working area is organized, clean and safe. It is the responsibility of the dentists to examine the dental health of the patient before prescribing medications and working with appropriate specialists when required. 6.3 Code of Ethics The dentists Code of Ethics is a set of principles that dentists are expected to observe so that they can fulfil their duties. For individuals seeking to become dentists, the Code of Ethics outlines the dentistry’s basic moral commitments and also acts as a source for reflection as well as education. The Code offers dentists with ethical practice direction; in that way, it doubles up as a self-evaluation basis. According to Canadian Dental Association, the Code of Ethics seeks to guide a dynamic interaction process between dental professionals as well as the patients. The Code reflects not just the present issues, but provides an ethical framework that can effectively respond to the changing values and needs. 7.0 Ethical Issues One of the ethical issue facing dentists is autonomy; given that it is the duty of the dentist to respect the patient's rights to confidentiality as well as self-determination. The dentists are required to involve the patients meaningfully in treatment decisions. Ethical issue is brought about by the fact that the patient is the one that makes the final decisions concerning treatment. The second ethical issue is the non-maleficence, which is associated with end-of-life decisions’ consideration. A dentist may find him/herself in a situation that they have to make a withholding or withdrawing treatment decision on the patient (Mathur and Chopra 4). In this case, denial or postponement of care complicates the provision of the best treatment leading to discomfort, unnecessary pain, increased expenses on treatment, and poor dental outcomes, which is against the ethical principles. The third ethical issue facing dentists is beneficence, whereby dentists are expected to serve in the best interests of their patients. Achieving an improvement in the oral health conditions of the patient is challenging because it is affected by variables like patient's general health, age, anatomy and adherence to instruction of oral hygiene. Dentists are expected to respect patients’ right to confidentiality as well as self-determination and also to promote the patients’ welfare. The fourth ethical issue is fairness considering dentists while serving patients can discriminate some patients because of their race, gender, colour or religion (Mathur and Chopra 9). The last ethical issue is the need for emergency care, whereby dentists are expected to be prepared for emergency care and decisions should be based on the patient’s specific condition or situation. 7.1 Case Studies A Survey carried out between 2007 and 2009, showed that the old people in Canada have unmet dental needs. Yao and MacEntee (1) explain that inequity that elderly Canadians face in oral care is attributed mainly to the current fee-for-service dental service system. Besides that, the inequity in dental care is caused by physical, behavioural and financial barriers, and both the dental profession as well as the community at large have social responsibility of reducing this inequity and offer fair older people a fair access to oral care. Dentists according to Yao and MacEntee (4) normally struggle with division of responsibilities, uncertain procedural guidelines, as well as ethical conflicts in delivery of oral care to older patients, particularly when patients show aggressive or uncooperative behaviour. Basically, managing frail elderly patients with different comorbidities normally needs teamwork from other health care professionals such as doctors and nurses, but these professional groups normally overlook the dentists’ role in integrated care for elderly people. According to McNally and Kenny (623), aging and health are extremely complex and meaningful realities. McNally and Kenny (623) analyse a number of ethical issues associated to oral health care that older population face in Canada. They examine representative cases where dental care needs are unmet; thus, uncovering some of the values as well as attitudes concerning oral health and the older people’s unique situations that result in barriers to suitable care. According to McNally and Kenny (625), alternative delivery systems presents a big ethical challenge to dentists based on how to balance the self-regulation and professional autonomy with a responsibility to identify and facilitate the required access to care. Some of the case presented in the study exemplify challenges such as need for advocacy, particularly for cognitive impaired patients; the need of addressing difficult and limited access to oral care, particularly for elderly people who are institutionalized; fair allocation of resources; developing age suitable standards of dental care; and the significance of reducing the oral health marginalization. 8.0 Dentists Strengths and Sensitivities One of the strengths of the dentists is that they are critical thinkers since dental care involves a range of functions. Therefore, a dentist is expected to understand every aspect of the teeth and the surrounding areas and also be able to think how they can to ensure accurate dental care for that meets their clients’ dental needs. Precise and nimble is another character of dentists, whereby dentist requires precise movements and nimble hands while doing procedures such as tooth extraction or cavity filling. They must ensure they are precise because a slight mishap may result in damage to the mouth, tooth or gum. A good dentist should be able to feel rewarded when they help others since it is their responsibility to help people having oral problems. Besides that, a good dentist must have a reassuring and confident demeanour. The dentists must help reduce the patients’ fears and make them feel more comfortable and safe. 8.1 Threats to the Integrity Even though, dentists are still widely trusted and highly regarded by most people, they are yet to instil a high sense of trust to their patients as well as to improve the patient-dentist relationship dynamics. Secularism and materialism have created an environment which complicates the real nature of dental professionals in the healthcare settings. Materialism has made dentists to be seen as mere complex machines, and dentists have found it almost impossible to treat patients reverently. The love for money has made dentists to use lethal and destructive means to win customers, and this a great threat to their integrity. Works Cited Adams, Tracey L. "Inter-professional conflict and professionalization: dentistry and dental hygiene in Ontario." Social Science & Medicine 58 (2004): 2243–2252. Burket, Lester William, et al. Burket's Oral Medicine. Shelton, CT: PMPH-USA, 2008. Canadian Dental Association. Dental Health Services in Canada. Facts and Figures. Toronto: CDA, 2011. CDA. Laws, Regulations and Guidelines in Health Care. 2014. 28 February 2016. . Freeman, R., R. Gorter and A. Braam. "Dentists interacting and working with female dental nurses: a qualitative investigation of gender differences in primary dental care." British Dental Journal 196 (2004): 161–165. Grignon, Michel, et al. Inequity in a market-based health system: evidence from Canada’s dental sector. Working Paper. McMaster University. Hamilton, ON: CHEPA Working Papers, 2008. Mathur, Shivani and Rahul Chopra. "Ethical Issues in Modern Day Dental Practice." Online Journal of Health Ethics 8.2 (2012): 1-12. McNally, Mary and Nuala Kenny. "Ethics in an Aging Society: Challenges for Oral Health Care." Journal of the Canadian Dental Association 65.11 (1999): 623-626. Puriene, Alina, et al. "General health of dentists. Literature review." Stomatologija, Baltic Dental and Maxillofacial Journal 9 (2007): 10-20. Quiñonez, arlos and and Paul Grootendorst. "Equity in dental care among Canadian households." International Journal for Equity in Health 10.14 (2011): 1-9. Ramraj, Chantel, et al. "Is Accessing Dental Care Becoming More Difficult? Evidence from Canada's Middle-Income Population." PLoS ONE 8.2 (2013): 1-6. Robinson, P. G., S. Acquah and B. Gibson. "Drug users: oral health-related attitudes and behaviours." British Dental Journal 198 (2005): 219–224. Thompson, Lisa A. Geriatric Dentistry, An Issue of Dental Clinics of North America,. London: Elsevier Health Sciences, 2014. Yao, Chao Shu and Michael MacEntee. "Inequity in Oral Health Care for Elderly Canadians: Part 2. Causes and Ethical Considerations." Journal of the Canadian Dental Association 80.10 (2014): 1-7. Read More