Burt and Eklund's Dentistry, Dental Practice, and the Community - E-Book

Burt and Eklund's Dentistry, Dental Practice, and the Community - E-Book

Amer Assoc of Public Health Dentistry, Ana Karina Mascarenhas, Christopher Okunseri, Bruce Dye, Ana Karina Mascarenhas, Christopher Okunseri, Bruce Dye

• Publisher: Saunders
• Year: 2020
• Print ISBN: 9780323554848
• eBook ISBN: 9780323554855
• Edition: 7
• Topic: Medicine
• Subtopic: Dentistry

Learn about the challenges, current trends, and the positive role that you can play in improving the dental health of the community. Completely revised and updated by members of the American Association of Public Health Dentistry, Burt and Eklund's Dentistry, Dental Practice, and the Community, 7th Edition presents dentistry and dental practice against the ever-changing backdrop of economic, technological, and demographic trends, as well as the distribution of the oral diseases that dental professionals treat and prevent. Readers will learn the latest techniques of research and measurement, and how oral disease may be limited through control and prevention. This updated text also addresses the new educational competencies for predoctoral/ post-doctoral dental students and dental hygiene students with updated and new content on cultural competency, oral health literacy, social responsibility, motivational interviewing, and oral systemic associations. All in all, this text takes a comprehensive look at the social context of dental care and the difference you can make in improving the health of the community you serve.- Logical four-part organization divides content into dentistry and the community; dental care delivery; methods and measurement of oral diseases and conditions; and health promotion and prevention of oral diseases.- A focus on need-to-know content emphasizes the important core information while providing comprehensive coverage of dental public health.- Comprehensive analysis of dentistry's social and professional role examines issues such as epidemiology of oral diseases, prevention, and the provision of care.- Evidence-based recommendations reflect the latest literature on today's public health issues.- Illustrations, tables, and graphics illustrate the key material and visually enhance discussions.- NEW! Completely revised and updated content looks at populations oral health and dental care as well as how it fits into a changing world.- NEW! Coverage of new educational competencies provides predoctoral/ post-doctoral dental students and dental hygiene students with updated and new content on cultural competency, oral health literacy, social responsibility, motivational interviewing, and oral systemic associations.- NEW! New chapters cover the applications of epidemiology and biostatistics in dental public health, oral health as it related to quality of life, oral health education, health literacy, social determinants of health and health disparities, and delivery of oral healthcare in Canada.- NEW! Newly revised competencies for the Dental Public Health specialty are incorporated throughout the book.

Part I

Dentistry and the Community

1

The Practice of Dentistry and Dental Public Health

Brian Burt, BDS, MPH, PhD^†; Ana Karina Mascarenhas, BDS, MPH, DrPH, FDS RCPS

Chapter Outline

• Development of the Dental Profession
• What Is Public Health?
  • Identifying a Public Health Problem
• Dental Public Health
  • Differences Between Personal and Community Healthcare
  • Collection and Use of Data in Dental Public Health

Dental practice has existed in some form since the dawn of time, but it is only sometime in the last century that its practitioners in most nations have achieved the status of a profession. Webster’s dictionary defines a profession as “a calling requiring specialized knowledge and often long and intensive academic preparation” and “the whole body of persons engaged in a calling.” The definition of professionalism is “the conduct, aims, or qualities that characterize or mark a profession or professional person.” These dictionary definitions, however, do not fully capture the essence of a profession or of professionalism: Commitment to patient welfare, ethics, and other professional ideals are not included. Nor are all aspects of professionalism necessarily high minded or noble. Admission to some professional groups can be based on self-perpetuation rather than public good.⁴³

Three models of professionalism have been described,²⁶ none of which by itself fully characterizes dentistry, although collectively they may do so. The first is the commercial model, in which dental care is viewed as a commodity sold by the practitioner. The services are thus not based primarily on the client’s needs but on what the client is able or willing to buy. This rather crass view is distasteful to many, although there are aspects of it in dental practice. The second is the guild model, in which dental care is seen as a privilege with the professional dominant in practitioner–patient relations. Here the professional is the repository of all knowledge and wisdom, the patient is a passive recipient, and the practitioner has an ethical trust to provide the best-quality care. This model has probably been dominant in the United States, although it is slowly merging with the third model, the interactive model, in which dental care is considered a partnership of equals. In this model, practitioner and patient jointly determine care provided through a combination of professional expertise and patient values.

What are the criteria that characterize a profession, and how can a profession be distinguished from, say, a trade union? The first is the criterion given in the dictionary definition—a substantial body of knowledge, a corollary of which is the obligation to keep that knowledge up to date through continuing education. The second is self-regulation, a tradition whereby society delegates to professional groups the legal responsibility for determining who shall join them in serving the public and for disciplining those members who do not meet the profession’s requirements. A third and perhaps the main distinguishing criterion of a profession is a code of ethics, guidelines for professional conduct that are rooted in a moral imperative rather than in law or regulation (see Chapter 4). A profession sets its own code of ethics and its own procedures for dealing with infringements. Taking the various criteria mentioned, one can distinguish a profession by the features listed in Box 1.1.

Box 1.1

Characteristics of a Profession

• • A body of knowledge exists that is constantly being expanded, updated, and archived in a literature record. The purpose is constant improvement of the quality of the profession’s service to individuals and to the public.
• • Academic preparation is required, carried out in specialized institutions.
• • The profession and its members accept a lifelong commitment to continuing education.
• • Society awards the profession the privilege of self-regulation, which means determining the requirements for entering and remaining in the profession and dealing with those members who do not meet the requirements.
• • Its members subscribe to a code of ethics drawn up by the profession itself.
• • The members form organized societies to enhance the development of the group and its societal mission and to serve its individual members.

A health profession can then be defined by paraphrasing Webster’s definition given earlier: a calling in the health sciences requiring specialized knowledge and one that meets the other criteria listed. Dentistry meets all the requirements of a profession.

Public health is one of those aspects of life that most people take for granted or more likely don’t think about at all. We take for granted that we can drink a glass of water without thinking about cholera, choose a restaurant without concern about rats in the kitchen, and buy a can of vegetables without worrying about botulism. The source of the occasional outbreak of food poisoning is rapidly identified by the authorities, and thoughts of scarlet fever, typhoid, and poliomyelitis simply never enter our heads. To many of the younger generations, dental caries is almost as distant as these infectious diseases of the past. But this happy state of affairs has not just happened; rather, it is the endpoint of years of public health research and practice.

The low profile of public health has both good and bad aspects. Although it is good that mostly invisible basics like drains, sewage treatment, fluoridated drinking water, food quality and safety, and immunizations against infectious diseases are part of the accepted institutions of modern life, it is not good that most people have so little grasp of how public health functions. It is not good because, without a constituency to press for it, funding and legislation for public health can be eroded—with subsequent threats to health and the quality of life. In contrast, everyone is acutely conscious of access (or lack of it) to personal health services, and that subject is a constant political issue. The development of the public health infrastructure has taken a long time and has required some painful lessons in lifting our quality of life to its present level.

The purpose of this chapter is to examine the development, structure, and practice of dentistry and dental public health in the United States and to develop the theme that dental public health and private dental practice need to work together for the good of the community’s oral health. The chapter also discusses an essential element of dental public health, the collection and use of data in dental public health.

Development of the Dental Profession

Dental diseases have afflicted the human race since the dawn of recorded history.^24,40 Dentistry, however, has existed as a vocation only in recent years, historically speaking, and it was not until modern times that any sort of scientific basis was developed for the care of oral diseases. One landmark event was the 1728 publication of Pierre Fauchard’s Le Chirurgien Dentiste, ou Traité des Dents, a two-volume book of more than 800 pages. Fauchard, a Frenchman, is seen as a seminal figure in the evolution of the dental profession. His work was the first complete treatise on dentistry published in the Western world, and it remained an authoritative document for more than 100 years. Despite his lack of formal training, Fauchard was clearly a first-class empiricist with keen powers of observation.

Aspiring dentists of the time served as apprentices. It is worth noting that even the formal education of G.V. Black, one of the profession’s most notable 19th-century pioneers, did not exceed 20 months. His introduction to dentistry consisted of “a few weeks” with one Dr. Speers, who was not considered a particularly good dentist and whose dental library consisted of one book.⁹ Fortunately, Dr. Black was a true professional and followed the precept that “a professional person has no choice other than to be a continuous student.”...

Table of contents

• Cover image
• Title page
• Table of Contents
• Copyright
• Dedication
• Preface to the Seventh Edition
• Foreword
• List of Contributors
• Part I: Dentistry and the Community
• Part II: Dental Care Delivery
• Part III: Methods and Measurement of Oral Diseases and Conditions
• Part IV: Health Promotion and Prevention of Oral Diseases
• Index