A Review of the Ethics of Patient-Based Licensure Examinations.

Purpose Concerns regarding the ethical justification for the use of single-encounter, procedure-based examinations on live patients for the licensure of dental hygienists and dentists in the United States persists despite decades of debate and publication on the subject. The purpose of this literature review was to summarize the specific ethical concerns and quantify recommendations in favor or against this examination methodology.Methods A population, intervention, control or comparison, outcome (PICO) question was developed to review the topic as follows: "For individuals receiving dental care as part of determination of candidates for competency and readiness for licensure, do patient-based licensure examinations, as compared to other assessment methods, violate or infringe upon ethical principles or ethical standards for health care or society?" An electronic search was performed in three databases: PubMed/Medline, Scopus, and Embase. Key search terms and Medical Subject Headings (MeSH) included the following: ethics, clinical, competence, dental, dental hygiene, dentistry, education, licensure, live patient, and practice.Results Ethical concerns about the use of patient examinations have been published in the professional literature for over 35 years. Of the 29 selected or endpoint articles identified, 27 articles cited one or more ethical concerns relating to single-encounter patient-based examinations while 20 articles recommended the elimination of this type of examination with an additional 6 articles citing elimination as an option in resolving the ethical issues regarding this type of licensure examination.Conclusion The literature holds a predominant, prevailing professional opinion that single-encounter, procedure-based examinations on live patients presents significant ethical concerns and should be eliminated as a method in initial dental hygiene and dental licensure. The literature also suggests that state dental boards should initiate corrective regulatory or legislative actions to expeditiously end recognition of live patient examinations in their licensure processes.

Evidence-Based Pain Management: Dispelling Disinformation in Dentistry.

According to the American Dental Association Principles of Ethics and Code of Professional Conduct, dental professionals hold a special position of trust and privilege within society, and thus are bound to adhere to the highest standards of conduct. This code of ethics defines key tenets, including veracity, patient autonomy, beneficence, nonmaleficence, and justice. Maintaining these ethical principles goes beyond the competent delivery of operative care and requires up-to-date, evidence-based knowledge and practices on the part of clinicians.1 With pain management being a key component of endodontics practice, clinicians must maintain their knowledge on the most effective evidence-based pain management strategies to ethically care for their patients.

Ethical issues in dental education-A cross-sectional study with pre-clinical and clinical dental students.

INTRODUCTION: Although ethics is an indispensable part of dental education, it has not yet played a relevant role in the dental curriculum in Germany. The study aimed at assessing their prior knowledge of ethical aspects, and their expectations of and wishes for ethics course of dental students, preclinical vs. clinical, at the dental school Kiel, Germany by means of a validated questionnaire. METHODS: A descriptive cross-sectional study design was used. The study population consisted of dental students, from pre-clinical (n = 105) and clinical semesters (n = 110). In January 2019, each student completed a validated questionnaire to identify semester-specific ethical teaching content. Besides descriptive analyses, Mann-Whitney U test was used to compare pre-clinical and clinical students. RESULTS: A total of 215 dental students, with a mean age of 25.3 (SD 4.1), participated in the study, of which 150 were female (69.8%) and 65 were male students (30.2%). The results in the areas of 'previous knowledge of ethical issues' and 'expectations and desires in terms of teaching medical ethics' showed similarities and differences between pre-clinical and clinical students. Both groups stated that they need training in ethics. Moreover, especially clinical students recognize that more ethical competence is needed if the first patient contact will start. CONCLUSION: The study indicates that there is a clear need for ethics education. Student awareness of the relevance of ethical competences and the perception of ethical problems increased progressively during the course of their studies. Overall, the study provides good support for the development of specific ethics courses.

Awareness and practice of Revised Code of Dental Ethics and Consumer Protection Act among dental practitioners in Andhra Pradesh: A cross sectional study.

BACKGROUND: Given the imperative for dental practitioners to be familiar with the existing ethical principles and laws governing their practice, this study aimed to evaluate awareness and practice of the dentists (code of ethics) regulations 2014 and consumer protection act 2019 among dental practitioners in Andhra Pradesh state, India. METHODS: A cross sectional study was conducted among 384 dental practitioners in Andhra Pradesh state, India. A questionnaire consisting of 25 items was used to assess awareness and practice of the dentists (code of ethics) regulations and consumer protection act. The data collected were analysed using IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp. RESULTS: Only 53(13.8%) dental practitioners in the study were aware that the dentists (code of ethics) regulations had been revised in 2014. About 190 (49.5%) practitioners were aware of the precise period for mandatory preservation of patient records. Most dental practitioners (278, 72.4%) accepted commissions in the form of gifts or cash from laboratories, radiologists, or pharmacists and 306 (79.7%) dental practitioners used unregistered dental lab technicians as employees in their practice. Furthermore, 297 (77.3%) practitioners were found to provide or sell drugs to patients in their clinic/office. The new regulations under consumer protection act 2019 were unknown to 194 (50.5%) dental practitioners. CONCLUSIONS: The present study indicates that the awareness of dental practitioners towards the dentists (code of ethics) regulations 2014 and consumer protection act 2019 is inadequate. It highlights the need for training programmes and curriculum changes with a focus on ethical and legal issues in clinical dental practice.

Instrument fracture in periodontal therapy: ethical disclosure and clinical management - a case report.

Periodontal instrument fractures are rare events in dentistry, with limited literature available on their occurrence and management. This case report highlights an incident involving the fracture of a periodontal sickle scaler blade during manual instrumentation for the removal of calculus. The fracture occurred during instrumentation on the mesial surface of the maxillary right second molar, and the separated blade was subsequently pushed into the sulcus. A radiographic assessment was performed to verify the precise location of the fractured segment. Following confirmation, the broken blade was subsequently retrieved using curved artery forceps. The case report highlights factors contributing to instrument fractures, emphasizing the importance of instrument maintenance, sterilization cycles, and operator technique. Ethical considerations regarding patient disclosure, informed consent, and instrument retrieval methods are well discussed. This case underscores the importance of truthful communication, the proper use of instruments, equipment maintenance in dentistry, and the significance of ongoing professional development to enhance treatment safety, proficiency, and ethical standards in dental care.

Lack of assent to dental examination in children with intellectual disabilities: Dentists' practices in Europe and ethical issues.

AIM: (1) To determine the repartition of criteria which can be considered as marks of lack of assent by the child with intellectual disabilities from the dentist's point of view and whether that influences the decision to examine the patient or not. (2) To explain the decision of practitioners and determine the ethical implications of these practices. METHODS: An anonymous and structured questionnaire was distributed online using the scenario of a 9-year-old child with moderate cognitive impairment with eight different oppositional behaviours. The practitioners were asked about their perception of the patient's lack of assent and about their decision to perform the dental examination or not. RESULTS: The proportion of them who performed a dental examination despite the patient's refusal represented between 13% and 28.8% of the population of respondents. CONCLUSION: There was an ambivalence among the practitioners who carried out a dental consultation when children were uncooperative. They adopted a teleological point of view. It calls for us to reflect on the ethical principles of autonomy and beneficence.

Difficulties experienced by dentists and orthodontists regarding ethical issues when announcing the diagnosis of a rare oral disease: a qualitative study in Marseille, France.

PURPOSE: It is traditionally considered that breaking bad news to patients does not represent a cause for concern for dental professionals. However, there are situations where they will be confronted with this task, as in the case of rare dental diseases. Little information is available regarding the feelings of healthcare professionals on this subject. There are no qualitative studies that explore how a diagnosis of oligodontia is announced to patients by dentists and orthodontists. The aim of our study is to explore the difficulties and ethical issues experienced by dental health professionals when they have to announce a diagnosis of oligodontia to a patient and their family. METHODS: This study relied on a qualitative research method using focus groups of dentists and orthodontists and a thematic analysis procedure. RESULTS: The difficulties experienced could be summarised within five topics: organisational difficulties, difficulties with the management of dental treatment and with the administrative management associated with this anomaly, difficulties with the content of the announcement, and relational difficulties. These could be grouped in two categories: practical difficulties and ethical difficulties. CONCLUSION: This survey allowed us to understand the difficulties encountered by dentists and orthodontists when announcing oligodontia. The participants felt uncomfortable with this task and were under stress. They reported difficulties in delivering the medical information and in adapting to the message. It is essential that dental professionals develop skills in medical communication.

A tecnologia da informação e suas decorrências: uma análise sobre os impactos das mídias sociais na odontologia / The information technology and its results: an analysys on the impacts of social media on dentistry

Na era contemporânea, a Odontologia está cada vez mais se voltando para o meio virtual. Os indivíduos não somente querem consumir um produto ou ter acesso a um serviço, mas querem entender também sobre quem está atrás daquilo ofertado. Nesse sentido, a Odontologia teve diversos benefícios com o advento das mídias sociais e das recorrências clínicas de toda Tecnologia da Informação. Com a chegada das redes e a troca exponencial de dados, Cirurgiões Dentistas tiveram muito a ganhar com maior possibilidade de divulgação e troca de dados. Cada vez mais os profissionais liberais utilizam meios para angariar pacientes e alavancar lucros, ou, ainda, aumentar o potencial de seu trabalho, seja de cunho científico, social ou pedagógico. Analogamente, questões éticas e aspectos legais são levantadas diariamente ao analisar o uso das mídias sociais pelos profissionais, visto as infrações de princípios morais cometidos, além dos excessos que banalizam e causam a perda de toda magnitude da profissão. O objetivo desse estudo foi analisar, através de uma revisão de literatura, os impactos das mídias sociais na Odontologia, dessa forma, buscando entender como os cirurgiões-dentistas, a sociedade e o mercado têm lidado com toda a mudança trazida pela Tecnologia da Informação e suas confluências. Com base na revisão de literatura realizada, foi possível concluir que as redes sociais são ferramentas imprescindíveis para a disseminação de informações e conteúdo de valor na Odontologia, que os profissionais, os pacientes e o universo acadêmico e científico têm muito a ganhar com os recursos tecnológicos provenientes das mídias sociais, principalmente, pela sua flexibilidade, por ser um meio democrático e oferecer baixo custo. Todavia, na dualidade apresentada pelo uso das redes sociais, o seu uso precisa ser criterioso e intencional, demonstrando ser uma questão de saúde pública, que envolve aspectos éticos e legais no meio odontológico, necessitando ter sua utilização profissional mais abordada nos meios acadêmicos e científicos. Ainda, indo na contramão das atuais tendências negativas das redes sociais e da Tecnologia da Informação, a Odontologia não deve perder a sua magnitude e profundidade para se adequar nos moldes da efemeridade das mídias sociais. O saber científico e a primazia técnica devem vir ainda em primeiro lugar, mesmo que isso não favoreça os algoritmos de alcance das redes sociais ou vá de encontro a interesses mercadológicos.

In the contemporary era, dentistry is increasingly turning to the virtual environment. Individuals not only want to consume a product or have access to a service, but also want to understand who is behind what is offered. In this sense, Dentistry has had several benefits with the advent of social media and the clinical recurrences of all Information Technology. With the arrival of networks and the exponential exchange of data, Dental Surgeons had a lot to gain from greater possibilities for disseminating and exchanging data. Liberal professionals are increasingly using means to attract patients and leverage profits, or even increase the potential of their work, whether of a scientific, social or pedagogical nature. Similarly, ethical issues and legal aspects are raised daily when analyzing the use of social media by professionals, given the violations of moral principles committed, in addition to the excesses that trivialize and cause the loss of all magnitude of the profession. The objective of this study was to analyze, through a literature review, the impacts of social media on Dentistry, thus seeking to understand how dentists, society and the market have dealt with all the changes brought about by Information Technology and their confluences. Based on the literature review carried out, it was possible to conclude that social networks are essential tools for the dissemination of information and valuable content in Dentistry, that professionals, patients and the academic and scientific universe have much to gain from technological resources. from social media, mainly because of its flexibility, because it is a democratic means and offers low cost. However, in the duality presented by the use of social networks, their use needs to be judicious and intentional, proving to be a public health issue, which involves ethical and legal aspects in the dental environment, needing to have its professional use more addressed in academic and scientific circles. . Still, going against the current negative trends of social networks and Information Technology, Dentistry must not lose its magnitude and depth to adapt to the molds of the ephemerality of social media. Scientific knowledge and technical primacy must still come first, even if this does not favor social media reach algorithms or go against market interests

Análise dos perfis de cirurgiões-dentistas de Londrina (Paraná, Brasil) no Instagram / Análisis de losperfiles de odontólogos de Londrina (Paraná, Brasil) en Instagram: aspectos éticos de la publicidade y propaganda / Analysis of the profiles of dentists of Londrina (Paraná, Brazil) on Instagram: ethical aspects ofadvertising and publicity

A Odontologia tem adentrado nas redes sociais como forma de atrair e manter pacientes. O profissional, por vezes, não está atento às normativas éticas para utilizar a publicidade/propaganda na internet, cometendo infrações éticas referente à essas condutas. O objetivodesta pesquisa foi analisar os perfis públicos (de acesso aberto) de cirurgiões-dentistas (CD) do município de Londrina (PR) na rede social Instagram®frente aos aspectos da publicidade e propaganda caracterizados no Código de Ética Odontológica (CEO). Foi utilizada uma listagem de CD ativos no município de Londrina, disponibilizado pelo Conselho Regional de Odontologia do Paraná. Como critério de inclusão, foi necessário que o CD possuísse o perfil público e caracterizado como profissional da área, sendo excluídos os perfis privados, sem identificações, sem publicações e apenas com publicações pessoais.Após a seleção, cada perfil foi avaliado separadamente, levando-se em consideração as dez últimas postagens, de acordo com nove itens pré-estabelecidos tendo como base o CEO. Foram identificados 213 perfis que atendiam aos critérios de inclusão, sendo 137 em desacordo com o CEO e 76 em acordo. A maioria dos perfis analisados infringia um ou mais itens que foram avaliados, sendo a exposição de imagens de "antes e depois" o item encontrado com maior frequência (AU).

La Odontología ha entrado en las redes sociales como una forma de atraer y fidelizar pacientes. El profesional, en ocasiones, no es consciente de las normas éticas para el uso de publicidad/propaganda en internet, cometiendo infracciones éticas en relacióncon estas conductas. El objetivo de esta investigación fue analizar los perfiles públicos (acceso abierto) de los odontólogos (CD) de la ciudad de Londrina (PR) en la red social Instagram®frente a los aspectos de publicidad y propaganda caracterizados enel Código de Ética Dental (CEO). Se utilizó una lista de CD activos en la ciudad de Londrina, facilitada por el Consejo Regional de Odontología de Paraná. Como criterio de inclusión fue necesario que el CD tuviera perfil público y caracterizado como profesional del área, excluyendo perfiles privados, sin identificaciones, sin publicaciones y solo con publicaciones personales. Luego de la selección, cada perfil fue evaluado por separado, teniendo en cuenta los últimos diez cargos, según nueve ítems preestablecidos en base al CEO. Se identificaron un total de 213 perfiles que cumplían los criterios de inclusión, 137 en desacuerdo con el CEO y 76 de acuerdo. La mayoría de los perfiles analizados violaron uno o más ítems evaluados, siendo la exhibición de imágenes de "antes y después" el ítem encontrado con mayor frecuencia (AU).

Dentistry has entered social networks as a way toattract and retain patients. The professional, sometimes, is not aware of ethical norms for using publicity/advertisement on the internet, many times committing ethical infractions regarding these behaviors. The aim of this research was to analyze the public (open access) profiles of dentists (DE) in the municipality of Londrina (PR) on the social network InstagramTMin view of the aspects of publicity and advertisement characterized in the Code of Dental Ethics (CDE). A list of active DEs in the city of Londrina, made available by the Regional Council of Dentistry of Paraná, was used. As inclusion criterion, it was necessary that the dentist had public profile and characterized as a professional in the area, excluding private profiles, without identifications, without publications and only with personal publications. After selection, each profile was evaluated separately, taking into account the last ten posts, according to nine pre-established items based on CDE. A total of 213 profiles that met the inclusion criteria were identified, 137 in disagreement with CDE and 76 in agreement. Most profiles analyzed violated one or more items that were evaluated, with the exhibition of "before and after" images being the most frequently found item (AU).