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.

Emergency management of dental avulsion and replantation: knowledge of undergraduate health care students / Manejo emergencial da avulsão dentária e do reimplante: conhecimento dos estudantes degraduação na área de saúde

Dental replantationis a major problem in public health. Its prognosis depends on emergency care, butthere is a lack of knowledge on it. So, this study aims to evaluate the knowledge of undergraduate students of Dentistry, Speech Therapy, Physical Education, Pedagogy,and Technologist in Radiology. One hundred and fifty-onestudents answered tenquestions about emergency replantation care. Then, an educational lecture was performed. The same questions were asked again to the same students to reevaluate their answers. The statisticaltests were employed at a significant level of p<0.05. There wasa significant difference (p<0.05)inthe responsesbefore and after the lecture. The dental students had a higher knowledge ofthe subject (p<0.05). The educational presentation reached its objective, since there was an improvement in the index of all answers of the post-lecture questionnaire, demonstrating thatthe people must be informedand trainedin the emergency management of dental avulsion (AU).

O reimplante dentário é um grande problema de saúde pública. Seu prognóstico depende do atendimento de urgência, mas ainda falta conhecimento.Assim, este estudo tem como objetivo avaliar o conhecimento de graduandos de Odontologia, Fonoaudiologia, Educação Física, Pedagogia e Tecnólogo em Radiologia. Cento e cinquenta e umalunos responderam a 10 perguntas sobre cuidados de reimplante de emergência. Em seguida, foi realizada uma palestra educativa. As mesmas perguntas foram feitas novamente aos mesmos alunos para reavaliar suas respostas. Os testes estatísticos foram empregados em um nível de significância de p <0,05. Houve diferença significativa (p <0,05) nas respostas antes e depois da palestra. Os estudantes de odontologia apresentaram maior conhecimento sobre o assunto (p <0,05). A apresentação educativa atingiu seu objetivo, visto que houve uma melhora no índice de todas as respostas do questionário pós-aula, demonstrando que as pessoas devem ser informadas e treinadas no manejo emergencial da avulsão dentária (AU).

Quackery in Dental Practice in Nepal.

Quackery and fraud in dental practice, seen in many countries, is also rampant in Nepal, and they are unethical practices. There is a growing need for strict enforcement of government policy measures to eliminate quackery and fraudulent dental practice in Nepal. The government should mobilize all dental workforce (dental specialists, dentists, and dental auxiliaries) and aware of their responsibilities and limitations. This article presents a brief review showing some cases of malpractice in dentistry in Nepal.

[The necessary ethical questioning regarding the caring relationship in dental telemedicine]. / Le nécessaire questionnement éthique autour de la relation de soin en télémédecine bucco-dentaire.

Technological innovations in the fields of medical imaging and communication have enabled the rise of dental telemedecine. By transforming the usual caring relationship, dental telemedicine virtualizes the medical procedure and generates a mutation of the classical relational model that rearticulates the relationship between the dentist and the patient. It introduces a positive lever that must stay up to the appraisal of the benefit-risk equation, that an ethical questioning will help to evaluate for every patient. Dental telemedicine must be understood as a mean, and not as an end. It must not be fantasized as a universal dental care model. It seems to be recommanded to investigate systematically the technological innovations and the development of protocols thanks to ethical guidelines in order to evaluate a priori and a posteriori any kind of progress that might be considered.

Manejo odontológico da Síndrome de Rendu-Osler-Weber: relato de caso / Dental management of Rendu-Osler-Weber Syndrome: case report

A Telangiectasia Hemorrágica Hereditária (THH) ou Síndrome de Rendu-Osler-Weber (SROW) é uma displasia fibrovascular sistêmica que apresenta alterações na camada muscular da parede dos vasos sanguíneos. Isto faz com que os vasos sejam sujeitos a rupturas frequentes.Este diagnóstico pode ficar a cargo do cirurgião dentista visto que os primeiros sinais podem ser observados em boca. Podem ser identificados telangiectasias e hemorragias na mucosa bucal.Por segurança, o manejo odontológico deste paciente deve ser focado na sua condição de saúde geral. Assim, este artigo tem por objetivo a descrição de um caso clínico de tratamento odontológico de uma paciente com SROW, esclarecendo as principais características dessa síndrome e relatando as peculiaridades do seu manejo.

The Rendu-Osler-Weber Syndrome or Hereditary Hemorrhagic Telangiectasia (HHT) is a rare systemic fibrovascular dysplasia, which causes a defect in the elastic and muscle layer of the blood vessel wall, turning them more vulnerable to traumas and spontaneous ruptures. The dentists can play an important role in this diagnostic because the first signs often appear in the mouth, such as telangiectasia and recurrent bleeding in the oral mucosa. The management of this patient should be appropriate to its systemic profile to ensure the safety and effectiveness of dental treatment. This work aims to describe the main characteristics of this syndrome, its peculiarities and limitations of management during dental treatment, followed by the presentation of a clinical case.

Ethics of Gaming the System.

Dentists justifiably bridle at having to compromise what they believe, based on evidence, is in the patients' best interests based on reimbursement rules of benefits providers. Benefits providers justifiably bridle at having to pay for services not contracted by those who purchase insurance. A particular case involving performing multiple quadrants of root planing at a single appointment is used as an example of this tension. One alternative is for the profession and the industry to seek to negotiate a win-win joint position. Another is for a few to game the system, which only makes it more difficult to reach ethical common ground.

[Dentists' Knowledge of Ethical Questions Regarding Dental Medicine - A Survey of Dentists from Saxony, Saxony-Anhalt and Thuringia (Germany)]. / Zahnmedizinethische Kenntnisse in der Praxis ­ eine Befragung von Zahnärzten aus Sachsen, Sachsen-Anhalt und Thüringen.

Background: Subjects regarding ethical questions in dental medicine are only slightly touched in the study of dental medicine or in the working regulations of the dentists' association. However, dentists are confronted with these matters in everyday working life. The empirical study at hand collects current data regarding the ethical knowledge about dental medicine in the practical experience of dentists in Saxony, Saxony-Anhalt, and Thuringia. Methods: The tool used in the survey was a structured questionnaire. Out of 600 randomly chosen and contacted dentists from Saxony, Saxony-Anhalt, and Thuringia, 290 replied (response rate: 48.3%). The anonymised assessment took place between June and November 2013. Results: Dentists frequently encounter ethical questions regarding dental matters. The dentists interviewed in the study are in favour of a participative relationship between patient and dentist. Simultaneously, the patient's health is predominantly seen as the good of higher value than his or her self-determination. The dentists show competent knowledge of ethical dental subjects, although increased uncertainties could be observed in more complex situations, e. g. considering contact with patients who are HIV-positive. Conclusions: Questions dealing with dental ethical questions do play a major role in the daily professional life of dentists. In order to further support and strengthen dentists in their individual dental ethical competence, we see a need for advanced training and further education regarding questions and problems in the area of ethics in dental medicine. Also, these topics should become a component in the curriculum of the study of dental medicine.

How much dentists are ethically concerned about overtreatment; a vignette-based survey in Switzerland.

BACKGROUND: Overtreatment (or unnecessary treatment) is when medical or dental services are provided with a higher volume or cost than is appropriate. This study aimed to investigate how a group of dentists in Switzerland, a wealthy country known to have high standards of healthcare including dentistry, evaluated the meaning of unnecessary treatments from an ethical perspective and, assessed the expected frequency of different possible behaviors among their peers. METHODS: A vignette describing a situation that is susceptible for overtreatment of a patient was presented to a group of dentists. The vignette was followed by five options. A questionnaire including the vignette was posted to 2482 dentists in the German-speaking areas of Switzerland. The respondents were asked to rate each option according to their estimation about its prevalence and their judgment about the degree to which the behavior is ethically sound. RESULTS: 732 completed questionnaires were returned. According to the responses, the most ethical and the most unethical options are considered to be the most and the least prevalent behaviors among dentists practicing in Switzerland, respectively. CONCLUSIONS: Suggesting unnecessary treatments to patients seems to be an ethically unacceptable conduct in the eyes of a sample of dentists in Switzerland. Although the respondents believed their colleagues were very likely to behave in an ethical way in response to a situation that is susceptible to overtreatment, they still seemed to be concerned about the prevalence of unethical behaviors in this regard.

O novo código de ética odontológica e as alterações no cotidiano do cirurgião-dentista / The new dental ethical code and the changes at everyday dentistry

O Conselho Federal de Odontologia elaborou um novo Código de Ética Odontológica (CEO), vigendo desde janeiro/2013. O CEO é referencial normativo para cirurgiões-dentistas (CD) que atuam no País. O aumento da quantidade de processos éticos instaurados nos Conselhos Regionais de Odontologia justifica a necessidade da análise comparativa do antigo e do novo CEO, para melhor compreensão e aplicação pelos profissionais. Objetivo: Realizar análise comparativa entre o CEO em vigor até 2012, aprovado pela Resolução CFO nº 42/2003, e o seu substituto desde de 1º de janeiro de 2013, aprovado pela Resolução CFO nº 118/2012; fazendo ainda uma reflexão sobre os principais tópicos do novo CEO, relacionando-o com o cotidiano da clínica odontológica, visando propiciar o seu correto entendimento. Considerações Finais: As alterações do novo CEO demonstram adequação ao momento histórico atual e representam avanço na regulamentação e orientação dos profissionais quanto à conduta frente aos colegas, empregadores e pacientes. Insere os profissionais da odontologia nas equipes de saúde pública; divide a responsabilidade dos CDs com os técnicos; esclarece a necessidade de cumprir obrigações financeiras e manter dados cadastrais atualizados junto ao CRO; informa que o prontuário odontológico deve ser legível e atualizado, em cada avaliação; e que o CD deve arbitrar o valor da consulta; aborda doação, transplante, banco de órgãos, tecidos e biomateriais; traz alterações importantes quanto à propaganda, e finalmente esclarece que as penalidades aplicadas pelos CROs aos infratores do CEO podem ser agravadas ou atenuadas, conforme as circunstâncias...

Introduction: The Brazilian Federal Board of Dentistry (CFO, in Portuguese) has developed a new Code for Ethics in Dental Practice (CEO, in Portuguese), in force since January 2013. The CEO is a normative reference for dentist-surgeons (CD, in Portuguese) operating in Brazil. The increasing amount of ethical processes initiated in the Regional Council of Dentistry (CRO, in Portuguese) justifies the need of a comparative analysis between the old and the new CEO for a better understanding of it and its subsequent implementation by professionals. Objectives: Compare analytically the CEO in force until 2012, which was approved by the CFO Act 42/2012, and the one which replaced it on January 1st, 2013, which was approved by the CFO Act 118/2012; by reflecting further about the main topics of the new CEO and its relationship with the everyday practice of dental clinics, focusing to provide a correct understanding of it. Final Considerations: The changes made in the new CEO are in accordance with the current historical moment and represent advances in regulations and guidance for professionals towards the expected procedures to deal with colleagues, employers and patients. It includes professional dentists in the staffs of public health; it divides the responsibilities of the surgical procedures between CDs and technicians; it clarifies the need to meet financial obligations and keep registration data updated at CRO; it mentions that dental records must be legible and updated at each assessment; and that the CD must impose charged consultations as a common obligation for professionals; it also mentions donations, transplantations, bank of organs, tissues and biomaterials; it brings remarkable changes regarding propaganda, and in the end it clarifies that the penalties imposed by the CRO to CEO infractors can be strengthened or mitigated according to the circumstances of each case...

Aspectos éticos relacionados con las remuneraciones en odontología / Ethical aspects related to dentistry remunerations / Aspectos éticos relacionados com as remunerações em odontologia

Existen diferentes modalidades para recibir las remuneraciones en carreras liberales como odontología. En general, el pago se hace por acciones realizadas o por el tiempo dedicado a ejecutarlas. En algunos casos el monto del pago está directamente relacionado con el diagnóstico realizado al paciente. ¿Existe un conflicto de interés en alguna de las modalidades? Para responder esta pregunta se realizó una búsqueda bibliográfica sobre el tema, encontrándose escasa literatura al respecto. A partir de lo revisado podemos concluir que la existencia del conflicto de interés no es el problema, la resolución del mismo es el que aporta la dimensión ética al tema de las remuneraciones.

There are different modalities to receive remunerations in liberal careers such as dentistry. In general, payment is done for actions carried out by time dedicated to execute them. In some cases, the amount of payment is directly related to the diagnosis of the patient. There is a conflict of interest in some of these modalities? To answer this question a bibliographical search was carried out on the topic, finding scarce literature on it. From the revised material, we can conclude that the problem is not the existence of a conflict of interest, but what brings an ethical dimension to the topic of remunerations is its resolution.

Existem diferentes modalidades para receber as remunerações em carreiras liberais como odontologia. Em geral, o pagamento se faz por ações realizadas ou pelo tempo dedicado a executá-las. Em alguns casos o montante do pagamento está diretamente relacionado com o diagnóstico realizado ao paciente. Existe um conflito de interesse em alguma das modalidades? Para responder esta pergunta se realizou uma busca bibliográfica sobre o tema, encontrando-se escassa literatura a respeito. A partir do que foi revisado podemos concluir que a existência do conflito de interesse não é o problema, a resolução do mesmo é o que aporta a dimensão ética ao tema das remunerações.

Ethical and legal issues on HIV testing, policy and the practice of dentistry.

This paper is structured around the following: autonomy and consent, confidentiality, disclosure, knowledge of patient and provider HIV status, the right to choose whom to treat, testing for HIV and the importance of HIV policies in the workplace to guard against discrimination. The emergence of the HIV/AIDS pandemic has challenged traditional ethical values of the health care profession. These include the infectious nature of HIV, the social stigma of the disease and its ethical and legal dilemmas. This paper addresses some of the pertinent questions related to HIV infection and AIDS. The three broad principles of ethics, namely, autonomy, beneficence and justice, provide the basic framework on which this paper is based. Advances in the biotechnology of rapid oral fluid testing particularly in the detection of HIV antibodies from patients in the dental setting have raised additional ethical and legal considerations in the subsequent management of HIV infected patients to include disclosure of test results to the patient and proper referral to physicians or nurse practitioners. The oral health care worker must thus have a solid foundation in the application of bioethical principles. A clinical case scenario related to HIV testing in the dental setting is presented to illustrate how a lack of understanding and the wrongful application of ethical principles may lead to patient harm and legal liability. Given the increasing infection rate of HIV worldwide, polices must be upheld and revised as needed to protect healthcare providers, patients, and society generally against discrimination.

How dentistry should approach its problems: a vote for professionalism.

Dentistry, like all professions, has always had ethical problems to contend with, including societal trust, flagrant advertising, commercialism, and access to care. Although the profession's interest and expertise in ethics has grown enormously in the last three decades, the issues facing dentistry have not really decreased, and perhaps have grown more problematic. Thus, despite the invaluable contributions of ethical progress to the structure and function of our profession, this paper argues that reflective ethics by itself appears unable to exact change. For change to occur, dentistry also needs a broad-based display of enlightened, and ethically-driven but action-oriented professionalism. This existed in the 1830s when U.S. dentistry was in its early stages of becoming thought of as a profession. Using the lessons learned from that period of our history, we need to do the same thing now--not excluding ethics, but working hand in glove with ethics. This paper suggests that, as in the 1830s, dentistry now needs the grassroots attention of its membership. Using recent publications about the importance of "connectedness" in dentistry, guidelines are presented that provide a framework for approaching the problems faced by dentistry and contributing to a more satisfying professional career.