IADR Abstract Archives
Overtreatment in Dentistry: An Ethical and Empirical Analysis
Objectives: Overtreatment is being defined as providing unnecessary or excessive services. There are a growing number of studies indicating that overtreatment has become a demonstrable issue not only in medicine but also in dentistry.
Objectives: (1) The incidence and key areas of overtreatment in dentistry, (2) the underlying causes of excessive services, and (3) the ethical implications of overtreatment on both patients and the dental profession.
Methods: (1) A systematic international review and a comparative questionnaire-based survey of dentists on the amount and core areas of dental overtreatment in Germany (n=101), (2) a literature study on the verifiable factors of overtreatment in dentistry, and (3) a normative analysis on the complex ethical impact of excessive or unnecessary treatment.
Results: The analyses demonstrate that overtreatment in dentistry is a serious issue, especially in orthodontics and implantology, but also in other fields. The causes are multifaceted; they include systematic factors (e.g. fee-for-service systems), aspects of inaedequate professional competences, competitive practice conditions, diagnostic overload, a lack of treatment selection criteria, and low awareness of professional ethics. The normative analysis on the ethical impact of overtreatment demonstrates that there are negative effects both on the doctor-patient-relationship (e.g. loss of patient confidence, fragility of treatment adherence) and the dental profession (e.g. erosion of professional values, negative self-image, loss of public status).
Conclusions: The findings suggest that dentistry is susceptible to overtreatment. Excessive treatment is a severe cause for professional concern, threatening the doctor-patient-relationship and the social prestige of the dental profession. Thus more efforts should be made (1) to overcome health system-oriented factors for overtreatment, (2) to establish evidence based treatment selection criteria and to (3) raise the self-awareness of dentists on questionable treatment procedures. Additionally, ethical sensitivity towards the issues should be increased through suitable teaching in ethics and providing adequate support.
Objectives: (1) The incidence and key areas of overtreatment in dentistry, (2) the underlying causes of excessive services, and (3) the ethical implications of overtreatment on both patients and the dental profession.
Methods: (1) A systematic international review and a comparative questionnaire-based survey of dentists on the amount and core areas of dental overtreatment in Germany (n=101), (2) a literature study on the verifiable factors of overtreatment in dentistry, and (3) a normative analysis on the complex ethical impact of excessive or unnecessary treatment.
Results: The analyses demonstrate that overtreatment in dentistry is a serious issue, especially in orthodontics and implantology, but also in other fields. The causes are multifaceted; they include systematic factors (e.g. fee-for-service systems), aspects of inaedequate professional competences, competitive practice conditions, diagnostic overload, a lack of treatment selection criteria, and low awareness of professional ethics. The normative analysis on the ethical impact of overtreatment demonstrates that there are negative effects both on the doctor-patient-relationship (e.g. loss of patient confidence, fragility of treatment adherence) and the dental profession (e.g. erosion of professional values, negative self-image, loss of public status).
Conclusions: The findings suggest that dentistry is susceptible to overtreatment. Excessive treatment is a severe cause for professional concern, threatening the doctor-patient-relationship and the social prestige of the dental profession. Thus more efforts should be made (1) to overcome health system-oriented factors for overtreatment, (2) to establish evidence based treatment selection criteria and to (3) raise the self-awareness of dentists on questionable treatment procedures. Additionally, ethical sensitivity towards the issues should be increased through suitable teaching in ethics and providing adequate support.