Dentists' perception of under-privileged patients: the path to understanding

Objectives: In Montreal, Canada, welfare recipients often report difficult experiences at the dental office and sometimes feel stigmatized by dentists. Their perspective informed our development of a twofold objective: a) to examine how dentists perceive welfare recipients and poverty in general; and b) to develop strategies to help dentists better understand their under-privileged patients. Methods: We first conducted 30 one-on-one semi-structured interviews with dentists in Montreal. Each interview was audio recorded and then transcribed. The analyses were based on the transcriptions and included the following phases: data reduction; presentation of results; interpretation. In the second phase of the project, we developed a collaborative process in which Canadian and European researchers, oral health care professionals, people living in poverty and anti-poverty organizations were involved as partners. They participated in a series of workshops in order to better understand each other and to develop concrete actions toward this end. Results: Most dentists interviewed do not perceive welfare recipients as “good patients” for reasons that relate to profitability, professional autonomy, and service organization. In particular, they deplore welfare recipients' apparent lack of motivation for their health and cannot comprehend their behaviors. Taking these results into account, the partners of the project's second strand determined that dentists needed to gain an appreciation of welfare recipients' perspectives and experiences. They thus decided to develop a pedagogical tool that includes short videos in which welfare recipients describe different aspects of their life, including oral health. After being evaluated, this tool will be provided to dental schools and oral health care professionals. Conclusion: In the field of access to dental services, “knowledge translation” is an important part of research as it allows the identification of concrete solutions.

This study received financial support from CIHR, FRSQ, and GREAS1.