The Board of Regents of the American College of Dentists
Excerpted from the Journal of the American College of Dentists 70(3):6-8, 2003
The American College of Dentists encourages ethical dental practice and actively opposes quackery, charlatanism, fraud, incompetence, and any other corruption of oral health care that places patients at unnecessary risk and threatens the integrity of the profession. The College also supports the advancement of the profession, especially continuous growth of the capacity of individual practitioners to provide effective, predictable outcomes deemed desirable by patients and the public.
While the vast majority of dental care is of high quality, a few individuals have abused the rights and privileges of the profession by misrepresenting the services they provide. Gross mistreatment of patients includes fraudulent billing, practicing without a license, and subjecting patients to dangerous and unproven treatments. Abridging trust can also take the form of gaps in competence and shading informed consent to favor procedures preferred by the practitioner. The College challenges the profession to study and understand the nature and damage of these unethical practices and to take appropriate action to eliminate them.
Ethical dental practice meets all of the following standards. Where one or two of the standards are imperfectly met, the practice is ethically questionable. Quackery and fraud are marked by clear and regular failure to meet any of these standards.
The accompanying table shows the characteristics, consequences, and some examples of ethical and questionable practice, and of quackery and fraud. Among the types of quackery and fraud, it is possible to identify distinct patterns of practice that damage patients and the profession, including:
Quackery and fraud can be the result of several motives, most commonly a desire (whether recognized or not) for status or income on the part of the dentist. Even when quacks and frauds believe they are acting in the best interests of their patients, they make the mistake of setting themselves up as the sole judge of their actions.
Although quacks and frauds are directly compromising patients, certain actions are required of ethical dentists. These responses are the result of dentistry’s obligation to protect patients and to preserve the reputation of the profession. Because quacks and frauds damage both individual patient’s and the public’s trust in dentistry, specific actions are necessary on the part of individual dentists toward their patients and toward their colleagues, of the profession generally, and of the research community.
|Categorizing Ethical Practice, Questionable Practice, and Quackery and Fraud
|Quackery and Fraud
|Improving the patient’s overall oral health and well-being through means understood and approved by the patient, other dentists, and society
|Placing the patient at risk for decreased overall oral health and well-being for the dentist’s benefit
|Damaging the patient’s overall oral health and well-being, undermining the public’s trust in dentistry as a profession, or breaking applicable laws
Quality, patient-centered treatment within standard of care
Innovative aspects of practice that meet the five standards of ethical practice
Experimental practice (research) that meets Institutional Review Board standards
Performing procedures that the patient, other dentists, or society would not choose if well informed
Performing procedures at marginal levels of quality or failing to provide necessary treatment
Failure to take reasonable steps remain current in knowledge and skill and awareness of prevailing standards of care
Withholding or distorting relevant information about treatment options, probable outcomes, or history of previous outcomes from patients, colleagues, or society for personal gain
Knowingly performing procedures that do not meet the standard of care
|Almost all established dental practices, those that remain on the leading edge through professional procedures development, approved research programs
|Overtreatment, undertreatment, poor quality care, lack of comprehensive care, failure to diagnose, misrepresentation of patient benefits, failure to refer when case exceeds skill
|Practicing without a license, practicing medicine or other health profession on a dental license, billing for procedures not performed, gross continuous substandard care, misrepresentation of one’s qualifications, distorting the scientific basis of dentistry