Australian Dental Perspectives

Welcome to Australian Dental Perspectives, articles looking at issues facing community dentistry. The material for this article was drawn from the Preventive Dentistry Forum (PDF), a meeting of Australia's leading experts in oral health.

Discussion at recent PDF meetings has highlighted the pressures on dentists to be health professionals, business people and increasingly educators as preventive and minimally invasive approaches to oral health are embraced. In order to explore these issues in more detail, attendees at the PDF meeting in May 2004 were divided into three groups to debate the merits of the statement 'The modern dentist is a healer, an educator and an entrepreneur'.

The first of these groups was challenged to discuss and agree whether the definition of the modern dentist was correct.

In dissecting the statement, the group made a number of modifications. Firstly, they replaced the word 'is' with the phrase 'should be', identifying that the modern dentist ought to do all of these things, but may not actually deliver them all in practice.

They also replaced the word 'healer' with the terms 'physician' and 'surgeon', feeling they more accurately reflected the scope of work performed and the skills involved.

While agreeing that being an 'educator' was an important function, the group agreed that auxiliary members of the team will increasingly fill this role.

The term 'entrepreneur' proved to be the most contentious term included in the definition. Most members of the PDF had some level of discomfort with the term, feeling it did not necessarily reflect the best interests of the patient. However, after extensive discussion, the group agreed it was an important inclusion. Indeed, without a certain level of business and entrepreneurial skill, the dentist's ability to maintain services would be compromised.

In closing, the group concluded that the most appropriate definition would be: 'The modern dentist should be a physician, a surgeon, an educator and an entrepreneur.'

Having agreed a revised definition, the second group of PDF members was asked to consider the issues associated with the diverse roles the modern dentist must play.

The most significant issue raised by the group was that fact that not all the skills required to shape the modern dentist necessarily reside in dental schools. In particular, the entrepreneurial aspects of the role were identified as an area that dental schools may need to focus on more comprehensively and potentially outsource in the future.

The importance of delegation skills was another key issue in light of the number and variety of tasks dentist must perform. PDF members commented that practitioners can often have difficulty managing all of these different demands. Involving auxiliaries was identified as an important part of the solution.

The PDF members also commented that forums where oral health professionals can share learnings and gain advice from others on how to balance all of these demands may prove helpful.

The third group in the debate was challenged to discuss and agree which of these 'traits' is the most important and develop an ideal model for the modern dentist by allocating appropriate percentages to each characteristic.

In developing this model, the group felt it was critical to place the patient at the core.

With this in mind, the group agreed that the 'healing' aspects of the role, the functions encompassed by the terms 'physician' and 'surgeon', were the most important and prevalent traits. They estimated that together these functions should represent approximately 70 per cent of the whole.

However, the group also identified that intervention is not always required and that in many instances facilitation and motivation are all that is needed.

While education was viewed as a vitally important function for patient motivation, support and instruction, the group made the important distinction that they were developing an 'ideal' model and as such only allocated 10 per cent of the whole to the 'educator' function. They commented that the modern dentist needs to be involved in education but that this responsibility could be delegated to the auxiliary team.

The group reflected the PDF members' concerns about the use of the term 'entrepreneur' by allocating only 10 per cent of the whole to these 'entrepreneurial' functions. They understood the importance of these functions, but agreed that in an ideal model they were merely support mechanisms that enabled the dentist and their team to continue to provide high quality care.

With the remaining 10 per cent, the group decided to add an additional 'trait' to the model, that of 'health partner'. In order to perform all of the functions detailed above, the group concluded that the modern dentist must be a knowledgeable and trusted partner. In addition to being actively involved in the industry, the dental professional must be an active consumer of information resources and must stay abreast of clinical and technological advancements through continuing professional education and training.

Despite the obvious pressures associated with the role, the PDF concluded that the model of the 'ideal' modern dentist was a sustainable one, so long as the dentist receives adequate support from industry, institutions, specialists and auxiliaries.