ethical scenarios

Question 1

Do you think that all dental treatment should be free on the NHS?

Answer 1

• In england, a few individuals are entitled to free NHS dental care
  
  • Pregnant women
  • Under 18s
  • Those receiving low income benefits
• Others pay for their treatment with regards to the different charge bands

Yes free
* Studies show that many patients avoid NHS dental treatment due to the cost. Many say that they choose their treatment based more on the price rather than their dentists clinical recommendations
* So Free treatment would hopefully encourage patients to attend the dentist more regularly, for routine checkups which are
* Crucial to spot dental health problems earlier on, for example dental caries, which are much more simple to treat if spotted at an earlier stage
* This could ultimately save money as less complicated procedures would be needed- more preventative care
* Justice- no discrimination against diff classes, everyone has access
* Less dental anxiety- ppl more used to going dentist
* Cosmetic dentistry
* Increase mental health
* Less insecure
* Social media unrealistic expectations

No free
* Cost of dental materials and instruments and equipment is extremely high, increased recently due to Brexit and anti immigration policies
* Importing medical equipment is harder
* Amalgam is more expensive
* so making NHS treatment free would lead to increased tax charges
* People may be opposed to paying increased tax
* Eg ppl w good oral health who dont visit dentist regularly
* Also initially when NHS was created dentistry was free
* Cost was so much
* Almost destroyed NHS as they couldn’t cover it
* Concerns that this could happen again and NHS could struggle to survive
* Burden on dentists
* Severely understaffed
* More stress
* Standards of care would go down
* Not all dental care is mandatory
* Dk where to draw the line
* Would cosmetics be free?

• In conclusion, I do not think all dental treatment should be free on the NHS
  
  • Although cost does contribute to why ppl avoid seeking dental care, this is not the only reason
  • Risks of making it free are too high
• Problem would be better addressed thru a public health campaign
  
  • Cheaper
  • Bigger impact imo

Question 2

Turkey teeth- should dentists fix complications that arose cos of them for free

Answer 2

Why do people get turkey teeth
* Despite professional dental bodies raising concerns about the risks of cheap overseas treatment over the past few years
* 86% of dentists say they have treated cases that developed complications due to travelling abroad for dental treatment
* Comparatively cheaper abroad
* Acc cos the quality of treatment is bad
* Chasing hollywood smiles
* Unrealistic standards set from media
* Social media marketing

Yes
* Beneficience- have to do what’s in the patients best interest
* Not fixing it would leave them in pain
* Justice- Everyone deserves healthcare
* Regardless of why they need it

No
* NHS dentistry is already underfunded
* dentists fear that if they attempt to fix work carried out abroad, they might be held legally liable for it
* Fixing can be hard, dk what procedures or materials were used

• In conclusion no
• Patients have already been advised about the risks but chose to take them anyway
• Instead, advise patients considering work abroad to consult a UK dentist first
  
  • Conduct thorough research]
  • Consider aftercare

Question 3

should all dentists have good teeth

Answer 3

• Good means diff things
  
  • Good oral hygeine, lack of oral diseases, so a good standards of oral health
  • Or aesthetically good- straight and white (created by social media standards)
• But having not straight or yellow due to staining is normal

Yes
* Role model and inspiration for patients, motivate them
* If a dentist is preaching good oral hygiene regimes, they should be following them
* If patients see dentists with aesthetically bad teeth they might be reluctant to take their advice, think it doesn’t work

No
* Goodness of teeth in any sense doesn’t have implications on ability to practice, doesn’t effect:
* Manual dexterity skills to carry out procedures
* Communication
* Learning capability

Question 4

A 7 year old child has entered ur practice w multiple dental caries. They need 5 fillings but the mother refuses

Answer 4

• Find out y mum is resistant
  
  • Maybe bad experience in the past w another dentist
  • Or thinks fillings r unnecessary
• Understand her concerns, dont belittle
• Explain y u think fillings r the best clinical decision and try convince
• R lots on misconceptions ab dental treatment and mistrust around dentist patient relationship
• After explaining y fillings r best option, outline other treatment options pros and cons
  
  • No treatment- explain long term effect
  • Extraction
• Respect patients autonomy
  
  • Mum consents for kid
  • Kid too young to give informed consent
  • Unlikely they’d be gillick competent as they r so young, but check if they are. sitch can be escalated if they r
    beneficence

Question 5

patient wants braces but doesn’t clinically need them. teeth make them depressed. should they get braces on the NHS?

Answer 5

• Even though doesn’t meet NHS criteria based on clinical need
• Distress and self consciousness is an important psychological concern- beneficence, put patients interests 1st
• NHS does consider severe psychological distress as a factor
  
  • Typically requires supporting evidence from GP/ psychcologist
• Refer to orthodontist
  
  • Second discussion
  • Discuss alternative options: private, cosmetic
• Address concerns empathetically
• Explore poss solutions
• Mental health support
• Ensures holistic approach to her well being

Question 6

patient w dental anxiety refuses to have a check up without sedation

Answer 6

Dent anxiety is common
Managing patient w dental anxiety requires a compassionate and patient- centred approach

• Create calm and reassuring environment
• Engaging in open communication- communicate effectively w patients (adapting)
  
  • Understand root of fear
• Gradual exposure techniques can help ease anxiety:
  
  • Explain each step of check up
  • Allow them to take breaks
• Non pharmacological methods like relaxation/ distraction techniques cld be introduced:
  
  • Music
  • Guided breathing
• Sedation may be an option in severe cases (minimal sedation options
  
  • Nitrous oxide aka laughing gas
    
    • Relaxation while keeping patient conscious and responsive
• But 1st explore behavioural strategies and minimal intervention approaches
• Built their confidence and trust in receiving routine dental care
• Beneficence

Essential to balance patients comfort w appropriate clinical practice
Deeper sedation levels typically necessary for routine procedures

Question 7

what would u do if u saw someone cheating on a test

Answer 7

• Confront first
  
  • Get their side, dont jump to conclusions
  • Escalating may be harmful to their mental health in long term
• Be empathetic
  
  • Dk what they’re going thru
  • What can u do to help
  • Encourage them to confront problem themselves and be honest
    
    • W personal tutor, person that created the exam
• Doing test is important
  
  • Patient safety
  • Put patients interests 1st