Private practice dentists' views of oral health injustice

Abstract

Objectives: There is a lack of research examining how dentists in private practice conceptualise the challenge presented by oral health injustice and how attitudes towards low-income patients might be influenced by the commercial nature of private dental care. This study provides insights into how dentists navigated the interactions between the commercial nature of dental practice and the provision of care to patients who either struggled to (or could not) afford the cost of self-funded care in private practice.

Methods: Participants took part in semi-structured interviews and were invited to keep an online diary of reflections. Thematic analysis was used to examine the data to extract and synthesise understanding of how practitioners conceptualised issues surrounding providing care for the disadvantaged and how this related to the economic realities of private practice.

Results: Twenty participants were recruited and interviewed from a variety of private practice environments and roles. This report focuses on one specific theme within the data that explored how participants viewed patients who received public dental care, as well as those privately funded patients who could ill-afford their treatment.

Conclusions: The findings raise how neoliberal attitudes towards oral healthcare and dental disease may act as a social determinant of health and contribute to the sustaining of structural barriers and inaction towards oral health injustice. For low-income patients, practitioners distinguish between (a) those who are deemed to be deserving of professional care and the charitable endeavours of the profession, and (b) those who are not. There appears to be no overt professional obligation to actively work towards the amelioration of oral health injustice.

Keywords: Access to care; Commercialism; Dentistry; Injustice; Professionalism; Qualitative research.