Ethical issues encountered by dentists in the care of institutionalized elders

Abstract

Increasing numbers of institutionalized elders have very poor oral health. It has been suggested that ethical problems may influence dentists who attempt to provide oral care for these people, but little attention has been given to research in this area. A qualitative interview method was used to investigate the the views and experiences of dentists working with institutionalized elders. Particular attention was given to the ethical difficulties encountered and how the dentists resolved them. Ten dentists experienced in long-term care were interviewed individually by means of open-ended questions. Thematic analysis identified ethical problems focused on the difficulty of identifying the wishes of patients or predicting the outcome of treatment. The participants reported few difficulties in making clinical decisions in this setting. However, analysis revealed that the ethical perspectives of the dentists varied substantially. Variation was notable particularly in their preference for ideal or practical treatment and in their preference for autonomy of beneficence.

Oral health and oral implant status in edentulous patients with implant‐supported dental prostheses who are receiving long‐term nursing care

“…One regrettable aspect is the negative opinion of dentists towards a well-organised community approach 16 even if, in Sweden, there are increased resources to meet the oral needs of the elderly 4,5 . As Bryant et al 17 have expressed:…”

Muted dental voices on interprofessional healthcare teams

“…45,50,51,62 This was clearly evident in an investigation of how dentists wrestle with the ethical challenges of unclear treatment outcomes that made it difficult to apply the principles of beneficence and nonmaleficence when caring for elders in LTC facilities. 47 Foucault 63 argued that physicians overpower other social groups because of their privileged positions within hospitals. This imbalance of power is evident most noticeably between physicians and nurses, at least from the perspective of nurses.…”

“…12,15,25,46 Dentists blame high costs and poor cooperation from residents, staff and administrators for their reluctance to provide help, compounded by the complexity of treating unstable patients in the unfamiliar setting of a LTC facility. 17,47 Dental hygienists in 2001 work mostly in private dental practice, except for Finland, Norway and Sweden where they work mostly in public and community health clinics, which includes LTC facilities. 48 In Canada, Denmark, Italy, Korea, South Africa, Spain and Australia they have a strong presence in community health clinics, although private practice still dominates.…”

Confronting dental uncertainty in old age

“…Bryant et al . looked more specifically for uncertainty among dentists attending to the needs of residents in long‐term care facilities.…”