Difficulties experienced by dentists and orthodontists regarding ethical issues when announcing the diagnosis of a rare oral disease: a qualitative study in Marseille, France

PURPOSE

It is traditionally considered that breaking bad news to patients does not represent a cause for concern for dental professionals. However, there are situations where they will be confronted with this task, as in the case of rare dental diseases. Little information is available regarding the feelings of healthcare professionals on this subject. There are no qualitative studies that explore how a diagnosis of oligodontia is announced to patients by dentists and orthodontists. The aim of our study is to explore the difficulties and ethical issues experienced by dental health professionals when they have to announce a diagnosis of oligodontia to a patient and their family.

METHODS

This study relied on a qualitative research method using focus groups of dentists and orthodontists and a thematic analysis procedure.

RESULTS

The difficulties experienced could be summarised within five topics: organisational difficulties, difficulties with the management of dental treatment and with the administrative management associated with this anomaly, difficulties with the content of the announcement, and relational difficulties. These could be grouped in two categories: practical difficulties and ethical difficulties.

CONCLUSION

This survey allowed us to understand the difficulties encountered by dentists and orthodontists when announcing oligodontia. The participants felt uncomfortable with this task and were under stress. They reported difficulties in delivering the medical information and in adapting to the message. It is essential that dental professionals develop skills in medical communication.

Gifts from orthodontists to general dentists

OBJECTIVES

To determine how often general dentists receive gifts from orthodontists, the value and number of the gifts they receive, and how they perceive the motivation behind the gift.

MATERIALS AND METHODS

This was a questionnaire-based study. A questionnaire was constructed and tested for validity and reliability. An electronic version of survey was sent via email to 1300 general dentists.

RESULTS

The validity and reliability of the survey was confirmed. Two hundred fifty-four valid responses were received (20%). Eighty-five percent of responding general practitioners reported that they received gifts from an orthodontist. Almost 100% reported that they referred patients to orthodontists. About one-third of the responding general practitioners reported that their office provided orthodontic care. There were statistically significant correlations between the number of annual patient referrals the general practitioners reported making and the number and value of the gifts they received from the orthodontists. Female general practitioners reported receiving a higher number of gifts of greater total value than male practitioners. General practitioners who reported providing orthodontic treatment did not differ from those who did not in the number of referrals they made annually and the number and value of the gifts they received. Quality of care was the most common reason general practitioners reported for their referral to an orthodontist. Forty-four percent of the responders reported that they received discounted orthodontic treatment.

CONCLUSIONS

General practitioners refer patients to orthodontists and receive gifts from them. The number and value of the gifts reflects the number of referrals they make.