Conflict of interest in dental hygiene and cosmetic dentistry

Ever wondered what is the primary role of your dentists when you visit their office? To me, I used to think that visiting the dentist would either mean extraction or filling when I was a kid. It’s a luxury to visit the dentist for regular clean up or check up in Malaysia. I guess I was poor. Toothbrush and paste was my guarantee for good dental hygiene.

I had a bad malocclusion and required orthodontic treatment. I had mine done at subsidised rate but had to be placed in a waiting list. I had mine done by three orthodontists. The first one was a male orthodontist who was frequently missing in action (MIA) and appointments were delayed. The second one was a female orthodontist who was very impatient and rough (I was always surprised by her crude way of treating me). I had on several occasions ended up with bleeding lips because she was so rough on the wires that the ends would accidentally cut deep into my lips. She was also the one who left two scratch marks on my molar that later deteriorated into cavities (after several years) by using her dental pliers with brute force during removal and re-fixing of the dental brackets. Suddenly one day, she left to work in private clinic without a word. The third was also a female orthodontist, and after the latest experience, she seemed way too gentle. She was the one who removed my braces.

Although my teeth was aligned, it had lost its function. The molars were not aligned as neatly as before, my jaws were way too inside my mouth as compared to previously. It’s noticeable when I try to bite an apple or something larger. The “backward pulling” of the jaws during the treatment was meant to align the teeth and also to close the four gaps (where four molars were extracted; e.g. two upper molars and two lower molars). The pull retracted my jaws into my mouth, and thus I have smaller jaws than previously.

Now back to my main purpose for this article.

When I approached the orthodontic clinic, my thought was to get a treatment to correct my misaligned teeth/jaw (aka malocclusion). But what the orthodontists were thinking was that “this patient” is here to get a “good looking” teeth. Good look over function? If you think about it, sometimes, dentists also play a role in (or provide) cosmetic dentistry treatment, e.g. dental implants, crowning, bridging, and among others. In my opinion, the latter treatments are mostly costly and surely will be more profit generating than that of patients coming in just to get their teeth cleaned. How then will this arrangement not provoke a sense of suspicion, especially considering that there is a direct conflict of interest? On one hand, dentists play a primary role in treating patients in order to preserve healthy teeth, while on the other hand, dentists gain profits from selling dental cosmetics. Put it simply, to have more patients with rotten teeth will be profitable as compared to have patients who have healthy teeth.

In my opinion, there shouldn’t be “amalgamation” of dental hygienist role with cosmetic dentistry. Dental hygienists should strive to preserve healthy teeth (full stop). They should profit by the sheer amount of patrons (what am I saying?). But I guess if that’s the case, there won’t be many dental hygienists, especially considering that the amount of time they spent on a patient would yield much lower in returns than cosmetic dentists earn from the same amount of time.

All in all, to me, visiting a dental clinic that also cater for cosmetic dentistry treatment sometimes make me uneasy, especially considering the conflict of interest involved. But I guess, any profession will have that one way or another. It all depends on professional ethics, and finding one dentist who are trustworthy is the best way to get a win-win situation. So, start making friends with dentists because you might need to visit them soon.

Just a thought.


One thought on “Conflict of interest in dental hygiene and cosmetic dentistry

  1. In North America, the conflict of interests are even more apparent. Although we haven’t explicitly focused on dentistry in our blog, we do have experienced and extensively researched on some of the topics. For example, while the cosmetic dentistry is a hoax, it’s only there because demands are present as well. As for the fillings, drillings, implants and root canals, none of them actually addresses the root causes of either cavity, periodontitis or other kinds of imbalance in the oral microbiome.

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