Effectiveness of Codes

Does the public consumer of dentistry recognize the presence of codes of ethics? In 2015, the ADA Council on Ethics, Bylaws and Judicial Affairs (CEBJA) commissioned a consumer survey regarding the ADA Principles of Ethics and Code of Professional Conduct. The results of the survey supports the belief that the ADA Code is noticed, acknowledged, and elevates the reputation of the dentist in the community. According to the survey of 1000 people, nearly 75% of patients reported they are more likely to choose an ADA member dentist knowing that those dentists follow an ethical code.¹² This is very reassuring to the organization and its investment in maintaining and promulgating the Code of Ethics among its members. Two in five consumers asked believed that ADA dentists hold themselves to a higher standard than other dentists. Interestingly, patients in the 35-64 age range were more likely to be influenced by the Code when choosing a dentist, while those 18-24 age range were considerably less influenced by the Code. This finding is not surprising as younger individuals seek information and referrals from various types of electronic social media.

Dentistry enjoys a strong public reputation and societal trust. Opinion polls usually rank dentists and medical doctors with a very high honesty and ethics rating. The ethical violations that occur are often related to the financial demands of dental practice, and the business side complexities, especially managing employees. Recent research on ethical issues facing practicing dentists placed dental overtreatment at the top of the list, followed by the pressures of third-party insurance payers who influence patient choices and subsequent reimbursement. Another topic of concern was colleagues failing to refer when a clinical case or situation is above the dentist’s skill level. Advertising that is misleading is also as troubling as the presence of colleagues impaired with alcohol or drugs.¹³ These ethical problems are likely rooted in some aspect of financial practice demand or lack of discernment as to the pull of self-interest.

The goal of the greater profession is to cultivate a culture of ethical excellence. To that end, ethics education is required in dental and dental hygiene schools. The dental and dental hygiene student learns about the ethical and professional responsibilities in numerous formal and informal ways. Ethics and professionalism content is required by the Commission on Dental Accreditation in the predoctoral dental and dental hygiene educational curricula. Currently, the Commission on Dental Accreditation addresses ethics training in Standard 2-21 for the dental standards and 2-19 for the dental hygiene standards. The standard for predoctoral dental students states that “graduates must be competent in the application of the principles of ethical decision making and professional responsibility.” The standard for dental hygiene students indicates that “dental hygienists should understand and practice ethical behavior consistent with the professional code of ethics throughout their educational experience.” Part of that education process is learning and applying the code of ethics. The two main goals of dental education programs in regards to ethics are that students gain the awareness to discern ethical issues and the commitment to act appropriately on a decision when necessary.