From the Editor

Gerard Kugel, DMD, MS, PhD

Dear Readers,

There are exactly three words that can strike fear in the hearts of many a dental practitioner: standard of care. The phrase evokes unpleasant images of insurance reimbursement and malpractice lawsuits. In an ever-evolving profession, figuring out what “standard” even means can cause plenty of headaches. It begs many questions while offering few truly concrete answers. Does a standard of care neatly define how dentists should practice their profession? Does it offer dentists a safeguard on which to base their clinical rationale for treatment decisions? Is a standard of care just a legal barometer, or is it an ethical one, too?

This month, Inside Dentistry sets out to answer these questions by exploring the standard of care in dentistry. While the term itself implies the legalities of practicing an art and a science such as dentistry, with the help of our distinguished panel of experts we also delve into the ethical issues of practicing that art and science.

Know Yourself. If I had but only one piece of advice to give, this would be it. To practice dentistry well, you first have to know what you can do, and then you absolutely must know what you cannot do. Our highest priority to our patients is to safeguard their quality of life. In many cases we can improve it, but in some cases we can only maintain it. Either way, we have a moral obligation not to worsen it. You need to know when to refer a case out to a specialist in your area; you need to know which cases you shouldn’t even think about trying to do yourself. Only when you know your own abilities and limitations can you be sure that you’re not putting yourself in a position where you could possibly hurt your patient and, in turn, violate a standard of care.

Do Your Research. It goes without saying that treatment plans must be based on sound clinical judgment. While much of that judgment is comprised of your own skill set and comfort level in a specific procedure, knowing what the evidence is in the current literature is part and parcel of making good clinical decisions and, by the same token, meeting a standard of care. Be informed about the techniques you’re using and the materials you’re incorporating. Read the literature in peer-reviewed journals. Deal only with reputable dental materials companies. Don’t take anything at face value; to be a good practitioner, you have to dig deeper.

When in Doubt, Ask. Collaborate with your fellow colleagues—discover not only what they’re doing and how they’re doing it, but also why they’re doing it. Join a study club that reviews and discusses the latest innovations in techniques and materials. Seek out reliable and reputable continuing education opportunities, and strive for a combination of high-quality home study and live, hands-on educational programs. Also foster relationships with the specialists in your geographic area; not only will you benefit from a possible referral arrangement, you may find an excellent teacher or mentor right in your own community. But, be discerning about deciding whether what you learn and discover is right for you, your patients, and your practice. Ultimately, it is up to you alone to ensure that you’re meeting a professional standard of care, both legally and ethically.

We hope you enjoy this issue and find that it helps you to put your clinical decisions into the proper perspective by better understanding what the standard of care means for the dental profession. We extend our sincere gratitude to our experts who very thoughtfully offered the discussion points we’ve presented here.

Please send us your feedback to letters@insidedentistry.net. As I emphasize each month, your thoughts, opinions, and reactions motivate us to continually improve our clinical content and coverage of the topics impacting our profession. Thank you for reading and for your continued support.

With warm regards,

Gerard Kugel, DMD, MS, PhD
Associate Dean for Research
Tufts University School of Dental Medicine
gkugel@aegiscomm.com