Defensive dentistry: perceptions and experiences among general dental practitioners in primary care

Abstract

Introduction Although the term ‘defensive dentistry' is documented, with a range of opinions around practising dentists, little is understood about the perception and the lived experiences of general dental practitioners (GDPs) about practising in a defensive way. Aim To explore how defensive dentistry is understood and experienced by GDPs working in primary care. Methodology An interpretive mixed-methods approach was adopted using an online questionnaire followed by semi-structured interviews. In total, 25 participants completed the questionnaire and six follow-up interviews were completed. Results Three main themes were identified: the sense of fear; practising the ‘act of avoidance' with certain patients and/or procedures; and the overall impact on the profession. Conclusion GDPs unanimously identified the negative aspects of defensive practice as actions carried out for self-protection rather than the interests of patients. The reasoning for such practices included fear of litigation and/or investigation by the General Dental Council, heightening in recent years due to increased public awareness of litigation, and loss of public trust. Participants reported stress, low morale and deskilling as outcomes for practising defensively.