Dentistry's social contract and the loss of professionalism

Abstract

The social contract between society and the dental profession is essential to the ability to provide high quality dental care to patients. The social contract defines the profession and its place in society, giving the profession its legitimacy. Society bestows benefits upon the dental profession in exchange for our ability to alleviate pain and suffering caused by oral disease. This article seeks to explore the nature of this social contract in the provision of oral health care and what may become of the profession should the expectations of either party not be met. Changing beliefs within society and within the profession have led to new concepts of professionalism that focus upon alternative values to what is termed ‘nostalgic professionalism’. It is concerning when these new values begin to focus upon financial reward built upon commercial practices, with patients slipping away to be replaced with clients; the dentist–patient relationship lacking in any degree of altruism. This article will argue that breaches in the social contract are not to the benefit of patients or the profession and that whilst specifics of the contract will inevitably change, the nature of this should not.