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

Area of Science:

• Dental Practice Management
• Professional Ethics
• Healthcare Provider Psychology

Background:

• The concept of 'defensive dentistry' is recognized, but the lived experiences and perceptions of general dental practitioners (GDPs) regarding its practice remain underexplored.
• Understanding how GDPs perceive and implement defensive practices is crucial for addressing potential impacts on patient care and professional well-being.

Purpose of the Study:

• To investigate the understanding and lived experiences of GDPs concerning defensive dentistry in primary care settings.
• To identify the motivations behind and consequences of practicing defensively among GDPs.

Main Methods:

• An interpretive mixed-methods approach was employed, combining online questionnaires with semi-structured interviews.
• Data were collected from 25 participants completing the questionnaire and 6 participants in follow-up interviews.

Main Results:

• Three primary themes emerged: pervasive fear among practitioners, the adoption of avoidance strategies for specific patients or procedures, and the detrimental overall impact on the dental profession.
• GDPs identified defensive practices as self-protective actions, distinct from patient-centered care, driven by fears of litigation and regulatory scrutiny.

Conclusions:

• Defensive dentistry is perceived by GDPs as detrimental, stemming from increased litigation fears and declining public trust, leading to negative outcomes like stress, low morale, and deskilling.
• The findings highlight the need for strategies to mitigate the negative effects of defensive practices on both practitioners and patient care in primary dental settings.