Medicine, Health Care and Philosophy

, Volume 21, Issue 4, pp 583–589 | Cite as

Consumer-driven and commercialised practice in dentistry: an ethical and professional problem?

  • A. C. L. HoldenEmail author
Scientific Contribution


The rise and persistence of a commercial model of healthcare and the potential shift towards the commodification of dental services, provided to consumers, should provoke thought about the nature and purpose of dentistry and whether this paradigm is cause for concern. Within this article, whether dentistry is a commodity and the legitimacy of dentistry as a business is explored and assessed. Dentistry is perceived to be a commodity, dependent upon the context of how services are to be provided and the interpretation of the patient–professional relationship. Commercially-focused practices threaten the fiduciary nature of the interaction between consumer and provider. The solution to managing commercial elements within dentistry is not through rejection of the new paradigm of the consumer of dental services, but in the rejection of competitive practices, coercive advertising and the erosion of professional values and duty. Consumerism may bring empowerment to those accessing dental services. However, if the patient–practitioner relationship is reduced to a mere transaction in the name of enhanced consumer participation, this empowerment is but a myth.


Dentistry Consumerism Commercialism Ethics Professionalism 


  1. American Board of Internal Medicine Foundation. 2005. The physician charter. Accessed 7 Feb 2018.
  2. Berkowitz, Eric N. 2017. Essentials of health care marketing. 4th ed. Burlington MA: Jones & Bartlett Learning.Google Scholar
  3. Christensen, Gordon. 2004. I have had enough! Journal of Esthetic and Restorative Dentistry 16 (2): 83–86.CrossRefGoogle Scholar
  4. Conrad, Peter. 2007. The medicalization of society: On the transformation of human conditions into treatable disorders. Baltimore: John Hopkins University Press.Google Scholar
  5. Derbyshire, David. 2007. Colgate gets the brush off for ‘misleading’ ads. The Telegraph. Accessed 8 Feb 2018.
  6. Foucault, Michel. 1990a. The care of the self: The history of sexuality. London: Penguin Books.Google Scholar
  7. Foucault, Michel. 1990b. The History of Sexuality, Volume 2: The Use of Pleasure. New York: Vintage Books.Google Scholar
  8. Halwani, Tharwat Mohamad, and Takrouri. 2006. Medical laws and ethics of Babylon as read in Hammurabi’s code (History). In The Internet Journal of Law, Healthcare and Ethics. Accessed 30 Jan 2018.
  9. Harris-Moore, Deborah. 2014. Media and the rhetoric of body perfection: Cosmetic surgery, weightloss and beauty in popular culture. London: Routledge.Google Scholar
  10. Holden, A. C. L. 2016. Dentistry’s social contract and the loss of professionalism. Australian Dental Journal 62 (1): 79–83.CrossRefGoogle Scholar
  11. Johnston, White v. 2015. NSWCA 18.Google Scholar
  12. Larkin, Mary. 2011. Social aspects of health, illness & healthcare. Berkshire: Open University Press.Google Scholar
  13. Lupton, Deborah. 1997. Consumerism, reflexibility and the medical encounter. Social Science and Medicine 45 (3): 373–381.CrossRefGoogle Scholar
  14. Lupton, Deborah. 1998. Doctors on the medical profession. Sociology of Health and Illness 32 (4): 480–497.CrossRefGoogle Scholar
  15. Mckinlay, John, and Lisa Marceau. 2002. The end of the golden age of medicine. International Journal of Health Services Research 32 (2): 379–416.CrossRefGoogle Scholar
  16. Oral, -B. 2018. Manual toothbrushes. Accessed 8 Feb 2018.
  17. Ozar, David. T, and J. David, and Sokol. 2002. Dental ethics at chairside: Professional principles and practial applications. 2nd ed. Washington DC: Georgetown University Press.Google Scholar
  18. Pellegrino, Edmund. 1999. The commodification of medical and health care: The moral consequences of a paradigm shift from a professional to a market ethic. Journal of Medicine and Philosophy 24 (3): 243–266.CrossRefGoogle Scholar
  19. Plato. 1997. Republic (trans: Davies, J. L., and D. J. Vaughn) Hertfordshire: Wordsworth Editions Ltd.Google Scholar
  20. Ritzer, George. 2004. The McDonaldization Thesis, Revised New Century Edition. London: Sage.Google Scholar
  21. Sandell, Michael. 2012. What money can’t buy: The moral limits of markets. New York: Farrar, Straus and Giroux.Google Scholar
  22. Scott, W. Richard, Martin Ruef, Peter J. Mendel, and Carol A. Caronna. 2000. Institutional change and healthcare organisations. London: University of Chicago.Google Scholar
  23. Starr, Paul. 1982. The social transformation of American medicine. New York: Basic Books.Google Scholar
  24. Sullivan, Deborah A. 2001. Cosmetic surgery: The cutting edge of medicine in America. New Brunswick, NJ: Rutgers University Press.Google Scholar
  25. Susskind, Richard, Daniel Susskind. 2015. The future of the professions. Oxford: Oxford University Press.Google Scholar
  26. The Semiotic Analysis. Sensodyne. Accessed 8 Feb 2018.
  27. Waring, Justin, and Simon Bishop. 2015. George Ritzer: Rationalisation, Consumerism and the McDonaldisation of Surgery. In The palgrave handbook of social theory in health, illness and medicine, ed. Fran Collyer, 488–503. Houndmills: Palgrave Macmillan.CrossRefGoogle Scholar
  28. Weber, Max. 1970. From Max Weber, eds. Gerth, Hans H, and Charles W Mills. London: Routledge, Keagan Paul.Google Scholar
  29. Weintraub, J. A. 2017. What should oral health professionals know in 2040: Executive summary. Journal of Dental Education 81 (8): 1024–1032.CrossRefGoogle Scholar
  30. Welie, Jos. 2000. The dentist as healer and friend. In The health care professional as friend and healer, eds. David C., Thomasma and Judith Lee Kissell, 35–48. Washington DC: Georgetown University Press.Google Scholar
  31. World Dental Federation (FDI). 2016. FDI unveils new universally applicable definition of ‘oral health’. Accessed 7 Feb 2018.
  32. World Health Organisation. 2012. Oral health. Accessed 7 Feb 2018.
  33. Zola, Irving K. 1977. Healthism and disabling medicalization. In Disabling professions, ed. Ivan Illich, 41–67. London: Marion Boyars.Google Scholar

Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Dental Ethics, Law and Professionalism, Faculty of DentistryThe University of SydneySurry HillsAustralia

Personalised recommendations