Abstract
Commercialisation and consumerism have had lasting and profound effects upon the nature of oral health and how dental services are provided. The stigma of a spoiled dental appearance, along with the attraction of the smile as a symbol of status and prestige, places the mouth and teeth as an object and product to be bought and sold. How the dental profession interacts with this acquired status of the mouth has direct implications for the professional status of dentistry and the relationship between the profession and society. This essay examines the mouth’s developing position as a symbol of status and prestige and how the dental profession’s interaction and response to this may have important effects on the nature of dentistry’s social contract with society. As rates of dental disease reduce in higher socioeconomic groups, dentistry is experiencing a reorientation from being positioned within a therapeutic context, to be increasingly viewed as body work. This is not in of itself problematic; as a discipline dentistry places a very high value upon the provision of enhanced or improved aesthetics. This position changes when the symbolic exchange value of an aesthetic smile becomes the main motivation for treatment, encouraging a shift towards a commercialised model of practice that attenuates professional altruism. The dental profession should not welcome the association of the mouth as a status and prestige symbol lightly; this article examines how this paradigm shift might impact upon the social contract and dentistry’s professional status.
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References
Ashenburg, K. 2007. The Dirt on Clean: An Unsanitized History. New York: North Point Press.
Baudrillard, J. 1981. For a Critique of the Political Economy of the Sign. St Louis: Telos Press.
Baudrillard, J. 1998. The Consumer Society: Myths and Structures. London: Sage.
Botto, R.W. 2007. Addressing the Marketplace Mentality and Improving Professionalism in Dental Education: Response to Richard Masella’s “Renewing Professionalism in Dental Education”. Journal of Dental Education 71 (2): 217–221.
Bourdieu, P. 1984. Distinction. A Social Critique of the Judgment of Taste. Cambridge: Harvard University Press.
Chambers, D. 2006. Commercialism in Dentistry and Its Victims. The Journal of the American College of Dentists 73 (1): 2–3.
Conrad, P. 2007. The Medicalization of Society. Baltimore: John Hopkins University Press.
Exley, C. 2009. Bridging a Gap: The (Lack of a) Sociology of Oral Health and Healthcare. Sociology of Health & Illness 31 (7): 1093–1108.
Foucault, M. 1990a. The Care of the Self: The History of Sexuality, vol. 3. London: Penguin Books.
Foucault, M. 1990b. The History of Sexuality, Volume 2: The Use of Pleasure. New York: Vintage Books.
Frencken, J.E., P. Sharma, L. Stenhouse, D. Green, D. Laverty, and T. Dietrich. 2017. Global Epidemiology of Dental Caries and Severe Periodontitis: A Comprehensive Review. Journal of Clinical Periodontology 44: S94–S105.
Gibson, B.J., and C. Exley. 2013. The Mouth. Social Science and Dentistry 2 (2): 50–57.
Goffman, E. 1963. Stigma; Notes on the Management of Spoiled Identity. Englewood Cliffs: Prentice-Hall.
Holden, A.C.L. 2017. Dentistry’s Social Contract and the Loss of Professionalism. Australian Dental Journal 62 (1): 79–83.
Holden, A.C.L. 2018. Cosmetic Dentistry: A Socioethical Evaluation. Bioethics 32 (9): 602–610.
Holden, A.C.L., B.J. Gibson, and H. Spallek. 2019. Embarrassing Realities: The Portrayal of Dentistry in Reality Tv ‘Dentertainment’. Community Dental Health 36 (1): 46–54.
Holden, A., and H. Spallek. 2018. How Compliant are Dental Practice Facebook Pages with Australian Health Care Advertising Regulations? A Netnographic review. Australian Dental Journal 63 (1): 109–117.
Horton, S., and J.C. Barker. 2010. Stigmatized Biologies: Examining the Cumulative Effects of Oral Health Disparities for Mexican American Farmworker Children. Medical Anthropology Quarterly 24 (2): 199–219.
Illich, I. 1995. Limits to Medicine; Medical Nemesis: The Expropriation of Health. London: Marion Boyars.
Khalid, A., and C. Quiñonez. 2015. Straight, White Teeth as a Social Prerogative. Sociology of Health & Illness 37 (5): 782–796.
Kickbusch, I., L. Allen, and C. Franz. 2016. The Commercial Determinants of Health. The Lancet 4 (12): PE895–E896.
Kleinberger, J.A., and S.M. Strickhouser. 2014. Missing Teeth: Reviewing the Sociology of Oral Health and Healthcare. Sociology Compass 8 (11): 1296–1314.
Lamont, T., H. Worthington, J. Clarkson, and P. Beirne. 2018. Routine Scale and Polish for Periodontal Health in Adults. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD004625.pub4.
Leadbeatter, D., and C. Peck. 2018. Are Dental Students Ready for Supercomplex Dental Practice? European Journal of Dental Education 22 (1): e116–e121.
Lyons, H. 1983. Commercialism; Professionalism. Viva la difference. Virginia Dental Journal 60 (5): 16–17.
Masella, R.S. 2007. Renewing Professionalism in Dental Education: Overcoming the Market Environment. Journal of Dental Education 71 (2): 205–216.
Miner, H. 1956. Body Ritual Among the Nacirema. American Anthropologist 58 (3): 503–507.
Moeller, J., and C. Quiñonez. 2019. Dental Pain as Social Injustice: A Rawlsian Perspective. Critical Public Health. https://doi.org/10.1080/09581596.2019.1648761.
Moeller, J., S. Singhal, M. Al-Dajani, N. Gomaa, and C. Quiñonez. 2015. Assessing the Relationship Between Dental Appearance and the Potential for Discrimination in Ontario, Canada. Social Science and Medicine Population Health 1: 26–31.
Nations, M.K., and SDaS Nuto. 2002. ‘Tooth Worms’’, Poverty Tattoos and Dental Care Conflicts in Northeast Brazil. Social Science and Medicine 54: 229–244.
Ozar, D.T., D.J. Sokol, and D.E. Patthoff. 2018. Dental Ethics at Chairside: Professional Obligations and Practical Applications, 3rd ed. Washington, DC: Georgetown University Press.
Patthoff, D.E. 2007. The Need for Dental Ethicists and the Promise of Universal Patient Acceptance: Response to Richard Masella’s “Renewing Professionalism in Dental Education”. Journal of Dental Education 71 (2): 222–226.
Pellegrino, E.D. 2008. The Philosophy of Medicine Reborn: A Pellegrino Reader. Notre Dame: University of Notre Dame Press.
Peres, M.A., L.M.D. Macpherson, R.J. Weyant, B. Daly, R. Venturelli, M.R. Mathur, S. Listl, R.K. Celeste, C.C. Guarnizo-Herreño, C. Kearns, H. Benzian, P. Allison, and R.G. Watt. 2019. Oral Diseases: A Global Public Health Challenge. The Lancet 394 (10194): 249–260.
Petersen, A. 2007. The Body in Question: A Socio-Cultural Approach. Oxford: Routledge.
Scheper-Hughes, N., and L. Wacquant. 2002. Commodifying Bodies. London: Sage.
Shilling, C. 2012. The Body & Social Theory. London: Sage.
Sorooshian, S., and A.A. Kamarozaman. 2018. Fashion Braces: An Alarming Trend. Sao Paulo Medical Journal 136 (5): 497–498.
Strauss, S. 1924. Things Are in the Saddle. Atlantic Monthly, November, pp. 577–588.
Welie, J.V.M. 2004. Is Dentistry a Profession? Part 3. Future Challenges. Journal of the Canadian Dental Association 70 (10): 675–678.
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Holden, A.C.L. Consumed by prestige: the mouth, consumerism and the dental profession. Med Health Care and Philos 23, 261–268 (2020). https://doi.org/10.1007/s11019-019-09924-4
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DOI: https://doi.org/10.1007/s11019-019-09924-4