Opportunities exist for students to travel to foreign countries to perform varying levels of community service to vulnerable populations. Oftentimes students who are unqualified, untrained, and unlicensed, practice dentistry - including extractions, administration of anesthesia, preparations, restorations, and prophylaxis. Practicing dentistry on vulnerable populations without proper training is self-serving, unethical, and immoral. These are human beings who deserve the best care and compassion we could provide, not guinea pigs or some other disposable item. Applicants to dental schools should know better.
what do you think about practicing dentistry without proper training?
- Thread starter dean
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Excellent post. I especially love how beautifully you articulated the alternatives for these populations as far as opportunities for health/dental care. Oh wait, you didn't. The fact is just like everything, there are self serving reasons to do things and there are just plain "serving" reasons. These outreach programs mostly exist because there is a demand for these services. It would appear that the 'trained professionals' are unavailable or unwilling to volunteer their time and talents in sufficient numbers to provide the services needed by the populace on location. So until you provide something better, please think before you post inflammatory unhelpful rubbish that has no real point other than attempting to start an argument.
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Good point. Should you come up with an acute case of appendicitis while "serving" in a foreign country, surely you would not mind having an appendectomy performed by a pre med.
Because I was insinuating that pre dents should be doing procedures that compare to this? My original point still stands. I've never had any patience for people who complain about something but offer no valid alternative. Are these programs like Global Medical Brigade unethical and immoral in your opinion Doc?
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You make it sound like they're treating the people like scum and giving them inadequate care. These are dental students who are there to help with the best of their ability. It's not like were sending a bunch of engineering students over there and handing them drills and forceps and saying "here, have at it."
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The OP is talking about pre-dents not dental students.
the recipients of this care have the option whether or not to accept care. like the underserved patient that u will care for in school, they may opt for care by an "undertrained" student-dentist because it is the only option they have affordable access to.
by undertrained i mean not u still have questions, need supervision, etc.
by undertrained i mean not u still have questions, need supervision, etc.
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Well I guess that's what I get for assuming
Nevermind then. But I don't see how schools would be allowed to do that. I mean us pre-dents really have no training whatsoever. Whats up with that?
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While the original poster is melodramatic, he is correct. Pre-dents should use good judgment before actively participating in dental procedures. Putting a patients health at risk for the sake of a "good dental experience" is wrong. Just stick to shadowing and assisting. Nothing else needs to be done.
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Before we ramble on about how wrong it is, I'd like to see (or at least hear of) some evidence that predents are running around doing procedures without the supervision of a licensed dentist. Because if there's a dentist around, who ultimately should be held responsible?
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Even if there was a supervising dentist there it doesn't make it right. Why can't the dentist just do the work and the pre-dent just assist?
But I agree, before we continue lets see some evidence of this claim.
N
NAVY DDS 2010
Where did the OP mention anything about the students he was referring to as pre-dents?
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Anyway, if it were dental students I don't see it as that big of a deal if they were working in their scope of knowledge/skill.
N
NAVY DDS 2010
Do you not think that the patients that a dental student sees are not guinea pigs? Everything we do in dental school is new to us, thus no matter how much supervision there is the patients are guinea pigs because no matter how much training you have in pre-clinical labs it is not the same as working on a real live patient. Plus, do you think we have much practice and training preparing for oral surgery? No. Our training mostly comes form hands on experience in the OS clinic.
I agree that at times during these mission trips, some people are allowed to do thigns that they have not received adequate training on. There are dental students and pre-dents who have no clincal experience who should never get a chance to do procedures in foreign countries until they have had the training. First hands experience at these places are not the place for a crash course lesson especially when there is not usually adequate personnel there or appropriate instuments and materials in case one of these individuals messes up. There needs to bbe some kind of credentialing done by the dentists who are leading the mission trips to verify what a student is capable of doing on these mission trips. It would really easy to do to prevent any major issues.
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Yes. The recipients surely are told that the predents in question have no dental experience whatsoever.
In the past, there has been a number of predents bragging about their dental bravado on mission trips.
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I wonder if the OP has ever been out in the field doing dental work for people who otherwise would never have access to treatment? I have. I've done dentistry on 4 different continents on several occasions with other health professionals in ad hoc medical clinics. Mostly what I did was extractions but we did have a few hygienists who did debridement and cleanings. I don't know how I would feel about a pre-dent doing OS but as a pre-dent I worked at the county hospital of a very large US city doing basic wound care (debridement, sutures etc) and I wasn't a doc or a med student. The people I treated seemed pretty happy with what I did and I had nurses and MD's to go to if I got over my head.
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Yea, some kid posted the other day how he personally extracted a tooth on his first mission trip. He also posted a picture of himself giving a patient a shot. Or he claimed it was him. He was a pre-dent and he had no previous experience with dentistry.
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If a predent tags along on a mission trip and a dentist lets him extract a tooth or shows him how to give an injection, who cares? I highly doubt anyone is letting predents run wild out there yanking teeth and giving arbitrary injections unattended. Assuming that the dentist hand picked the procedures and was there watching and guiding the student, its no big deal...this is pretty much what happens in dental school.
Heh, and you'd be surprised at how easy some extractions are...if these students were performing operative, fixed or endo...then I would have an issue with it.
Heh, and you'd be surprised at how easy some extractions are...if these students were performing operative, fixed or endo...then I would have an issue with it.
N
NAVY DDS 2010
How about those easy extractions performed while taking impressions? Or the ones you can extract by flicking with your middle finger like that old paper footbal game you use to play in middle school? I don't think most dentists leading a mission trip would have a problem with a high schooler taking those out let alone a pre-dent.
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Playing dentist is practicing dentistry without a license no mater how difficult or easy extractions may happen to be and the legality of the action is not up to the "dentists leading a mission trip".
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A pre-dent practicing dentistry is no different than Ronald McDonald practicing dentistry.
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The fact is just like everything, there are self serving reasons to attend a 3-year accelerated program which may not allow its D3 &D4 students much time to participate in such programs, all of whom are excellent alternatives to clueless pre-dents.
Oh how cute. Taking a shot at me out of complete ignorance just to satisfy your own...no clue. Fact is if you knew anything about the school and it's program you'd be able to avoid making yourself look stupid by implying Pacific students have no opportunities to participate in such programs. Please, carry on.
N
NAVY DDS 2010
No kidding doc. I was being facetious. Is this a touchy subject with you? Who the hell said anything about it being legal? No one here is stating anything about it being legal. My comment about 'dentists leading a mission trip' was made because the dentists leadign the mission trips are the ones who coordinate the trips and assign the students to different tasks, so they would be the ones putting a high schooler (which no respected, ethical, sane dentist would do) in a position to extract those teeth.
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This is not about the mission programs, GMB or others, but rather about medical/dental procedures performed by totally untrained participants.
Sounds like a meritorious 4 gold star award should be forthcoming for managing, wittingly or unwittingly, to break the dental practices acts on 4 continents. One could certainly argue that performing dental procedures in an uncontrolled environment in a hut/makeshift clinic is quite different from the controlled environment in a county hospital irrespective of country.
In the U.S., the dental practice acts are passed by the legislatures of each state and enforced by the State Board of Dental Examiners. In foreign countries, they come under the jurisdiction of Ministries of Health. You keep asking for options even though they are self evident. Mission trips do have qualified clinicians to attend to those in need. Moreover, a practitioner is likely to do a procedures in a fraction of the time it takes to instruct an unqualified, inexperienced volunteer in the art of providing anesthesia/oral surgery.
If we are to take at face value the claims made by some predents on this forum, it would appear that some otherwise "respected, ethical, and sane dentist" appears to have lost his/her better judgment once across the border. That they were put "in a position to extract those teeth" is not much of an ethical or legal defense once they are beyond the age of consent. What the OP was trying to tell the would be mission trip volunteers is that they should not trumpet too loudly their claim of conquest in the dental area since adcoms/ds are likely to look askance at such an adventure and, possibly, jeoparde their chances of admission.
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they do get to do injections/extractions but i think it's better for them to receive some sort of dental care rather than no dental care at all. You have to realize they are going to really impoverished places where dental care isn't even an option.
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I see no problem with this at all. The fact is, these places are grossly underserved and the people are happy to receive any treatment.
And all the predents have a dentist either alongside or over the shoulder, so it's really NBD.
And all the predents have a dentist either alongside or over the shoulder, so it's really NBD.
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Want to explain how exactly "broke the dental practices acts on 4 countinents when I had more experience and training than the majority of the native dentists in the countries where I rendered aid?
So if the mission trips have qualified clinicians, WHY is this "breaking of the dental practices acts" occurring? Furthermore, you say the options are self evident and yet there is obviously a disconnect between what you're saying is the law overseas and what these students are actually doing. But you're right, it's the those TERRIBLE students who go overseas to help people who we should be vilifying.
I think the point being made by the folks against this sort of thing taking place is that students without training shouldn't be carrying out the procedures...and it shouldn't be their call. It should be the Ministry of Health's call. So, why isn't the Ministry of Health preventing such extractions and treatment? Why is the treatment so commonplace that "predents come on the forum and brag about it"? To me those should be the questions being asked, not ripping into the students for participating in the missions.
Doc you're right, it's not about GMB or other programs, it IS about untrained indviduals "playing dentist". So why are they allowed to when the knowledge of their inolvement MUST be known to the Ministry?
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I was referring to dental school applicants (college students) extracting teeth on orphaned children in third world countries. While I have no answer for the disparity in oral health care in third world countries, or in the U.S., I know that the dental profession deserves more respect (not to mention the patients) than to have non-professionals rendering professional care. When pre-med college students begin performing emergency appendectomies in Costa Rica, I'll stop arguing that unqualified students administering anesthesia and extracting teeth is inappropriate, unethical, disrespectful, and dangerous.
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This is a serious problem and should be regulated. I recall watching an ESPN special about Tim Tembow and his mission trip. In the interview, Tebow claimed he circumcised kids from the Phillipines. Here is a link to the video: http://www.youtube.com/watch?v=ZUc_JO7A6OU
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You are right. "It does not take a rocket scientist to perform an extraction", but it does take a dentist. If it takes a pre dent supervised by a dentist wouldn't it be more expedient/efficient for the trained professional to perform the procedure?
You could also kill or severely hurt the client you treat because you did not have the proper training. Having supervision is not good enough, you actually have to KNOW what you are doing. Don't you take your ethics courses in dent? Ethics travel across borders too. Just because it is not illegal does not mean it's unethical. If it's so easy for people to do extractions, why do we need licensed dentists to do it? Going by your argument, would you let pre-dents do the extractions in your office even if you are supervising them?
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i was asked by the dentist that im currently shadowing whether i would be interested in going to a mission trip.
i'm planning on going even if i am accepted to d school since it'll be a good learning experience
i'm assuming most of my duties would be limited to assisting and helping out with small tasks.
i would never have imagined predents doing extractions even with supervision
(another question that comes to mind is, why can't the supervising dentist extract the tooth himself/herself? Obvisouly, the predent wouldn't be as efficient as a trained dentist and there's minimal benefit to the predent student. the predent will learn how to do extractions and get sufficient training in d school, so why risk the patient's health?)
imo, regardless of the alternative, predents shouldn't be allowed to do such procedures.
what if something goes wrong?
i'm sure proponents of this idea would never allow a predent to inject them with a needle and extract their own tooth so why should people in 3rd world countries be exposed to such risk? let the dentist do his work. predents aren't dentists yet and flying to a poorer country doesn't change that.
pre-dents, irregardless of their background, have insufficient training and should know their place. just stick to assisting.
i'm planning on going even if i am accepted to d school since it'll be a good learning experience
i'm assuming most of my duties would be limited to assisting and helping out with small tasks.
i would never have imagined predents doing extractions even with supervision
(another question that comes to mind is, why can't the supervising dentist extract the tooth himself/herself? Obvisouly, the predent wouldn't be as efficient as a trained dentist and there's minimal benefit to the predent student. the predent will learn how to do extractions and get sufficient training in d school, so why risk the patient's health?)
imo, regardless of the alternative, predents shouldn't be allowed to do such procedures.
what if something goes wrong?
i'm sure proponents of this idea would never allow a predent to inject them with a needle and extract their own tooth so why should people in 3rd world countries be exposed to such risk? let the dentist do his work. predents aren't dentists yet and flying to a poorer country doesn't change that.
pre-dents, irregardless of their background, have insufficient training and should know their place. just stick to assisting.
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aren't the dentists that go on mission trips volunteering their time?
but when i think about it more, perhaps the other side of the argument makes a good point.
i was more focused on why the predent would want to do such risky things and how it might benefit him/her but thinking in the shoes of the patient, my stance on this issue has softened a bit.
if the patient understands that someone with minimal training is treating them and the risk involved, then why should it be a problem?
it's the patient's right to choose and if he feels that a risky treatment is better than no treatment then who are we to stop him from receiving that care.
the point of the mission trip is to help as many people with adequate oral care in a limited amount of time.
as unideal as it is, if predents can relieve the dentists of some of the more "basic" duties while doing a reasonable job and let the dentists on premise do more difficult procedures, then the mission trip would be more efficient and achieve greater good for a wider population. Of course, this is provided that the students are sufficiently trained by the dentists.
im backtracking a bit but under the circumstances perhaps division of labor may not be such a bad thing as long as the patients understand and consent as it allows for greater efficacy in the distribution of healthcare.
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For those of you who don't think that a dental education is required for the practice of dentistry, you will not be offended by the information in the following link: http://www.islonline.org/programs/dental/
It is disturbing enough that legislators devalue a dental education by increasingly allowing less qualified health care team members to perform duties that have been historically in the sole domain of the highly educated, extensively trained dentist. To read that aspiring dentists place such little value on the profession is worse.
It is disturbing enough that legislators devalue a dental education by increasingly allowing less qualified health care team members to perform duties that have been historically in the sole domain of the highly educated, extensively trained dentist. To read that aspiring dentists place such little value on the profession is worse.
