An evaluation of defensive dentistry: w(h)ither the profession?

Introduction Defensive dentistry has become a popular choice for dentists in practice over the past decade, partly in response to the supposed increasing risks to patient safety, of litigation and of health and safety concerns to patients and staff.Methods Using a quantitative analysis, care plans of 96 dentists were examined from one day in April 2017 and compared against these known risks. One thousand four hundred and seventeen care plans were coded by treatment type. The risks of completing each item were coded as high or low for either clinical risk, health and safety risk and risk of litigation. Subsequently, semi structured interviews were conducted with 12 participants; five practitioners of over 25 years' experience and seven practitioners of less than five years' experience.Results All assessments and treatments, including no treatment, had recognised risks. 'Doing nothing' also carried a risk of litigation. Four themes were identified from the interviews: 'there by the grace of God, go I', 'limitations on the scope of practice', 'fear' and 'c'est la vie'.Discussion The profession is at a crossroads. The options for the future are discussed, including immediate retraining for all dental care professionals.Conclusion Within the limitations of this study, it is concluded that increasingly, no risk or only low risk treatments will be undertaken by the profession, with both experienced and less experienced practitioners limiting their scope of practice, with possible deleterious consequences on the dental health of the population.