The key feature of denturism is that denturists have a combination of clinical and technical skills, which enable them to decide with the patient what dentures are required and then make those dentures themselves. Put simply, denturists offer a ‘one stop shop’ form of service. By contrast, dentists almost invariably subcontract the work of manufacturing the dentures, which they prescribe to dental technicians. This is often because dentists are not trained to do this work.
One of the advantages of having the denturists’ services is that they see the patient ‘one to one’ before carrying out the technical side of the work.
It is astonishing that the Republic of Malta and the Superintendent of Public Health base some of their submissions on information found on “Wikipedia”!
Almost invariably, dentists are not the ones to manufacture the denture. It often happens that from the clinical prescription issued by the dentist, some patients’ needs, such as the psychological attitude of the patient, are not reflected and indicated to the dental technologist / manufacturer in the laboratory. If the patient is less tolerant, a thinner or smaller denture is fitted. The fact that patients are never likely to meet the manufacturer is a serious shortcoming. Patients are being denied all these benefits.
The illogicality of this scenario in Malta is brought into greater focus when considering the ethos of professionalism which is taught to trainees. The profession has its regulatory framework. If the quality of work is below the required standard the remedy is a professional negligence claim.
The Council and the Superintendent are failing in many ways:
- failure to provide any evidence that there is a risk to public health,
- failure to consult,
- failure to listen to constructive criticism of the present scenario,
- failure to understand the advantages of reform,
- failure to understand the context of the work provided,
- failure to demonstrate flexibility and openness to reasoned arguments.
But, above all else, denturists have to fight against the die-hard attitude of the Dentists’ lobby. A document published by the FDI World Dental Federation unashamedly states:
“.... the FDI World Dental Federation: ....
Opposes any kind of undergraduate and post-graduate education which gives the dental laboratory technician the status of a healthcare provider.”
The Department of Dentistry at the National Hospital “Mater Dei Hospital” has issued the following consent form to be signed by patients, entitled “General Consent Form for Dentistry”:
“I realize that full or partial dentures are artificial, constructed of plastic and may have metal wire. Multiple visits are required for the construction of dentures. I realize the final opportunity to make changes in my new dentures will be the “teeth in wax” try-in visit.
“I understand the wearing of dentures is difficult, especially in the initial period after insertion. Sore spots, altered speech and difficulty in eating are common early problems. Other problems may arise with time including looseness, soreness and possible breakage. I(n) these cases, modification of the existing dentures (easing, repair, reline, rebase) or provision of new dentures is at the discretion of the dentists working within the Dental Department.”
This is the truth. The rest is a dangerous cocktail of fiction and bad faith.
Advocate Tonio Azzopardi
2 March 2017