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Br Dent J 2016;221: 477–484; http://dx.doi.org/10.1038/sj.bdj.2016.777

Credit: ©azgAr Donmaz/iStock/Getty

Patient-centred care (PCC) is a universal concept which is well recognised amongst all health professionals. In broad terms we understand it to be treating the people using health and social services as equal partners in planning, developing and monitoring care. PCC requires us to treat a patient as a person who may have a tooth attached as opposed to a tooth that may or may not be attached to a person.

However, given the significant role that PCC plays in the dental profession today, it is not enough to be able to define PCC in its broadest of terms. Instead, a more specific definition is required that is tailored for those involved in the profession.

In this BDJ article, Dr Sasha Scambler and colleagues endeavor to clarify the ambiguous literature of PCC as applied to dentistry. The team of academics carried out a systematic review of the definition of patient-centered care in the dental literature.

The papers they found were assessed on two main criteria: quality of the definition of patient-centred care, if one was present, and the type of evidence base. The electronic database search returned a total of 390 citations, with just sixteen considered to have met the measures for the study.

Analysis of the papers exposed the great degree of variability in how authors define and perceive PCC. What's more is that most of the papers selected originated from the USA, where the structure of the healthcare system is quite different than to the UK, which could further alter definitions of PCC.

Patient-centred care is becoming an increasingly overt concept in dentistry that cannot be overlooked, and in order to do this, the dental profession needs to be able to provide a universal definition.

By Russell Hashemi (Plymouth University Schools of Medicine and Dentistry, www.thesmilingtooth.com )

Author Q&A with Sasha Scambler King's College London Dental Institute

Why did you review patient-centred care in dentistry?

The term patient-centred care is increasingly being used in official documents related to dentistry and in research papers focusing on the provision of good quality care. Our previous work suggests that, whilst the term is widely used, there is little shared understanding of what patient-centred care consists of and how it should be practised.

How do you feel PCC in dentistry compares to that in medicine?

There is an established body of work on patient-centred care in medicine. We contend that, whilst the basic tenets are similar, there are key differences in the relationship between dental and medical professionals and their patients. Active treatment is a routine part of dental consultations. This means that within a consultation dentists have to make and explain a diagnosis, outline the different treatment options and carry out the agreed treatment. This is compounded by the fact that, for at least part of the consultation, that patient will be unable to speak while examinations and treatment are carried out. In addition, at the system level primary care dentists are required to negotiate co-payments which potentially alters their relationship with the patient. All of these factors, we suggest, require a different approach to, and understanding of, patient-centred care within the dental context.

What would you like to study next?

Building on our theoretical work, we have now carried out research looking at patient-centred care from the perspective of dentists and within the literature. We are currently looking at the ways in which the concept and practice of patient-centred care can be integrated across the undergraduate dental curriculum and we plan to explore the experiences, needs and understandings of people receiving dental care, to include patients with dental anxiety.