Defensive dental behaviour: illusion or reality?

Summary Defensive medicine or defensive behaviour of physicians is considered a major problem in contemporary health care. It seems reasonable to assume that defensive behaviour also occurs in dental practice, although so far very little has been published in the dental literature on this subject. The main objective of this study was to investigate whether defensive behaviour occurs in dentistry. As a survey study 38 dentists were interviewed: 30 men and 8 women, mainly general dental practitioners with an average of 20.9 years in practice. The results of this pilot‐study indicate that it is very likely that defensive behaviour occurs in dental practice, despite the fact that there is hardly any evidence of fear for malpractice claims and lawsuits among the respondents. The majority of the dentists interviewed stated that they carried out some treatments at their patient's request although they did not believe the treatment to be necessary from a professional point of view. A motive for deliberately refraining from treatment is lack of dental motivation by the patient and poor oral hygiene. According to some respondents patients are sometimes referred unnecessarily to specialists. Also ‘difficult’ patients run the risk of unwarranted referral to specialists, and, moreover referrals because of insurance reasons are mentioned. The financial situation of the patient and the defensive behaviour of dental practitioners seem to be closely connected. Résumé Le comportement dentaire défensif; illusion ou réalité? La médecine défensive ou le comportement défensif des médecins sont considérés comme étant actuellement un problème majeur, dans le domaine médical. On peut raisonnablement penser que ce type de comportement se retrouve également au cabinet dentaire, en dépit du peu de littérature disponible sur le sujet dans le secteur dentaire. L'objectif principal de cette étude était de rechercher la présence d'un tel comportement en dentisterie. Dans le cadre de cette étude, 38 dentistes ont été interviewés: 30 hommes et 8 femmes, la plupart praticiens généralistes, avec une durée moyenne d'exercice de 20,9 ans. Les résultats de cette étude‐pilote révèlent que vraisemblablement ce type de comportement existe au cabinet dentaire, même si les dentistes interrogés ne manifestent ouvertement quasiment aucune crainte quant aux plaintes pour mauvais exercice ou aux assignations en justice. La majorité des dentistes interrogés déclarent effectuer certains traitements à la d