The popularity of cosmetic surgery has seen a rapid increase recently, with the trend mirrored in dentistry. The Department of Health expressed concerns about the potential for biological and psychosocial harm of these cosmetic procedures. Furthermore, the dental public health implications (DPH) of the growing uptake of cosmetic dental procedures have not been explored.
Conduct a scoping review to explore the DPH implications of cosmetic dentistry and identify gaps for future research.
A fivestage scoping review was conducted of studies identified using the search terms cosmetic AND dentistry. Data from the studies meeting the inclusion criteria were extracted, collated and summarised into themes.
Fifty-seven papers met the inclusion criteria (11 cross-sectional studies, 10 literature reviews and 36 opinion pieces). The DPH implications were summarised into five emergent themes: dento-legal and ethical, marketing, psychosocial, biological and workforce. These themes revealed patients' increased expectations, expanding commercialisation of the profession, psychological risks to vulnerable patients, the iatrogenic consequences of invasive cosmetic dental procedures and workforce implications of the current trends.
The scoping review found that existing literature on cosmetic dentistry is predominately anecdotal - professional opinions and discussions. Despite this, our findings demonstrated workforce training and governance implications due to increased demand for cosmetic dentistry. Further empirical research is needed to understand the DPH implications of the increasing demand and uptake of cosmetic dental procedures to guide evidence-based policy to safeguard patients and improve the quality of dental services.
AhmadI. (2010): Risk management in clinical practice. Part 5. Ethical considerations for dental enhancement procedures. British Dental Journal209, 207-214.
2.
AliZ.AshleyM.WestC. (2013): Factors to consider when treatment planning for patients seeking comprehensive aesthetic dental treatment. Dental Update40, 526-528.
3.
ArkseyH.O’MalleyL. (2005): Scoping studies: towards a methodological framework. International Journal of Social Research Methodology8, 19-32.
4.
AustinC.J. (1994): Marketing strategies for the cosmetic practice. Current Opinion in Cosmetic Dentistry1994, 123-133.
5.
BeckettH.A. (2010): An investigation into the current practice of tooth whitening in a southern English city in the context of associated legal issues. Primary Dental Care17, 127-135.
British Association of Aesthetic and Plastic Surgery, BAAPS (2008): Over 32,400 cosmetic surgical procedures in the UK in 2007. London: BAAPS. http://baaps.org.uk/about-us/audit/280-over-32400-cosmetic-surgery-procedures-in-the-uk-in-2007
8.
BrownA.FurnhamA.GlanvilleL.SwamiV. (2007): Factors that affect the likelihood of undergoing cosmetic surgery. Aesthethetic Surgery Journal27, 501-508.
9.
BurkeF.J.KelleherM.G. (2009): The “daughter test” in elective esthetic dentistry. Journal of Esthetic and Restorative Dentistry21, 143-146.
10.
BurkeF.J.KelleherM.G.WilsonN.BishopK. (2011): Introducing the concept of pragmatic esthetics, with special reference to the treatment of tooth wear. Journal of Esthetic Restorative Dentistry23, 277-293.
11.
ChateR. A. C. (2013): Truth or consequences: the potential implications of short-term cosmetic orthodontics for general dental practitioners. British Dental Journal215, 551-553.
12.
ChristensenG.J. (1994): How ethical are esthetic dental procedures? Journal of the American Dental Association 125, 1498-1500, 1502.
13.
ColquhounH.L.LevacD.O’BrienK.K.StrausS.TriccoA. C., Perrier, L., Kastner, M. and Moher, D. (2014): Scoping reviews: time for clarity in definition, methods, and reporting. Journal of Clinical Epidemiology67, 1291-1294.
Creative Research (2012): Regulation of cosmetic interventions: Research among general public and practitioners, and teenagers. London: Creative Research Limited
16.
CurrieR.B.PrettyI.A.TickleM.MaupomeG. (2012): Letter from America: UK and US state-funded dental provision. Community Dental Health29, 315-320.
17.
DalyB.BachelorP.TreasureE.andWatt, R. (2013): Essential Dental Public Health. Oxford: Oxford University Press.
18.
De JonghA.OosterinkF.M.Van RoodY.R.AartmanI.H. (2008): Preoccupation with one’s appearance: a motivating factor for cosmetic dental treatment? British Dental Journal 204, 691-695.
19.
De RoubaixJ.A.M., (2011): Beneficence, non-maleficence, distributive justice and respect for patient autonomy – reconcilable ends in aesthetic surgery? International Journal of Surgical Reconstruction 64, 11-16
20.
Department of Health, DH (2009): Adult Dental Health Survey. London: DH.
21.
DickersonW.G. (1997): Integrating cosmetic dentistry into a busy practice. Dental Economics - oral hygiene 87, 30-32, 34-36.
22.
DowlingN.A.HonigmanR.andJ. Jackson, A.C. (2010): The male cosmetic surgery patient: A matched sample gender analysis of elective cosmetic surgery and cosmetic dentistry patients. Annals of Plastic Surgery64, 726-731.
23.
DownerM.C.GelbierS.GibbonsD.E. (1994): Introduction to Dental Public Health. In, C, Pine, C. and R, Harris, R. eds. 2007, Community Oral Health. Surrey: Quintessence. EU Cosmetics Regulation 1223/2009 http://ec.europa.eu/growth/sectors/cosmetics/legislation/index_en.htm
24.
General Dental Council, GDC (2013): Standards for the dental team. London: GDC.
General Dental Council, GDC (2014b): The General Dental Council Position Statement. London: GDC. www.gdc-uk.org/membersofpublic/illegalpractice/documents/position%20statement%20on%20tooth%20whitening%20ud%2029.05.pdf
27.
GlickK. (2000): Cosmetic dentistry is still dentistry. Journal of the Canadian Dental Association66, 88-89.
HonigmanR.J.JacksonA.C.DowlingN.A. (2011): The PreFACE: A preoperative psychosocial screen for elective facial cosmetic surgery and cosmetic dentistry patients. Annals of Plastic Surgery66, 16-23.
30.
IllichI. (1976): Limits to medicine. London: Marion Boyars.
31.
JamesonC. (2006): Increasing your practice with cosmetic dentistry. Texas Dental Journal123, 452-453.
32.
KelleherM. (2012): Ethical issues, dilemmas and controversies in ‘cosmetic’ or aesthetic dentistry. A personal opinion. British Dental Journal212, 365-367.
33.
KelleherM.G. (2010): The ‘Daughter Test’ in aesthetic (‘esthetic’) or cosmetic dentistry. Dental Update37, 5-11.
34.
KelleherM.G.D.DjemalS.LewisN. (2012a): Ethical marketing in ‘aesthetic’ (‘esthetic’) or ‘cosmetic dentistry’ part 1. Dental Update, 39, 313-326.
35.
KelleherM.G.D.DjemalS.LewisN. (2012b): Ethical marketing in ‘Aesthetic’ (‘Esthetic’) or ‘Cosmetic Dentistry’ part 2. Dental Update39, 390-406.
36.
KeoghB. (2013): Review of the regulation of cosmetic interventions. London: Department of Health.
37.
KingJ., (2002): Rights and responsibilities in dentistry. In, Lambden, P. (ed), Dental Law and Ethics. Oxford: Radcliffe Medical, pp13-20.
38.
LevacD.ColquhounH.O’BrienK. (2010): Scoping studies: advancing the methodology. Implementation Science5, 1-9.
LevinR.P. (1997): Marketing the cosmetic dental practice. Current Opinion in Cosmetic Dentistry4, 1-5.
42.
LevinR.P. (2007a): Six ways to increase cosmetic dentistry in your practice. Compendium of Continuing Education in Dentistry28, 340-341.
43.
LevinR.P. (2007b): Want to increase cosmetic dentistry? Targeted internal marketing is your secret weapon. Compendium of Continuing Education in Dentistry28, 674-675.
44.
LewisK. (2011): Dento-legal risks associated with treating the older patient. Faculty Dental Journal of the Royal College of Surgeons of England, 2, 123-126.
45.
MadowR.H. (1997): Gateways to patient acceptance of cosmetic procedures. Current Opinion in Cosmetic Dentistry4, 29-34.
46.
MagladA.S.WassellR.W.BarclayS.C.WallsA.W.G. (2010): Risk management in clinical practice. Part 3. Crowns and bridges. British Dental Journal209, 115-122.
47.
MaihoferM.G. (2009): Cosmetic dentistry is not a recognized specialty. Journal of the Michigan Dental Association91, 18.
48.
MathewsonH.RudknD. (2008): The GDC - Lifting the lid. Part 5: Illegal practice. British Dental Journal205, 153-155.
MorleyJ. (1994): Integrating cosmetic dentistry into your practice. Dentistry Today13, 64-65.
51.
MorleyJ. (1997): The esthetics of anterior tooth aging. Current Opinion in Cosmetic Dentistry4, 35-39.
52.
MorleyJ. (1999): The role of cosmetic dentistry in restoring a youthful appearance. Journal of the American Dental Association130, 1166-1172.
53.
MulcahyD.F. (2000. Cosmetic dentistry: is it really health care? Journal of the Canadian Dental Association 66, 231-232.
54.
New Zealand Dental Council, NZDC (2009): Practice Statement for Cosmetic Dentistry. Auckland: NZDC.
55.
Office of Fair Trading (2012): Dentistry: An OFT market study. London: The National Archives.
56.
PhilipsE. (1998): Contemporary cosmetic dentistry. Where do we go from here? Oral Health 88, 21-22, 25-26, 28.
57.
RobertsD.H. (1970): The relationship between age and the failure rate of bridge prostheses. British Dental Journal, 128, 175-177.
58.
RossiM.S. (2006): The cosmetics of dentistry. Who will be left smiling? New York State Dental Journal 72, 6-7.
59.
SaundersW.P.SaundersE.M. (1998): Prevalence of periradicular periodontitis associated with crowned teeth in an adult Scottish subpopulation. British Dental Journal185, 137-140.
60.
SimonsenR.J. (2007): Commerce versus Care: troubling trends in the ethics of esthetic dentistry. Dental Clinics of North America51, 281-287.
61.
TheobaldA.H.WongB.K.J.QuickA.N.ThomsonW.M. (2006): The impact of the popular media on cosmetic dentistry. New Zealand Dental Journal, 102, 58-63.
62.
VallittuP.K.VallittuA.S.LassilaV.P. (1996): Dental aesthetics--a survey of attitudes in different groups of patients. Journal of Dentistry24, 335-338.
63.
WulfmanC.Tezenas Du MontcelS.JonasP.FattouhJ.Rignon-BretC. (2010): Aesthetic demand of French seniors: a large-scale study. Gerodontology27, 266-271.
