Is there a social justice to dentistry's social contract?

Abstract

How should the dental profession of the 21st century frame its interactions with the society it is tasked to care for? What has this relationship looked like in the past, and what does it look like today? In this article, we examine these and other issues through the framework of the social contract, with a focus on exploring how social justice fits within the transaction of duties between the dental profession and society. We begin by describing the social contract and how this is uniquely defined within the context of dentistry; specifically, how the context of dentistry as, in part, an aesthetically driven discipline, impacts the social contract. We then consider how the nature of the profession's relationship with society, and the orientation by which it provides its services (which is sometimes critically unclear in its definitional terms), impacts the profession's contribution to ensuring social justice in oral health and oral healthcare. Through examining the nature of how the social contract has shifted (for example, by the attenuation of professional monopolies), we also ask whether this is evidence of a loss of confidence in the dental profession as an altruistic institution. We end by suggesting that the dental profession must engage with the tenets of social justice within the social contract. Failure to do so is likely to lead to erosion of dentistry as a high-status profession and societal willingness to seek solutions to oral health needs from other professional and non-professional sources.