Public perception of the dental degree

Abstract

When one raises the issue of educational degrees in oral and maxillofacial surgery circles it generally triggers a discussion of the advantages and disadvantages of dental versus combined dental and medical training. Although this issue still remains to be resolved, there is yet another degree-related issue that, although perhaps not as critical, may also have an impact on the practice of our specialty. I refer to the fact that in the United States, unlike most other countries around the world, there are currently 2 different degrees being awarded to dental school graduates despite there being no difference in their education and training. Thus, we have some oral and maxillofacial surgeons practicing with a Doctor of Dental Surgery (DDS) degree and others practicing with a “Dentaraie Medicinae Doctor” (DMD) degree. This would have no practical significance it were not for the potential confusion that it could raise in the minds of the lay public regarding scope of practice. The question of whether or not it is confusing having 2 different dental degrees has been raised previously on numerous occasions, and a study recently published in the Journal of the American College of Dentists confirms this fact.1Lalumandier JA Pyle MA Sawyer DR Public perception of DDS versus DMD degrees.J Am Coll Dent. 1999; 66: 29PubMed Google Scholar In this study, 524 persons (188 males, 332 females, 4 missing), mostly of white or black origin, ranging in age from 18 to 95 years, and having varying income levels, were interviewed at 4 designated locations. The majority of those interviewed had at least a high school education, with 22.3% also having had 2 years of college, 17.7% having had 4 years of college, and 14.7% having attended graduate or professional schools. Nearly three quarters had visited a dentist within the year. The survey included 6 questions related to perception about scope of training and practice. When asked about who they would visit for a “filling,” 61.6% answered DDS, 5.2% responded DMD, 12.8% stated “either,” and 20.4% were not sure. The responses favored the DDS degree less when asked who they would visit if they needed dental surgery, with 34.5% responding DDS, 25% responding DMD, and 27.9% not sure; only 12.4% said “either.” Moreover, when asked who they would visit if they had a heart problem and needed dental surgery, only 14.9% answered DDS, while 40.3% responded DMD. Although the majority of those interviewed stated “neither” to the question regarding who they would see to have their appendix removed, those who did select a dental degree overwhelming selected DMD (23.1%) over DDS (1.9%). Finally, when asked about whether both professionals had the same level of training, only 19.6% know that it was similar. Of those who thought the level of training was different, the vast majority (69%) felt the DMD degree indicated a higher level. The findings of this study clearly indicate that there is considerable misunderstanding on the part of the public about the training and scope of those who have a DDS and those who have a DMD degree. As the patient's health worsened or the complexity of the procedure increased, respondents were definitely more likely to select a practitioner with a DMD degree, even when asked about an operation outside the field of dentistry. It was also noted in the report that many of the respondents commented at the end of the interview that the DMD sound more like a medical doctor because of the MD part of the abbreviation and, therefore, those with this degree were able to perform more complex procedures. The authors of the article argue that the important issue is not which degree should be used, but rather that there should be only a single degree awarded. Although this would reduce the confusion of the public, it would also seem appropriate, at the same time, to select the degree that best describes what the dentist actually does. Dentistry has made tremendous progress in the more than 150 years since the first dental school was established in the United States and dental medicine is definitely more descriptive of the modern scope of practice than is dental surgery. A parallel can be found in medicine, where the MD degree encompasses the surgical treatment of disease as well as its medical management. Use of only the DMD degree would be of particular benefit to the oral and maxillofacial surgeon, whose training and practice bridge the fields of dentistry and medicine, by giving the public a more accurate perspective of what we do. Currently, those who understand the meaning of DDS often believe that their dentist is also an oral surgeon. The issue of establishing a single dental degree has come before the American Dental Association House of Delegates on 3 occasions in the past and each time no definitive action has been taken. Perhaps, for the benefit of the public and the profession, as noted by Meskin,2Meskin LH Much ado about nothing?.J Am Dent Assoc. 1993; 124: 11Abstract Full Text PDF Google Scholar it is time to eliminate ambiguity, maximize public understanding, and adopt the degree that engenders the greatest public confidence. This is definitely the DMD degree.