AAPHD Policy Statements

  1. AAPHD Policy Statement on National Health Reform
  2. AAPHD Policy Statement on Primary Care
  3. AAPHD Interim Policy Statement on IOM Report
  4. Code of Ethics and Standards of Professional Conduct

AAPHD Policy Statement on National Health Reform
Adopted by the assembly of members of AAPHD November 5, 1993
J Pub Health Dent 1994; 54(2):113.

The American Association of Public Health Dentistry (AAPHD) supports fundamental health system reform in the United States. The Year 2000 Objectives for the Nation, as stated in Healthy People 2000, cannot be achieved without such change. This change must address access, cost, and quality of health care.
The AAPHD supports a national health system that focuses on the health needs of society, and one that will contribute to the improvement of the health of the nation through universal access to primary health care. Oral health is an essential component of the overall health of individuals, communities, and the nation. It is only through a healthy society that the full potential of the nation can be achieved.
A wide range of health services is available, but not all have the same potential to improve the health of the nation. A fundamental premise of this policy statement is that prevention of disease is preferable to treatment of disease or disability. While primary prevention is essential, it is not sufficient to maintain health. Therefore, health reform must include all primary health care services.

 

FUNDAMENTAL PRINCIPLES TO GUIDE NATIONAL HEALTH REFORM

The American Association of Public Health Dentistry supports and promotes 15 basic principles to guide national health reform, and for including oral health in any product of such reform. The principles are organized in five broad categories and include:

 

ACCESS AND AVAILABILITY

1. Coverage for all individuals.
2. Equitable availability of services.

 

SCOPE OF SERVICES

3. Comprehensive primary health care services.
4. Primary health care services provided regardless of discipline of provider, disease, or disability.
5. Services provided based on health promotion needs, disease risks, treatment needs, and scientific evidence of effectiveness and efficiency.
6. Primary oral health care includes the prevention and control of oral diseases or disability (dental caries, periodontal diseases, soft tissue pathologies, trauma, and oral and facial defects that compromise health and well-being).
7. Primary prevention for individuals and communities within both the private and public sectors must be the foundation of the health system.
8. Oral health services beyond primary health care linked to comparable medical services in an overall national health program.

 

ADMINISTRATION

9. Public accountability for cost, quality, and access, with ongoing planning and evaluation that includes provider and consumer participation.
10. Primary health care services provided with maximum effectiveness and efficiency through a balance of individual and community approaches.
11. Integrate public health and private services.
12. Equitable sharing of costs among all segments of society based on ability to pay.
13. Fair and equitable compensation for providers.

 

HEALTH PERSONNEL

14. Adequate supply, appropriate distribution, and effective utilization of trained health personnel.

 

RESEARCH

15. Sound biomedical, sociobehavioral, and health services research to support the organization, financing, and delivery of services.

Back to top

 

AAPHD Policy Statement on Primary Care
Adopted by the assembly of members of AAPHD October 7, 1995
J Pub Health Dent 1996; 56(2):102.

The American Association of Public Health Dentistry (AAPHD) reaffirms that "oral health is an integral part of total health, and oral health care is an integral part of comprehensive health care, including primary care." Oral diseases are among the most common in the United States, affecting both children and adults. Oral diseases profoundly influence general health and quality of life, including speaking, eating, learning, working, and other functions. Primary oral health care services are directed toward promoting health and preventing and managing oral diseases and conditions. By addressing the vast majority of the oral health problems present in the community, oral health professionals provide the foundation for an effective and efficient oral health care system.

Oral health care is an integral part of primary care because:

1. The mouth is part of the body, and oral pain, disease, and disability should be prevented and/or treated. Many people are at risk of oral diseases, and risk continues through a lifetime.
2. Oral health professionals develop sustained partnerships with patients and families with the mutual expectation of continuation over time.
3. Oral health professionals are accountable for the delivery of primary health services for the most common oral problems, including screening, monitoring, and providing preventive, counseling, and treatment services.
4. By tradition and law, many of the essential health care services to maintain oral health are only provided by oral health professionals. These clinicians are uniquely qualified to prevent, treat, and manage diseases and conditions of the oral cavity, have a recognized scientific knowledge base, and have the statutory authority to direct the delivery of personal health services to patients.

The AAPHD believes that primary care clinicians should be identified by skills needed to address patient and community needs rather than by clinicians' credentials. Oral health professionals fulfill the expectation of primary health care by ensuring coordinated, appropriate, and comprehensive personal and community-based services with an understanding of the patient's living conditions, family dynamics, and cultural background.

Back to top

AAPHD Interim Policy Statement on IOM Report
Resolution on the Institute of Medicine's Report: Dental Education at the Crossroads: Challenges and Change
Approved by the assembly of AAPHD members October 7, 1995
Communique Nov 1995;14(4):6.

Background

The Institute of Medicine (IOM), part of the National Academy of Sciences, established a Committee on the Future of Dental Education "to identify measures to strengthen dental education in the United States and stabilize its position within the university." The specific charge to the Committee was to: examine the current status of dental education and oral health in the United States and consider future scientific, demographic, economic, organizational, and other developments that may affect oral health status and the system for educating dentists and other dental personnel; develop a statement of how, over the next 25 years, oral health and oral health services should be improved in the United States, and identify the short-term and long-term implications of this statement for dental education and public policy; describe strategies that will help dental education, research, and practice improve oral health by responding effectively to current problems and future developments in both science and society; and consider ways in which each dental school can better relate to the mission of its university and to the community at large.

Through site visits, personal interviews, mail and telephone surveys, and oral and written testimony from the dental, medical, and lay communities, the committee collected "information and perspectives of dental education in the context of the broader systems of health professionals education and health care delivery." Based on their findings, the committee issued a report, entitled Dental Education at the Crossroads: Challenges and Change, in January 1995. This report included 22 recommendations covering dental education, research, and dental care delivery. Supporting materials for the recommendations were contained in the report and in background papers published in the Journal of Dental Education.

· WHEREAS, the American Association of Public Health Dentistry (AAPHD) seeks to improve the oral and general health of all Americans; and
· WHEREAS, the AAPHD believes that education, research, and care delivery are necessary to improve the oral and general health of all Americans; and
· WHEREAS, the Committee on the Future of Dental Education, Institute of Medicine, National Academy of Sciences, issued its report Dental Education at the Crossroads: Challenges and Changes, containing 22 recommendations to improve dental education, research, and patient care; and
· WHEREAS, the AAPHD has reviewed the IOM report and other documents and developed a response, identifying relevant and important recommendations to which it should respond; therefore,

BE IT RESOLVED THAT THE AMERICAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY:

· Endorses the Institute of Medicine's report Dental Education at the Crossroads: Challenges and Change; and
· Supports implementation of those findings and recommendations targeted toward improving the health of the public and securing the future of dental education; and
· Calls upon other dental, health, education, and public health organizations to work cooperatively with the AAPHD in implementing these recommendations; and
· Calls upon federal, state and local governments as well as appropriate private entities to maintain their commitment to oral and general health through continued and enhanced support of dental research; dental education, including graduate programs in dental public health; and prevention and public health programs, community outreach, and personal dental services.

Back to top

AAPHD Code of Ethics and Standards of Professional Conduct
Interim Policy Adopted October 16,1997

I. Introduction

The American Board of Dental Public Health defines the profession's role as follows:

. . .science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice which serves the community as a patient rather than the individual. It is concerned with dental health education of the public, with applied dental research, and with the administration of group dental care programs, as well as the prevention and control of dental diseases on a community basis.

Dental public health professionals represent many talents including those required for clinicians, scientists, educators, administrators, and policy makers. Primarily however, these represent individuals who combine skills in all such fields in varying proportions or different roles and responsibilities over time. The diversity in scope of the members' roles poses a particular challenge to dental public health professionals when charged with determining an ethical stand for issues they may encounter.

A profession has the obligation to be self-regulating. Implicit to this concept of self-regulation is the notion that a profession will have a written code of ethics that provides guidance for appropriate conduct of members in their professional practice. The dilemma of choosing between an individual as a patient and that of a community requires the creation of a code that formalizes guidance for professionals forced to make those decisions. The purpose of developing these guidelines is to provide guidance to people engaged in dental public health activities, assist in the education of public health students who are new to the profession, and provide an institutional memory when faced with challenges.

Codes of ethics identify the principles that underlie professional behavior. They guide individual professionals and serve as evidence that a professional discipline is worthy of the public's trust. Codes of ethics are beliefs. Standards of professional conduct represent behavior guided by such beliefs. Professional conduct describes actions that are good and right for the community and civilization, performed without regard to concerns for personal benefit.

The American Association of Public Health Dentistry (AAPHD) includes members who voluntarily agree to uphold, abide by, and promote the AAPHD Code of Ethics and Standards of Professional Conduct This code of ethics is aspirational, and not a legal instrument. The AAPHD Code of Ethics describes principles and beliefs inherent to the practice of a professional dedicated to improving the health of a community, thereby expanding and clarifying issues not defined in a code where the scope of practice is treatment of an individual patient.

II. Preamble

The American Association of Public Health Dentistry, directly and through its individual members, is committed to improving the oral health and general well-being of the public based on principles of public health. Association goals, strategies, policies, and services are founded in its Code of Ethics and Standards of Practice. The association strives to ensure that members are dedicated to excellence in the science, art, and practice of dental public health.

Principle 1: Autonomy ( "Self-governance")

The dental public health professional has a duty to respect the rights of individuals and the organizations by which they collectively govern and express themselves.

STANDARD OF PROFESSIONAL CONDUCT

A. RIGHT TO KNOW: Dental public health professionals have the responsibility to inform individuals and community organizations about the adverse conditions or problems known, issues involved, options available for correcting oral health problems and inequities, recommended courses of action, and the rationale for and possible side-effects of the recommendations.
B. LEADERSHIP: Dental public health professionals have the responsibility to seek out and respect the views of individual and community organizations and to facilitate health care decisions and support the course of action selected. Individuals and organizations have the right to access information supporting these policies and actions.
C. CONFIDENTIALITY: It is the responsibility of the dental public health professional to ensure that patient re-cords in public programs do not breach individual patient confidentiality. Administrative information beyond that essential to patient care should be limited to group data.
D. DIGNITY: The dental public health professional must be sensitive to and respect individual and community customs, beliefs and other cultural variations.

Principle 2: Nonmaleficence ("Do No Harm")

The dental public health professional has a duty to protect individuals from physical, mental, and social injury.

STANDARD OF PROFESSIONAL CONDUCT

A. COMPETENCE: The dental public health professional has a duty to engage in professional life-long learning and skills development. The professional has a responsibility to keep abreast of developments in the scientific literature and professional discourse on professional and scientific issues. The professional has a duty to promote the application of scientific knowledge in his or her practice.
B. REFERRAL: The dental public health professional has a duty to recognize the limits of his or her abilities, and to seek consultation and/or refer individuals and organizational representatives to more competent authority. When referral is indicated, the dental public health professional is responsible for ensuring follow-up.
C. SCOPE: Individual and community services must be provided in a socially responsible manner. The dental public health professional must respect the reputation of each individual, organization, and community.
D. RESOURCES: Dental public health professional services must be performed with respect for the value of the services received, and conservation of individual, private, and public resources.
E. PERSONAL IMPAIRMENT: It is unethical for a dental public health professional to practice when one's judgment or skill may be impaired for any reason.

Principle 3: Beneficence ("Do Good")

The dental public health professional has a duty to understand and promote individual and community health and welfare.

STANDARD OF PROFESSIONAL CONDUCT

A. CLINICAL CARE: Clinicians are committed to helping patients who need or request health services. Resources are often a compromising factor, particularly in public programs. The dental public health professional must provide the best care possible, but with the constraint that care should be equitable-i.e., the best possible care that helps the largest number of people for the longest period of time.
B. COMMUNITY PRACTICE: The dental public health professional has a duty to promote policies that improve oral health service resources.
C. PRIMARY CARE: The dental public health professional must cultivate independent responsibility for oral health and general well-being by individuals and communities.

Principle 4: Justice ("Fairness")

The dental public health professional has a duty to treat individuals and community organizations fairly.

STANDARD OF PROFESSIONAL CONDUCT
A. DISCRIMINATION: The dental public health professional must not discriminate against any individual or group on the basis of race, creed, color, gender, national origin, sexual orientation, age, and other personal characteristics.
B. COMMUNITY PRACTICE: The dental public health professional has a duty to promote policies that ensure the equitable distribution of available resources.
C. COMMUNITY POLICY: The dental public health professional has a duty to ensure that spokespersons for the public or segments of the public under consideration are included in the public policy development process and, to the extent possible, in the administration of programs on behalf of such groups.

Principle 5: Veracity ("Truthfulness")

The dental public health professional must be honest and not misleading in all communications.

STANDARD OF PROFESSIONAL CONDUCT

A. REFERENCES: The dental public health professional respects copyrights and responsibly attributes original ideas.
B. RELIABILITY: The dental public health professional abides by his or her written and verbal direct and implied agreements.
C. CONFLICT OF INTEREST: The dental public health professional does not engage in activity in which there is a conflict of interest or where there is a potential for, or appearance of, conflict of interest
E. DEGREES: The dental public health professional refrains from using unearned and nonprofessionally related degrees.

Principle 6: Professionalism ("Collegiality")

The dental public health professional has a duty to ensure the development of the science, art, and practice of dental public health among colleagues; to recruit, educate, and train future dental public health professionals; and to promote dental public health understanding and practices by the public.

STANDARD OF PROFESSIONAL CONDUCT

A. ADVANCEMENT OF KNOWLEDGE: The dental public health professional should contribute to the scientific literature, participate in professional and community meetings, and to otherwise share his or her knowledge and skills with colleagues and the public.
B. MENTORING: The dental public health professional has a duty to promote the development of those who possess less experience and/or skills.
C. SERVICE: The dental public health professional has a duty to promote this code in all his or her social and community endeavors.
D. MISCONDUCT: The dental public health professional has an obligation to protect the public, to lead by example, and to advise colleagues who may not be abiding by this code.

Back to top