Chapter 1 (INTRODUCTION) presents the relationship of oral health to systemic health. Also, it introduces the concept of Europeanization and the development of the European Union as a result of a chain of treaties. Professionalization is discussed, as well as the European Union's legal instruments for professional training and legal recognition.
Chapter 2 (THE FIRST STAGE OF PROFESSIONALIZATION: EDUCATION) focuses on education and training of dental care professionals. It discusses this topic from the perspective of all members of the dental team, which includes dentists, dental hygienists, dually qualified dental hygienists-therapists, dental technicians, clinical dental technicians, and dental assistants/nurses. It also discusses dentists' education in light of European Union policies. In addition, it considers student attitudes and behavior, the learning environment, faculty, curricula, interprofessional training, as well as other programs and teaching methods.
Chapter 3 (DENTAL CARE PROFESSIONALS--REGULATION) deals with professional regulation of dental team members. It sets forth the different types of arrangements used for this purpose. More specifically, it focuses on diverse types of regulatory processes and structures utilized. It discusses governmental units, chamber structures, and the council model. Professional regulation is also related to continuing professional development, codes of ethics, usually one of the last stages of professionalization, and patient empowerment.
Chapter 4 (MEMBER STATES: HEALTHCARE PROVISION) is devoted to the operation of healthcare delivery systems in the Member States. The financing of systems and the provision of services are presented along with the role of secondary health insurance. The purposes for which the latter is used and by whom are described. Systems are financed and operate differently. Oral health care falls short to the chagrin of the Council of European Chief Dental Officers.
Chapter 5 (THE DENTAL SQUAD) discusses the role of the members of the dental team and especially, the transformation of females in dentistry. Teamwork, skill mix, and the importance of human resources planning are underscored. Direct access to some dental care professionals is noted. Also, the chapter points out how unmet oral healthcare needs present problems in several Member States.
Chapter 6 (THE WORKPLACE), for the most part, demonstrates the European Union's control over many facets of the world of work via its policies in many areas, which include advertising, work time, equality, non-discrimination, stipends, waste management, and medicinal products, plus many other sectors. The European Union's efforts in the workplace sector demonstrate interest in the determination of worker safety as well as patient safety and the harmonization of diverse practices.
Chapter 7 (SUBJECTS FOR DISCUSSION IN THE PROFESSIONS). All professional communities usually confront challenges and issues on diverse subjects. In these situations, the professionals, those who are providing services, and policy makers have to determine a solution. In this case, the responsibility falls on the shoulders of the dental team, patients, and decision makers in the European Union and the Member States. Hopefully, the solution will be consensual, but such does not always occur.
Issues that have raised discussion within the dental squad's professions include their role in suspecting or acknowledging patients subject to domestic violence, maltreatment, child abuse, and neglect. Moreover, they have had to consider their role in dealing with patients' lifestyle, physical activity, and use of tobacco and alcohol, all of which impact oral health. Other challenges relate to teeth whitening and use of dental amalgam for treatment purposes. Not all of the solutions to these issues were consensual, but they have remained.
Chapter 7 now includes discussion of climate change and the United Nations Sustainable Development Goals (SDGs). Many of the hazards created by climate change impact oral health and particularly, that of children who are exposed to new diseases and experience a change in their growth and development cycles. Also, it is noteworthy that climate change can affect agriculture and thus, a population's diet and food and herbal medicine availability. Climate change presents opportunity as well as hazards. It is essential to take advantage of any evident opportunity and to assess and mitigate its risks.
Closely related to general and oral health are the UN SDGs with obtaining a more sustainable future for all with nobody left behind. Agreed to in 2015, they consist of 17 ambitious objectives and 169 targets to be accomplished by 2030. Although progress for many Goals has been achieved, a recent United Nations report (2019) raises questions. If the Goals are accomplished, and hopefully they will be, oral health would not be a major problem as it is today. Still, much remains to be done.
Chapter 8 (CONCLUSION) states that the European Union, even though it possesses no formal powers in the healthcare arena, has exerted great influence on it. It has acted in patients' interests as well as in those of providers of oral health care. Also, it has exhibited diverse roles in its activities, ranging from initiator to coordinator. As mentioned throughout this work, its impact on health care, including oral health care, results from activities in other sectors of policy. Therefore, its influence is due to the spillover effect. Activities in one field influence another, in this case, oral health care.
Moreover, diversity penetrates the dental team between the Member States and often within them. In making policies, the EU engages in consultations with the public and appropriate organizations. It has injected transparency into many policies.
For the future, some hope the so-called dental-medical divide will be eliminated with the integration of general and oral health care, and that new members will be added to the dental team that will cross the so-called divide. The Council of European Dentists has developed a profile of the future DCP that will help solve the personnel problem that is on the horizon.
In closure, it is noted that it would behoove all DCPs to inform themselves of the European Union's operations. Policies do not just happen. All DCPs, making an effort, can help design them and they should.
This book discusses dental healthcare professionals in the European Union and EU policy output and activities in the context of Europeanization and its impact on oral health care. Adopting a framework focused on an institution and its policies allows for discussion from the perspective of multiple actors, both national and international. The research is timely and significant because of the momentous changes that have taken and are taking place in healthcare delivery systems and professions in the Member States of the European Union.
In the book, the author constructs a profile of the oral healthcare professions in the Member States; creates an inventory of challenges faced by these professions; illustrates the impact Europeanization and one of its organs, the European Union, have had on oral health care; demonstrates the way in which national traits and institutions exercise a role in the transposition of EU outputs; and catalogues the stages and views of some representatives of the dental team. Topics explored include:
- The First Stage of Professionalization: Education
- Dental Care Professionals: Regulation
- Member States: Healthcare Provision
- The Workplace
- The European Union and the Dental Team
Readers not only learn the fundamentals of oral health professions, their realities, and healthcare delivery, but also become familiar with the political concepts, institutions, and practice related to the field.
The Dental Team in the European Union, having academic and general interest as well as practical value, appeals to diverse audiences. The book is an invaluable resource for researchers and practitioners in the social sciences and the healthcare and dental worlds. It also can be used as required or supplemental reading for students in the healthcare professions, public policy, and political science. Decision-makers at various levels of government and persons affiliated with funding agencies as well as scholarly and professional associations in the United States and abroad also would find this a useful text.
Sondra Z. Koff, PhD, is professor emerita in the Department of Political Science at the State University of New York at Binghamton, New York, USA, with teaching experience in the areas of comparative and healthcare politics at the undergraduate and graduate levels. She has conducted research as a North Atlantic Treaty Organization, Gladys Krieble Delmas Foundation, and Fulbright scholar. Dr. Koff has published in her areas of specialization in the United States and abroad. She also has had practical experience in the healthcare arena with a variety of healthcare boards as a public member at the local, state, regional, and national levels and often in a leadership capacity.