WHAT constitutes good dental practice? Such qualitative questions about dentistry are often asked. But who decides whether a practitioner is performing well? Who lays down the guidelines? Who takes action to rectify an unacceptable level of dental care? These questions and many more are rightly asked within the profession among colleagues and, increasingly today, by the public—our patients.

What constitutes good dental care has been chiefly a prerogative of the dental profession. However, concentrating on the technical aspects of need, such as levels of dental technology, precludes giving sufficient attention to the attitudes and behaviour of patients, and any assessment of need should include their perceptions.

Aspects of good dental care that would be identified and proposed by patients may not necessarily be the same as those proposed by the dentist. Major differences in emphasis on the concept of quality have been identified between the perspectives expressed by the providers and users of health services.

Whilst professional emphasis is on technical skills and freedom in prescribing care, patients place emphasis on responsiveness and politeness from the dentist, along with relief from symptoms or improvement in oral function.

A survey was conducted to assess patients’ evaluation of the criteria for good dental practice proposed by both patients and dentists. The criteria originated from patients were: the dentist’s skills, a caring dentist, sterilisation/hygiene, understanding with children, explanation of procedures, a good appointment system, and the dentist’s qualification.

The criteria originated by dentists were: pleasant décor and surroundings, friendly staff, pain-free dentistry, cost, being seen in an emergency, up-to-date equipment, and good practice image.

A total of 344 patients were evaluated using 14 criteria for good dental practice. Questionnaires containing the seven pairs of criteria, randomly assigned by a computer, were prepared, with each pair comprising one patient and one dentist criterion. Patients were asked to indicate their preference. The number of times each criterion was preferred was scored and ranked.

The three highest-ranked criteria were the explanation of procedures, sterilisation/hygiene, and the dentist’s skills (all criteria proposed by patients), while the three lowest-ranked criteria were up-to-date equipment, pleasant décor and surroundings, and a good practice image (all criteria proposed by dentists).

Many factors influence whether an individual is satisfied with the dental care they receive. Among those identified have been the technical competence of the dentist, the characteristics of the practice, the cost of treatment, the attitude of the receptionist, and the practice’s cross-infection control procedures.

Additionally, levels of patient satisfaction have been shown to influence rates of use of medical services and levels of compliance with advice. If the dentist meets a patient’s expectation of good dental practice, then they will be more satisfied.

Finally, I challenge the Consumer Associations to explore the option of systematic collection of consumer feedback, which would give dentists a clearer idea of what their patients want, and to encourage public discussion on this topic. In this way, we can all play a part in improving the practice of dentistry in Guyana.