Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Aug;51(4):609-614.
doi: 10.1111/cdoe.12854. Epub 2023 Mar 26.

Centring anti-oppressive justice: Re-envisioning dentistry's social contract

Affiliations
Review

Centring anti-oppressive justice: Re-envisioning dentistry's social contract

Eleanor Fleming et al. Community Dent Oral Epidemiol. 2023 Aug.

Abstract

Objectives: We re-envision dentistry's social contract and elaborate on the idea that it is not neutral and free from such things as racism and white supremacy and can act as a tool of oppression.

Methods: We critique social contract theory through examination of classical and contemporary contract theorists. More specifically, our analysis draws from the work of Charles W. Mills, a philosopher of race and liberalism, as well as the theoretical and praxis framework of intersectionality.

Results: Social contract theory supports hierarchies and inequities that may be used to sustain unfair and unjust differences in oral health between social groups. When dentistry's social contract becomes a tool of oppression, its practice does not promote health equity but reinforces damaging social norms.

Conclusion: Dentistry must embrace an anti-oppression framing of equity and elevate the principle of justice to one of liberation and not just fairness. In doing so, the profession can better understand itself, act more equitably and empower practitioners to advocate for justice in health and healthcare in its fullest sense. Anti-oppressive justice supports health not as merely an obligation but as a human duty.

Keywords: dentistry; intersectionality; justice; professionalism; social contract; theory.

PubMed Disclaimer

References

REFERENCES

    1. Cruess SR, Cruess RL. Professionalism and medicine's social contract with society. Virtual Mentor. 2004;6(4):virtualmentor.2004.6.4.msoc1-0404.
    1. Cruess RL, Cruess SR. Professionalism, communities of practice, and Medicine's social contract. J Am Board Fam Med. 2020;33(Suppl):S50-S56.
    1. Raskin SE, Diep VK, Chung-Bridges K, Heaton LJ, Frantsve-Hawley J. Dental safety net providers' experiences with service delivery during the first year of COVID-19 should inform dental pandemic preparedness. J Am Dent Assoc. 2022;153(6):521-531.
    1. Centers for Disease Control and Prevention. Oral Health Surveillance Report: Trends in Dental Caries and Sealants, Tooth Retention, and Edentulism, United States, 1999-2004 to 2011-2016. Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2019.
    1. Cost Barriers to Dental Care Among the U.S. Population, by Race and Ethnicity. HPIgraphic 0421. American Dental Association, ADA Health Policy Institute; 2021.

LinkOut - more resources