Orlando Monteiro da Silva

The red lines, the limits of negotiation and the possible compromises in the profession result from the regulatory framework determined by the Statute and Code of Ethics of the Portuguese Dental Association and other applicable regulations.

The ability to negotiate effectively is crucial for dentists, particularly in an era of rapid technological change and rising patient expectations.

William Ury, a negotiation expert from Harvard, highlights the importance of each of us assuming ourselves to be a “possibilist” – someone who sees conflicts not as insurmountable barriers, but as opportunities for creative solutions.

Ury suggests that the first step in any successful negotiation is to influence yourself, adopting a broader and more distanced perspective, avoiding impulsive reactions. This is particularly relevant for dentists, who must manage patient expectations while defending clinical practices and procedure proposals on an ethically sustainable basis.

Ury also emphasizes the importance of building a “golden bridge” in negotiations, which is a way of facilitating conflict resolution by making the other party see an honourable and mutually beneficial way out. In the context of dentistry, this can mean finding ways to align patients’ interests with clinically appropriate and economically viable practices.

Negotiation and compromise in dentistry should therefore be seen as essential components for a professional practice that not only responds to patients’ immediate needs, but also contributes to a fairer, more balanced, and resilient health system.

Adopting a possibilist approach, as described by Ury, can help dentists navigate contemporary challenges and foster a constructive dialog with patients and other stakeholders.

For a proper negotiation, information is crucial. Information about the party or parties with whom we are negotiating and information about the red lines we can walk.

These red lines, these limits to negotiation and possible compromises in the profession, are the result of the regulatory framework determined by the Statute and Code of Ethics of the Portuguese Dental Association and other applicable regulations.

In Portugal’s current context, where liberal professions and professional associations are fundamental pillars for the harmonious development of society, dentistry is no exception.

Regulation and supervision of professional practice are essential to maintain high ethical and technical standards, and it is crucial that dentists are committed not only to the quality of service, but also to the well-being of society.

The diversity of profiles and skills in dentistry will continue to require attentive and adaptive regulation that can continue to respond to the emerging needs of a changing market. In Portugal, professional associations, including the Portuguese Dental Association, play a crucial role in mediating conflicts and ensuring that patients’ complaints and needs are met effectively. This responsibility increases the importance of the commitment to moderation and the search for balanced and innovative solutions that respect the fundamental principles of the profession.

The challenges are amplified by the polarization and radicalization present in the public debate, where extremist views can negatively influence the quality of the
services provided. It is imperative that dental professionals reaffirm their commitment to constructive dialogue and moderation.

Regulation geared towards measurable results and the promotion of good practices is fundamental.

Professional associations must adapt to technological and social changes, such as artificial intelligence and the digital transition in general, to continue to guarantee excellence in their professionals’ services.

Ultimately, the renewed commitment of professional associations and liberal professionals to society must reflect a balance between professional autonomy and social responsibility, promoting not only the quality of services, but also the well-being of dentists in society.

Through this commitment, Portugal can ensure the growth and appreciation of its liberal professions, guaranteeing a prosperous and competitive future for dentistry in the country.

In Portugal, the dental profession, like other liberal professions, faces the ongoing challenge of balancing high-quality service with social and ethical expectations.

Regulation and professional supervision, which are essential for maintaining these standards, must be understood not just as bureaucratic measures, but as part of a broader commitment to excellence and innovation.

The active representation of dentists in their professional association and the fair defence of their interests at national and European level are essential to ensure that their voices are heard and that their contributions to health and the economy are recognized and valued.

You can read the full article, in Portuguese or English, in the Portuguese monthly edition of Dentistry magazine:

Open the English version of the article (pdf).

Open the Portuguese version of the article (pdf).

Through the acronym of three words – Portugal, Oral, All – I intend to address the pertinence of oral health in my country, Portugal, and at a global level, being more inclusive of all the professions that make it up.

Specifically, I’m referring to dentists, leaders, oral hygienists, and dental technicians: for different reasons, and in different contexts, these are the jobs that work most closely in the oral health team.

My vast international experience at the helm of the FDI – World Dental Federation, CED – Council of European Dentists and FEDCAR- Federation of Dental Competent Authorities and Regulators makes me confident that this path should be taken further by the main global organizations representing dentistry.

Preface: the growing scientific evidence of the intrinsic relationship between oral and systemic health has caused global health organizations, academia, health professions, regulators, professional organizations, and society in general to reflect.

Patients and their organizations, as well as insurers and public and private funding systems, have taken this integrated approach to oral health into account. Nothing could be more right and proper.

Involving family doctors in the context of the desirable inclusion of oral health in primary health care, in a universal coverage approach, with their collaboration:

• nutritionists, given the widespread sharing and relationship between nutrition and oral health,
• psychologists, now that everyone is aware of the impact and relationship of oral health on mental health and vice versa. In the latter case, it would be enough to take into account the impact of addictions to various substances on oral health;
• also in terms of temporomandibular joint pathology, TMJ, bruxism and occlusal problems and their relationship with physiotherapy, sleep medicine and neurology.

And other collaborations could be identified with nurses, pediatricians, speech therapists, etc. examples of this relationship between oral and systemic health in various areas of health.

But with so much looking around, we’re perhaps forgetting to look inwards, at the oral health team with whom we work every day.

Note that the “Global Report on the State of Oral Health: Towards Universal Health Coverage for Oral Health by 2030” presents a comprehensive overview of the challenges and opportunities in the field of oral health globally.

The World Health Organization (WHO) highlights that oral diseases are among the most common non-communicable diseases, affecting approximately 3.5 billion people worldwide.

These diseases are, as an obvious result, dental caries, and periodontal disease, which are largely preventable through educational, preventive, and clinical interventions, along with approaches to combat risks common to all chronic diseases.

The report points to the need to include oral health services in publicly funded national health coverage services, accessible free of charge or at a cost that people can afford.

In addition, it describes the main determinants and risk factors of oral diseases, including sugar consumption, tobacco use and excessive alcohol consumption.

This approach highlights the fact that chronic diseases and some pathologies of the oral cavity share a set of risk factors that can be conditioned or altered.

Oral hygienists, who are true experts in prevention, play an essential role in the prophylactic and educational approach and in oral health literacy.

On the other hand, in the rehabilitation of edentulism and tooth loss, the device developed by Dental Prosthesis Technicians (DPT) is crucial.

As such, while not being exhaustive, because these senior health technicians, OH and DPT, are broader in their professional scope than described collaboration and dialog between dentistry and these oral health jobs is fundamental.

It would be highly advisable to establish permanent contact platforms between these different professional profiles, for the sake of patients and users.

True alliances for oral health.

In conclusion:

Yes, it is essential to look at interprofessional collaboration with other areas of health. It certainly is. But we can’t leave behind dialog and interaction with those who work with us every day to prevent, treat and rehabilitate diseases of the oral cavity.

The major international and national organizations that represent and regulate oral health must include the medicine of oral hygienists and dental technicians with dental medicine.

In the name of excellent interdisciplinary oral health: PortugOralL.

You can read the full article, in Portuguese or English, in the Portuguese monthly edition of Dentistry magazine:

Open the English version of the article (pdf).

Open the Portuguese version of the article (pdf).