Department of Dental Education, College of Dentistry, Yonsei University, Seoul, Republic of Korea.
Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Republic of Korea.
Community Dent Health. 2022 May 27;39(2):131-136. doi: 10.1922/CDH_IADR22Junhewk06.
The established method of understanding power in dentistry is based on the early Foucauldian discourse that dentistry enforces oral health discipline to the people on behalf of state power. This exhibits the hierarchy between dentists and patients, which clearly appears in clinical dentistry and effectively explains the responsibility of oral care assigned to patients. However, there presents no way to becoming free from the framework in the discourse as a resistance. Beyond the political aspect of the medico-sociological framework, this paper seeks a different way to understand power in dentistry through 'care of the self', a late Foucauldian concept. First, based on the current discussion of the dentist-patient relationship (DPR), the paper examines two trends of clinical dental treatments in South Korea. The high prevalence of dental implant and orthognathic surgery indicates that traditional prejudices including ableism and pursuit of Western beauty still remain in South Korea albeit with the society overcoming paternalism in DPRs. These dental phenomena, however, contain excesses that cannot be explained only by traditional prejudice, and this paper attempts to interpret them as the pursuit of care of the self that appears in the dentist's professionalism and the patient's self-determination. In dentistry, care of the self can be introduced in the form of empowerment, which is implemented through the improvement of oral health literacy and shared decision-making. This paper argues that this interpretation helps surmount the traditional dyadic model of the DPR and revise the understanding of power in dentistry.
现有的牙科权力理解方法基于早期福柯式论述，即牙科代表国家权力，向民众执行口腔健康规范。这体现了牙医与患者之间的等级关系，这在临床牙科中表现得尤为明显，并有效地解释了患者所承担的口腔保健责任。然而，作为一种抵抗，这种论述框架中并没有摆脱权力的方法。除了医学社会学框架的政治方面，本文试图通过福柯后期的“自我关怀”概念，从另一个角度理解牙科中的权力问题。首先，本文基于当前对牙医-患者关系（DPR）的讨论，考察了韩国两种临床牙科治疗趋势。种植牙和正颌手术的高流行率表明，尽管社会已经克服了 DPR 中的家长式作风，但包括残疾歧视和对西方美的追求在内的传统偏见在韩国仍然存在。然而，这些牙科现象并不能仅用传统偏见来解释，本文试图将其解释为牙医的专业性和患者的自我决定所表现出来的自我关怀的追求。在牙科中，自我关怀可以通过增强权能的形式引入，这是通过提高口腔健康素养和共同决策来实现的。本文认为，这种解释有助于克服 DPR 的传统二元模式，并修正对牙科权力的理解。
