Oral separation of “cosmetic dentistry”, is it to go to a specialist or to divide the cake?

Cosmetic Dentistry is a secondary medical subject under the Department of Medical Aesthetics.

Writing | Wan Shunshun

Source | “Medical Community” Public Account

On August 10, the Chinese Stomatological Association and the China Association of Aesthetic Plastic Surgery jointly issued the group standard of “Oral Medical Aesthetic Service Specification” (hereinafter referred to as “group standard”).

“Oral medical project is called medical project! It can never be called beauty, it is said to standardize medical beauty, between the lines, the name of oral medical treatment is indeed a nest of magpies! Wanting to subtly change everyone’s understanding is just as vicious as a poisonous textbook.”

In the forwarding area of ​​the Chinese Stomatological Association, this document that regulates the behavior of oral medical beauty services has caused collective doubts among dentists.

Dentist Chen Yulin (pseudonym) told the “medical community” that the medical association has a good direction and wants to regulate the practitioners of oral medical beauty services. At the beginning of this year, the “Draft for Comments” Part 6 “Qualifications of Dental Aesthetics Practitioners” clearly stipulated that “Practicers must have the qualifications of dental practitioners”, and the content of the official release was changed to “By the Qualified Health Technician Expand”. How to determine the qualifications is what most dentists care about.

“Oral Medical Cosmetic Service Standard” group standard

Professor Hou Benxiang, director of the Department of Dentistry and Endodontics of Beijing Stomatological Hospital and document reviewer, forwarded the original blog saying that there will be further expert interpretation.

“The setting of cosmetic dentistry comes from the Ministry of Health (Health and Health Commission), not any association or society. The health administrative departments in various places should manage stomatologists according to this.” Hou Benxiang explained that the aesthetic dentistry department The setting is not the will of the dentist.

What is cosmetic dentistry?

In order to manage the chaos in medical cosmetology, the former Ministry of Health issued the “Administrative Measures for Medical Cosmetology Services” in 2002, in which the medical cosmetology department is subdivided into cosmetic surgery, cosmetic dentistry, cosmetic dermatology and cosmetology Chinese Medicine.

Cosmetic Dentistry is a secondary treatment subject under the Department of Medical Aesthetics.

The Chinese Association of Plastic and Cosmetic Surgery, which jointly publishes group standards with the Chinese Stomatological Association, is not a “pheasant institution.” Under the organization and leadership of the National Health Commission, it completed the revision of the “Administrative Measures for Medical Aesthetic Services” and the formulation of the 2020 “Medical Aesthetic Attending Physician Filing Training Outline”.

Chairman of Oral Plastic and Cosmetic Branch of China Plastic and Cosmetic Association, Vice President of Chinese Stomatological Association, and Director of Stomatology Center of PLA General Hospital, Professor Liu Hongchen.

Chen Yulin said that the medical cosmetology attending physician was initially promoted by Professor Liu Hongchen, and the requirements were relatively high. Stomatologists need to have the qualifications of practicing physicians, have more than 5 years of clinical experience in cosmetic dentistry or stomatology, and need to specialize in medical cosmetic clinical institutions before they can issue a medical cosmetic attending physician qualification certificate.

What is the relationship between a medical aesthetic attending physician and a dental practitioner? Liu Hongchen said in an interview with China Medical Tribune that if a dental practitioner is equivalent to a general practitioner, the attending physician in medical cosmetology is equivalent to a specialist in medical cosmetology.

At present, the medical beauty attending physician has changed from the examination and certification to the filing system, that is, after training, it will go to the local health administrative department for filing.

“The oral market is too big, and there are always people who want to come over and get a piece of the pie.” Chen Yulin worried that the establishment of other qualifications in addition to the stomatologist’s qualification certificate will lead to the situation of catching fish in troubled waters. In his circle of friends, a certain video account sells all kinds of certificates such as dentists, oral radiologists, third-level prosthodontics, and dental implantists. The copy said, “You can get a job with a certificate, no exams are required, and the certificate will be issued in about a month.”

Clinical dentists should study at a professional college for at least 5 years. If they participate in standardized training, or pursue a postgraduate or doctoral degree, they need 8-10 years of professional study. After a long training period, doctors who have obtained the qualification certificate of a practicing doctor engaged in cosmetic dentistry projects, but may be punished for exceeding the scope of practice.

Dentist fined for cosmetic charges

This year, the Shenzhen health supervision department issued a fine of 70,000 yuan and 5,000 yuan to a private dental clinic and a dental practitioner, respectively, because the clinic doctor carried out dental porcelain veneers for customers. Serve.

The punishment is based on the “Notice of Guangdong Provincial Health and Health Commission on Further Strengthening the Management of Medical Cosmetology” issued in 2020. The attending physician responsible for the implementation of medical cosmetology projects not only needs to have a practicing doctor qualification certificate, “Medical Aesthetic Attending Physician Qualification” is also required.

In addition, the Supplementary Provisions of the “Administrative Measures for Medical Beauty Services” mentioned that surgery, stomatology, ophthalmology, dermatology, traditional Chinese medicine and other related clinical disciplines are during the treatment of diseases involvesThe related medical cosmetic activities are not subject to adjustment by these Measures.

Therefore, the controversy lies in whether porcelain veneer belongs to disease treatment or medical beauty? In the textbook of Prosthodontics, tooth defects clearly include veneer restoration.

Chen Yulin revealed that the word “beauty” has been added to the porcelain veneer project of the dental institution. If it is a repair veneer, there is no problem at all. “There’s not much difference between the two, it’s just a play on words.”

There is no clear boundary between aesthetics and functionality in oral medicine. “Clinically emphasizes that the restoration of anterior teeth is for aesthetics, and the restoration of posterior teeth is for function. The anterior teeth are equivalent to cosmetic surgery for patients. Are people who do not have a cosmetology doctor in violation of the law? Because this is a cosmetic procedure, and the dentist cannot move.” Chen Yulin felt puzzled.

In order to avoid the incident of “beauty restoration and veneer”, the Guangdong Private Dental Association recommends that: in practice, strictly implement the medical routine of the dental department, and the name of the charging item should be the item name stipulated by the state, and no other Give it a name, and don’t make a random ad for the so-called “Cosmetic Dentistry”.

In the industry standard formulated this time, there are 9 items of oral medical cosmetic services: medical cosmetic for tooth color change, medical cosmetic for tooth shape modification, dental cosmetic cosmetic, cosmetic cosmetic for tooth defect Restoration, periodontal medical cosmetology, cosmetic restoration of dentition defects and deletions, cosmetic correction of malocclusion, oral and maxillofacial plastic surgery, oral and maxillofacial plastic surgery.

The common items in dental treatment such as implantation, restoration, orthodontics, etc., plus the word “beauty”, are classified as “oral medical beauty items”, which also makes dentists question the “dove” of beauty. Occupy the magpie’s nest”.

Regulate industry behavior, or share the cake?

“The most frightening thing is that there is a group of people who don’t need to participate in regular training, do not need to take the examination of practicing doctors, or even need to learn 5 years of oral surgery. They only need to participate in training in cosmetic and plastic institutions, After the certificate is issued, you can do cosmetic dentistry, but the dentist can’t do anything for 8 years.” Chen Yulin said.

If “Cosmetic Dentistry” puts shackles on dental practitioners, will it bring commercialization risks due to its focus on “beauty”? Ignore the treatment of diseases, the attention to the function of teeth, and the most basic “medical treatment”?

Earlier, the All-China Federation of Industry and Commerce Beauty and Cosmetics Chamber of Commerce, China Hair and Beauty, etc. successively established professional dental committees, under the banner of standardized training of dental practitioners, to quickly cultivate non-stomatology professionals A licensed esthetician. In response, the Chinese Stomatological Association issued the “Statement on Resolutely Resisting the Chaos in the Commercialization of Oral Medicine”, the statement reads:

In addition to people’s oral health behavior such as brushing their teeth, any treatment of teeth must be based on biomedicine and implemented in qualified medical institutions, and the treatment of teeth belongs to oral medical care There is no so-called “non-medical dental aesthetics” concept, nor can it be classified as cosmetics. Any invasive operation on the teeth by any person without a qualified dentist will irreversibly damage the teeth and oral softness. The structure of hard tissue affects oral health and even general health.

In the industry standard issued by the Chinese Stomatological Association this time, “practitioners must have the qualifications of dental practitioners” was deleted and replaced with “must be qualified by qualified medical institutions in medical institutions with corresponding qualifications.” Health technicians carry out the procedure and go through the filing procedures in accordance with the regulations”, leaving room for interpretation, which makes the dentist feel angry.

Chen Yulin has reservations about the industry standards jointly issued by the two associations, “We need to wait and see, and wait for the detailed interpretation of the oral medical service cosmetic specification by experts, and it is not yet determined when it will be released. Does it belong to practitioners who have a professional dental practitioner qualification certificate or an assistant practitioner qualification certificate?”

This industry standard will be implemented on September 1st of this year. Some dentists have also noticed that according to the “Group Standards Management Regulations”, team standards are adopted by group members or voluntarily adopted by the society, and are not mandatory.

However, Article 28 states, “If the implementation of group standards is effective and meets the requirements of national standards, industry standards or local standards, the group standard issuing agency may apply for conversion into national standards, Industry or local standards.”

Chen Yulin revealed, “After the industry standard is formulated, it will provide reference for the health and health commissions in various places. It is still unknown how the health supervision institutes under the health and health commission will understand and implement it.”


Source: Medicine

Editor in charge: Yan Xiaoliu

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