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For patient safety and public trust in dental care it is essential that the patient can trust the person who is providing him with care. It is increasingly common for dental care to be provided by non-dentists. The regulations governing this practice are contained in the Individual Healthcare Professions Act. A recent evaluation of this legislation revealed that those affected are not generally aware of the conditions under which non-dentists are permitted to carry out tasks in dental care or that they are unsure how these requirements have to be put into practice. It is a matter of concern that this knowledge, by comparison with a previous study, has hardly increased and in some cases has actually decreased.

Judges up to and including the Law Lords (Supreme Court) and the Central Disciplinary Tribunal for Healthcare in the Netherlands do not consider guidelines to be optional. This offers security to patients and dental care professionals. But a field of tension can exist between, on the one hand, a patient's right of self-determination and the dental care workers professional autonomy and, on the other, a guideline. This field of tension can be resolved by first limited testing of the acceptability of the goal of care desired by the patient, taking into consideration at the same time professional autonomy; and, subsequently, by selecting the most effective treatment for achieving this goal of care on the basis of 'evidence'. With respect to the current definition of guidelines for clinical practice, this means that patients and healthcare workers explicitly acknowledge that they have been able to agree on a goal of care that deviates from the ideal. In this way, a judicially responsible balance is achieved between the right of self-determination and professional autonomy, on the one hand, and, on the other, the desire for evidence-based treatment and a limitation on unaccountable variation in treatment and transparency of care.

Each generation likes to see itself as unique and thinks that the conditions under which people live and work are also unique. This position does not, for the most part, apply to dentists. Two questions which are now under discussion were also under discussion in the past. In the first case, this has to do with whether dentistry should be seen especially as a profession in which skill and competence are central, or as a medical discipline in which science (too) is central. The second question which was posed in the past as it is now is whether the dentist is seen especially as a salesman, albeit as a healthcare provider. Both questions are of the greatest significance for the image of dentists and also perhaps indirectly for the future of the professional group. Indeed, the answer to these questions has determined in the past as well as now the image of dentists and the degree to which the government has believed that dentists could be replaced by less highly educated non-dentists. For that reason, a clear answer to these questions ought to be formulated. It is possible that the answers given to these same questions in the past will be helpful in formulating answers now.

When faced with the question whether a particular treatment is indicated, dentists have to ask themselves to what extent it fits within a health care goal. If it does not, then the indication is usually rejected because it is in conflict with professional standards. Dentists who nevertheless consider such an indication have to bear the responsibility to make clear to the patient not only the general risks of a certain treatment but also the additional risks associated with the hazardous indication.Bij de vraag of een bepaalde behandeling is geïndiceerd moeten tandartsen zich afvragen in hoeverre de behandeling past binnen een zorgdoel. Is dit niet het geval, dan wordt de indicatie doorgaans afgewezen omdat deze in strijd is met de professionele standaard. Op tandartsen die een dergelijke indicatie toch overwegen, rust de plicht de patiënt niet alleen op algemene risico’s van een bepaalde behandeling te wijzen, maar ook op de extra risico’s in verband met de risicovolle indicatie.

Oral healthcare is to an ever-larger extent delivered by a team or network. Members of such a network often seem to be unsure about the rules that govern the distribution of tasks. The Individual Healthcare Professions Act (Dutch: Wet BIG) in which this distribution is defined, makes use of very specific terms. Clarity concerning these terms is a prerequisite to be able to reflect, in a subsequent contribution, on the realisation of the prerequisites that are applicable to working in a team or network.Steeds vaker wordt mondzorg binnen een team of een netwerk geleverd. Leden van een dergelijk netwerk blijken vaak onzeker over de regels die gelden voor de verdeling van taken. De Wet op de beroepen in de individuele gezondheidszorg waarin deze verdeling is geregeld, gebruikt heel specifieke termen. Duidelijkheid over deze termen is een voorwaarde om in een latere bijdrage te kunnen reflecteren op het operationaliseren van de voorwaarden die gelden voor werken in een team of een netwerk.