Can you afford to smile? The Economic disparities in oral health care provision


  • Leanne Sykes Head of Department of Prosthodontics, University of Pretoria
  • Amelia Cronje Department of Prosthodontics, University of Pretoria
  • Idah Mmutlana Specialist, Department of Prosthodontics, University of Pretoria





Tooth loss can have a negative impact on a patient’s quality of life. However, many patients cannot afford the treatment necessary to restore their dentition optimally. Their final choice may be dictated by what they can afford rather than consideration of the advantages, disadvantages or biological sacrifices associated with proposed options. At the same time, clinicians often express feelings of helplessness and stress when confronted with having to decide on, and provide treatment that is within the patient’s financial means, rather than according to what they deem to be “best practice”. This paper uses a patient case to illustrate how the four-principle approach proposed by Beauchamps and Childress (1983) can be used during treatment planning, and to justify the final decision making process.


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Author Biography

Leanne Sykes, Head of Department of Prosthodontics, University of Pretoria


Gortmaker SL. Medicaid and the health care of children in poverty and near poverty: some successes and failures. Med Care 1981 19: 567-582. 49. DOI:

Grembowski D, Andersen RM, Chen MS. A public health model of the dental care process. Med Care Rev (1989) 46: 439- 496. DOI:

Pack AR. Disease prevention in developing countries. Int Dent J (1998) 48 (supplement l), 239-247 DOI:

Gallagher JE, Colonio-Salazar FB, White S. Supporting dentists' health and wellbeing - workforce assets under stress: a qualitative study in England. Br Dent J (2021) Jul 20;1-12. Accessed online at: doi: 10.1038/s41415- 021-3130-9 DOI:

Beauchamps TL and Childress JF. Principles of Biomedical Ethics. (1983). Oxford University Press; Oxford. New York.

Moodley K and Naidoo S. Ethics and the Dental Team. (2010) Van Schaik Publishers. Pretoria. Pg. 5-42.

Ali Z, Baker SR, Shahrbaf S et al. Oral health-related quality of life after prosthodontic treatment for patients with partial edentulism: a systematic review and metaanalysis. J Prosthet Dent (2019). Vol 121;1; 59-67. DOI:

Yin Z, Yang J, Huang C, Sun H and Wu Y. Eating and communication difficulties as mediators of the relationship between tooth loss and functional disability in middleaged and older adults. J Dent (2020) 96; 103331; 1-6. DOI:




How to Cite

Sykes, L., Cronje, A. ., & Mmutlana, I. . (2022). Can you afford to smile? The Economic disparities in oral health care provision. South African Dental Journal, 77(02), 104–106.

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