INTRODUCTION
Humans and
medicine can not be separated from everyday life.
This is because medicine is closely linked to health and sickness. Doctors are
partners in social health whose aim is to preserve human health and restore
human health. A doctor's essential position includes schooling long enough to
be considered a doctor (Adisasmito, 2007).
Medical
education with the fastest period of education of 5 to 6.5 years should be
carried out. Medical students will study many medical books, conduct
discussions, conduct operations, review journals, anatomy, physiology, disease,
patient practice (OSCE), and so on in the first 4-4.5 years until they get S.
Ked (Azizah, n.d.).
After the
graduate, however, medical graduates were not permitted to practice medicine.
1-1.5 years of hospital education is required. They are called co-assistants
for students who graduate from medicine. All knowledge is directly applied at
this time, until graduation and getting the title of Dr. or Doctor. The doctor
will conduct the service period after holding the title and account for the
title he has. The average program for this specialization lasts about 4-5 years
if they want to continue with specialist programs or deal with only one area of
disease. The important role of doctors has caused many to want to enter the
medical world (Pengertian
Ilmu Kedokteran dan Lika-Liku Kuliah di Jurusan Ini, n.d.).
Being a
doctor also has risks, one of which is malpractice, not infrequently. Malpractice
is an act of professional negligence by a health care provider that causes the
treatment provided to not conform to standard operating procedures, causing
worsening medical conditions or even death (Dananjaya, Sutama, & Priyanto, 2018).
Post-cesarean section infections that cause the stomach of a patient to be
pierced, mismanagement of labour that causes the baby
to experience a broken neck and peeling skin, blindness after an appendectomy,
incorrect medication, blindness after birth, near loss of vital organs due to
laser circumcision, and many more are some examples of terrible cases of
malpractice. This has resulted in many individuals issuing opinions about
perpetrators of malpractice who should be sued and convicted (Etika, 2007).
In
dentistry, this can also occur. The dentist is a doctor with special oral
health expertise. Dentistry is not only limited to teeth and mouth, but dental
implants, abnormalities in the oral cavity, cleft lip disorders, tumors and
cysts in the oral cavity or jaw, repair of the jawbone, and esthetic procedures
are also treated by oral surgeons (SpBM).
There are
also a number of other dentistry specialists, including Orthodontics Specialist
(SpOrt), Periodontist Specialist (SpPerio),
Dental Conservation Specialist (SpKG), Pediatric
Dentistry Specialist (SpKGA), Oral Disease Specialist
(SpPM) and Dentist Specialist (SpRKG).
Cavities, gum disease, oral cancer, sensitive teeth, and many more are diseases
which dentists can handle. One important thing is to monitor the dentist. This
is because the teeth and mouth are the primary organs that receive food and
drink sources, so there are many opportunities for disease or abnormalities (Tobing, 2015).
The
importance of this dentist also causes many cases of fraud to occur. One of
them was a dentist who was abusing the rules. Dentists are only allowed to
install loose dentures. Denture artisans generally have no formal education,
only courses that cost around 7 million rupiahs. Based on Article 6 Paragraph
(1) Permenkes 39/2014, the work of prosthetic
dentists can only be carried out if it does not endanger health, does not cause
illness and death, is safe, does not conflict with efforts to improve health
status, and does not conflict with the norms and values that live in society.
The work of prosthetic workers is limited to Article 6 Paragraph (2) Permenkes 39/2014 which only makes partial and/or full
removable dentures made of heat curing acrylic which meets the health
requirements, and installs partial and/or full removable teeth made of heat
curing acrylic without covering the rest of the tooth root (Harahap, 2017).
However, in
the field of dental work, it is not uncommon to make mistakes that cause health
impacts. The practice that was done was not in accordance with the regulations
made; they even put on braces, made permanent dentures, removed teeth, filled
teeth, and even whitened them. In addition, there have been many denture
artisans who practice without a permit and are illegal. Many denture artisans
are not competent but provide services like a dentist, as in the case of
dentists who install loose dentures without removing the residue from the roots
first (Savitri, 2018). This, of
course, will cause abscess or pus. Therefore, the authors are interested in
analyzing cases of denture prosthetic victims in Indonesia in health law (RUSTANDI, 2016).
METODE
This
study uses a qualitative research method by obtaining secondary data from the
internet that is credible and adjusted to the research title. The analysis
technique used is a descriptive qualitative analysis technique, data processing
by looking for an overview of the research data, comparing the data obtained
and looking for the relationship between each data obtained so as to produce
final conclusions about the research carried out.
RESULTS
AND DISCUSSION
There are many cases associated with denture artisans
that occur in Indonesia. For instance, for example, a dentist who performs installation
services for braces, then there is an error causing the tooth to become
infected. A perforated mouth, upward growing teeth, and even the severity of
which causes death are other cases (Tobing, 2015). Article
276(2) states that 'Any person who, for a special or part-time livelihood,
performs a job resembling a doctor or dentist shall be punished with imprisonment
for a maximum of 5 (five) years or a maximum fine of Category V or 500 million.
It is what caused the Union of Dentists to hold a protest against the Criminal
Code Bill that takes into account the criminalization of dentists (SP, 2014).
People prefer to go to a dentist,
even like the above, compared to a dentist who has a special certification, of
course. The community's reasons vary, such as the price factor. Even though the
risk value is sometimes ignored, professional work, and many more, the
dentures' quality is the same. So far, dentists have only been treated by those
who have a high economic status. Many Indonesians, meanwhile, fall into the
lower average or middle to lower classes. Dentists are saying that unscientific
dentists such as dentists have cheated society. However, the reality is that
there are still denture craftsmen who make people satisfied and complain about
nothing. The elimination of dentists also raises many questions because,
because of the factors mentioned above, it is not certain that denture
artisans' removal causes many individuals to turn to dentists, to return.
However, if this continues, there will be even higher prosthetic artisan victims cases, as many do not have permits in Indonesia and
abuse the authority regulated in the Permenkes. The
regulations regarding dental technicians are in the laws and regulations
Article 73 and Article 78 of Law Number 29 of 2004 concerning Medical Practice.
This Law has undergone a revision through a Constitutional Court decision,
which briefly states that dental technicians must be coached, not abolished.
Apart from the Law, regulations regarding other dental artisans can be seen in
the Minister of Health Regulation Number 39 of 2014 concerning Guidance,
Supervision and Licensing, Dental technician jobs. Based on Article 1, number 1
Permenkes 39 of 2014, a dental technician is any
person who has the ability to make and install removable dentures (Lima Penyebab Tarif Perawatan Dokter Gigi
Mahal Halaman all - Kompasiana, n.d.).
Based on the Permenkes,
all dental technicians who carry out dental technician jobs are very obliged to
register with the district or city government or to the district or city health
office to obtain a dental technician license. This rule is in article 2
paragraph (1) Permenkes 39 of 2014. This dental
technician license is given for 2 (two) years but can be extended as long as it
meets the requirements. However, so far, many dental technicians are still
illegal or have not registered themselves with the local government. Even these
individuals confidently opened a dental technician clinic at a low price. Not
only that, even if they broke the rules, there were dental technicians who used
their abilities as doctors (SALIM, 2019).
Based on Article 9 Permenkes 39/2014, it is strictly regulated that dental
technicians are strictly prohibited from doing work that is outside their
authority. Apart from that, dental technicians are also prohibited from
representing their work to other people, carrying out promotions that include
jobs other than those regulated in Article 6 paragraph (2), and carrying out
work on a mobile basis. Even if the dental technician violates these rules, the
dental technician may be subject to administrative sanctions by the district or
city government in the form of a written warning, temporary license revocation,
and permanent license revocation (Tobing,
2015).
However, illegal dental technicians
tend to ignore the rules above and want to reap as much profit as possible.
This stems from the less strict arrangements for enrolling dental technicians.
Therefore, one of the things that can be done is to revolutionize the
arrangement of dental technicians. The government must act decisively and urge
all regional governments to be firmer in granting permits.
The first thing is that if there are
dental technicians who wish to register, they should do a more stringent test
first. The test can be done with written and practical tests. The written exam
contains the authority or knowledge of dental technicians. Then, the most
important thing is to do a practical test. Through this test, the government
can see whether it is feasible or not to be granted a permit. It is written,
and practical test can certainly assess the ability of the dental technician.
With this test, dental technicians who will apply will also be more careful and
think twice about those who are not very good at teeth but want to become
dental technicians.
The second thing is that the
government can provide a letter of agreement in advance regarding dentists'
practice. This letter contains an agreement not to abuse power and is ready to
accept the government's consequences if there is a report. Concerning fines and
penalties can also be stated in this agreement letter. Fines and penalties
given are adjusted to the prevailing laws and regulations. However, this
agreement letter is made more detailed and explained in advance after the
dental technician has successfully passed the written exam and practical exam.
After the permit is granted, the
local government must also continue to control and check the dental
technician's practice. The government must continue to carry out evaluations
through the community around dental technician practices. Matters regarding
this supervision can also be stated in the agreement letter that was stipulated
earlier. With this supervision, of course, the dental technician will feel that
there is supervision and will be more careful in practising.
This supervision is one of the most important ways because many think that after a permit is granted, it can be released
just like that, even though there should still be control and evaluation from
the local government. This supervision can be carried out periodically in
accordance with the decisions of each region. For example, once every three
months, but unknown to the dental technician, this ignorance makes the dental
technician unprepared to show only the good things.
This incompetent ability causes many
victims of dental technicians to experience severe side effects after fitting
their teeth. Even these victims made Instagram accounts of dental technician
victims, which had 113.9k followers and 821 posts. One of the viral posts was
that a 40-year-old woman came to the dentist with complaints that her roots
became increasingly visible after four months of putting braces at a dental
technician. There is a tilt, but an unnatural roll, because it reaches the
gums. It is caused by improper handling. The second severe case was a junior
high school student with braces, but then his cheeks became swollen. The swelling
is very large.
Not only that, but other severe
cases are the palate becomes largely perforated as a result of permanent
denture infection. There are also posts from Instagram victims of dental
technicians whose victims died. A mother who died developed oral cancer after
using dentures from dental technicians. His mouth cancer has already spread,
making it difficult to save. Another victim who died was Sgt. Hartono, a member
of Kodim 13403 South Sulawesi, who died after accidentally
swallowing his dentures.
The victims above should be a reflection of the government because they have caused
serious illness, even casualties. Dental technicians are styled like dentists
who know many things. In fact, it is known that dentists need more than six
years of education to obtain the title of doctor and dental specialist. Of
course, this cannot be compared to a dental technician who has only undergone a
few months of training. The tools used are sometimes not in accordance with the
health standards applied by the government. Dental technicians also tend to
abuse their authority often and do what dentists are supposed to do.
CONCLUSION
Based on the discussion, it can be concluded
that there are many cases of dental technician victims who cause severe
illness, even death. It is because dental technicians are not professional and
often perform tasks outside of their authority. This is certainly not in
accordance with what is stated in the health law in Indonesia. The government
must be strict in enforcing applicable health laws regarding dental
technicians. Another thing that can be done to reduce the risk of dental
technician sacrifice is to certify that person who wants to become a dental
technician profession. All training centres providing
courses on dental technicians must be transformed and revolutionized greatly.
To obtain a dental technician certification, you should not be fake but must
use a strict selection. In providing training, educators must also instil ethics and morals in dental technicians. They are not
easy to do things beyond their authority. Based on the above conclusions, the
authors suggest that the government be able to make the best policies to tackle
the rampant victims of dental technicians in Indonesia.
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