The ethics of a fair and honest treatment plan

An interesting article titled “The ethics of presenting a fair and honest treatment plan,” is written by Marvin Elwood Rice, appearing in JADA, April 2017, vol. 148, issue 4. The article discusses a dentist who has had numerous occasions in which a relative, past patient, or a new patient has called for a second opinion because of what another dentist has shown them on the oral camera screen. These are patients who take care of their teeth and are familiar with their conditions. In each instance, the patient was in a panic because the dentist enlarged his or her teeth on the overhead screen and pointed to a dark developmental groove or a stained pit and tried to convince the patient that they had a cracked tooth and needed a crown or that the stained areas were active carious lesions and they had to be restored.  Once the dentist did the examination, most of the concerns raised by the new dentist were not valid. None of the patients examined needed a crown for a cracked tooth and most of the dark areas were simply stain with no evidence of caries during dental examination.

The article goes into the ethical issues surrounding treating such patients. The article says

“You should explain that there are many different philosophies that dentists have and are entitled to as long as they are honest and looking out for the best interest of the patient. Some may think a deep noncarious lesion needs to be filled to prevent decay at a future appointment and another may say until evidence of decay is present on the radiograph or it has a stick with the explorer, a restoration is not necessary.”

The article goes on to say that some dentists have been known to increase production to increase profits. With such pressure crossing the ethical boundary may occur. Dentists should keep in mind that the benefit of the patient is the primary goal and at the end of the day know that they did the best for themselves and the profession.

The article goes on to say

“We must never use technology or the prospect of financial gain to try and promote work that does not need to be done. Promoting unnecessary treatment would be in violation of [the section that states] “[a] dentist who recommends and performs unethical dental services or procedures is engaged in unethical conduct.”

The article encourages dentists to be fair and honest with their treatment planning to help dentists retain existing patients. This may also help  generate new patients and help promote public trust in the dental profession.

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