Dr Jenson, you and I definitely agree—sometimes we should just say no. However, neither of us has the right to make that statement as a blanket policy for every dentist and every patient. Each case must be considered individually. And, more importantly, to make those decisions while ignoring our patients’ views is the epitome of arrogance.
Treatment decisions and communication are two-way streets, and, as I indicated, communication is the key. It is our responsibility not only to communicate with, but also to educate, our patients. (And sometimes we must even communicate with ourselves and be open to their educating us.)
Some patients actually may need that makeover. Some patients really do have an unattractive smile. They deserve the same choices, the same fullness of communication and the same education as those who just want that makeover. Patients have the right to participate in their own treatment. To do so, they must be well-educated and, yes, informed.
Face it, some of what we do is truly optional. However, esthetics is an integral part of our profession. As I tried to suggest, the issues we face on a daily basis implicate every one of the Principles of Ethics. And, as the Introduction to the Principles and the Code affirms, the "principles may at times need to be balanced against each other, but, otherwise, they are the profession’s firm guideposts."
Hopefully, the questions I posed in my response will make every dentist consider those Principles with every patient they see. That’s the whole point.
