Ethical Dilemmas in Orthodontics

Introduction: Doctors and dentists possess special training and expertise which patients and their
families do not. This special knowledge and skillset, which has the potential to benefit as well as harm
patients, places on the medical or dental professional the moral obligation to act in the interests of the
patient.
Aim: To present a clinical case as an example of an ethical dilemma that orthodontists may face
when advocating for the best interests of a child.
Case Presentation: A five-year-old girl attended my private orthodontic clinic with a main complaint
of lower anterior teeth overlapping her upper anterior teeth. She was in the primary dentition stage.
There was a conflict between the orthodontist’s interests of the child and the need to respect parental
autonomy. Her mother had doubts and misgivings about the effectiveness of orthodontic treatment
and was reluctant to have her daughter begin treatment at this age.
Discussion: Factually, there are ethical problems continuously encountered by orthodontists during
orthodontic interventions, even though there are important human values at stake in the course of
treatment. These values may include preventing pain, maintaining and restoring oral function for
normal speech and eating, preserving and restoring the patient’s physical appearance, and promoting
a sense of control over and responsibility for one’s own health. Last but definitely not least,
orthodontists deal largely with children, and ethical problems arise especially when there is moral
uncertainty.
Conclusion: The ethical traditions and codes of conduct of medicine and dentistry require
orthodontists to act in the interest of their patients regardless of financial arrangements, and even, at
times, with risk to themselves. In the case of children, this interest in the patient becomes even more
pronounced and may conflict with the orthodontist’s interests to respect the wishes of the patient.