Ethical Dilemmas in Orthodontics

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.