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Clinical Sciences

Operative Dentistry

Orthodontics and Pediatric Dentistry

Principles of Ethics

Patient Management

Principles of Ethics

Clinical Sciences
Principles of Ethics

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Question 1 of 12

1. Question

Informed refusal

A patient with symptomatic caries is informed of the need for root canal therapy or extraction but refuses all treatment after understanding the risks. The dentist should:

Proceed with root canal therapy because it is in the patient’s best interest
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Document the discussion and the patient’s informed refusal, and respect their decision
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Dismiss the patient immediately without documentation
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Tell the patient there are no risks if they delay treatment
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Question 2 of 12

2. Question

Confidentiality with minor

A 16-year-old patient discloses recreational drug use and asks you not to tell their parents. They have no signs of immediate danger. Ethically, you should:

Immediately inform the parents regardless of circumstance
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Respect confidentiality, while advising the patient about health risks and support resources, within local legal limits
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Report to authorities as child abuse
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Refuse to treat the patient
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Question 3 of 12

3. Question

Treating beyond competence

A general dentist is asked to place complex implants and full-arch restorations but has minimal training in implantology. Ethical response?

Accept case and learn as you go
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Decline and refer to or collaborate with a practitioner with appropriate training
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Attempt the surgery but inform the patient you are inexperienced
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Refuse all implant cases permanently
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Question 4 of 12

4. Question

Terminating dentist–patient relationship

A patient repeatedly misses appointments and refuses recommended treatment. You decide to terminate the professional relationship. Ethically and legally, you should:

Stop all care immediately without explanation
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Provide written notice, offer emergency care for a reasonable time, and assist in transferring records
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Tell the patient’s insurance company only
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Abandon the patient once they decline your advice
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Question 5 of 12

5. Question

Capacity and consent

An 82-year-old with mild cognitive impairment understands the procedure and can explain risks and benefits back to you. How should consent be handled?

Consider them incapable due to age
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Obtain consent from a family member instead
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Accept their informed consent as they demonstrate decision-making capacity
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Proceed without any consent because treatment is minor
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Question 6 of 12

6. Question

Treating without informed consent

A patient scheduled for a small composite filling is sedated and the dentist also decides to extract an adjacent asymptomatic tooth without prior discussion. This primarily violates:

Beneficence
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Nonmaleficence only
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Autonomy and informed consent
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Veracity only
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Question 7 of 12

7. Question

Breaking bad news

You must inform a patient that biopsy results show squamous cell carcinoma. The most appropriate approach is to:

Give full details in clear, empathetic language and allow questions
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Avoid the word “cancer” to reduce anxiety
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Tell the family only and not the patient
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Deliver the diagnosis quickly and then leave
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Question 8 of 12

8. Question

Second opinion

A patient questions your treatment plan and asks for a second opinion. The most appropriate response?

Discourage them; it shows lack of trust
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Encourage them and offer to forward records/radiographs
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Refuse further treatment and dismiss them
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Charge an extra fee for releasing records
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Question 9 of 12

9. Question

Informed consent

Which statement best describes informed consent?

Patient signs a form; no further discussion is needed
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Dentist makes the decision and informs the patient after treatment
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Dentist explains diagnosis, treatment options, risks, benefits, and alternatives, and patient voluntarily agrees
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Consent is only required for surgical procedures
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Question 10 of 12

10. Question

Confidentiality

A 17-year-old patient tells you they are pregnant and asks you not to tell their parents. They are competent and treatment is dental. What is the best response?

Immediately inform parents
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Respect confidentiality and not disclose without patient consent, unless there is risk of serious harm
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Tell the patient you will inform parents later
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Discuss it with your staff at lunch
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Question 11 of 12

11. Question

Treatment refusal

A competent adult patient with severe caries refuses treatment after being informed of risks. What should you do?

Force treatment because it’s in their best interest
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Respect their decision, document the discussion, and offer alternative options/future care
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Refuse to ever see the patient again
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Begin treatment without telling them
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Question 12 of 12

12. Question

Conflict of interest

A dental company offers you free expensive equipment if you agree to use and promote their brand to all patients. Best ethical response?

Accept and not tell patients
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Accept but still charge patients fully
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Decline or disclose the relationship clearly and ensure recommendations are evidence-based, not financially driven
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Accept and stop using all other materials
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