CONTEXT

The dental landscape has witnessed significant transformations influenced by shifting patient demand and engagement, evolving socioeconomic demographics, media impact, the adoption of digitalization, artificial intelligence and the integration of various technologies. Each of these poses challenges for the ethical framework guiding the profession. The mutual recognition and trust between patient and dentist, as well as between the profession and society, are fundamental to all aspects of dental practice. Such trust can only be fortified by reaffirming the profession’s ethical foundation. This policy statement seeks to build on that principle and serve as a reminder that ethics must be at the very core of everything the profession does. The policy statement is intended to be used in conjunction with the FDI Ethics Manual and with the existing FDI Policy Statements in relation to dental ethics. 

SCOPE

This statement is aimed not only at dentists and dental team members but also at national dental associations (NDAs), educators, specialist societies and other representative bodies. It aims to reiterate to the profession the paramount importance of ethics and to underscore the considerable shifts in ethical principles and policies that warrant scrutiny as societal values and perceptions evolve.

DEFINITIONS

Dental ethics:  the critical examination of the values, rights, principles and norms that guide the practice of dentistry. Within this statement, ethics pertain to normative ethics, which concern themselves with establishing and assessing moral norms to guide and evaluate conduct. 

PRINCIPLES

These are the principles or moral norms on which dental ethics are based: 

Patient Autonomy: Respect the wishes of patients or their authorized representative, provided their wishes are consistent with professional standards.  Patient autonomy is supported by valid consent, truth-telling and confidentiality. 

Beneficence: Commit to the well-being of patients, families and society as the foremost aim of healthcare provision.

Non-maleficence: Do no harm to patients, families or society. 

Justice: Ensure that each person is given the healthcare opportunities and resources they require, treating every person with equal consideration and inclusion.

Accountability and veracity: Be truthful and demonstrate responsible conduct as a member of the profession, being mindful of your accountabilities for the outcomes of your actions in all professional matters.

Integrity: Behave with honour and decency. Safeguard, influence and promote the highest professional standards.

Professionalism: Commit actively to support and promote the profession and public service.

Tolerance: Tolerate diversity and recognize cultural differences to understand patient choices and treatment.

Compassion: Ensure a caring attitude and look to the patient’s overall well-being. Kindness, sympathy and empathy for the patient should always be utilized.

POLICY

Patient focused: 

• Be aware of conflicts of interest, the influence of third parties on the patient-dentist relationship (especially through financial pressure or incentives) and prioritize the well-being of patients and society in all decisions;
• Patients and, where appropriate, their approved representative and/or their families should be fully informed about the diagnosis, benefits and risks of any treatment or no treatment, including future related treatments and any potential costs involved in their healthcare decisions;
• Informed consent underpins ethics.  It should be obtained after discussion with the patient as a two-way process. For complex or elective procedures, it should allow for a period of reflection and be reviewed at appropriate time intervals;
• Establishment of capacity to give consent is an essential prerequisite;
• Consider the patient’s comprehensive well-being while striking a balance between restoring oral health and addressing aesthetic considerations;
• Ensure that treatments provided are patient-centered, evidence-based and within the dentist’s expertise and experience;
• Be clear, avoid jargon and be transparent about treatment and realistic about expectations. Be truthful and do not mislead patients through advertisements and social media and have due regard to national legislation and professional guidance in relation to advertising;
• Recognize that a professional’s social media posts are public rather than private, and speak and act accordingly; 
• Ensure appropriate policies for addressing patient concerns, complaints and redress where necessary, as well as maintaining appropriate clinical negligence indemnity.

Profession focused: 

• Ensure compliance with regulatory requirements for dental professionals in line with national, regional and local legislation as appropriate;
• Remain vigilant regarding conflicts of interest and prioritize the welfare of patients and society in all decision-making;
• Keep knowledge and skills current;
• Maintain awareness of competency limitations and refer patients when treatment exceeding those limitations is needed; 
• Promote a culture of equality, diversity and inclusion within the profession and promote ethical collaboration both within the profession and with other professions;
• Treat patients with dignity and respect at all times; 
• Patients’ personal data shall remain strictly confidential as regulated by national legislation; 
• Advocate for just and fair oral health policies;
• NDAs and other professional bodies to promote optimal oral health and ethical behaviour (“corporate ethics”);
• Oral Health is recognized by the World Health Organisation (WHO) as a key component of general health and wellbeing. All members of the dental team, together with NDAs and other professional bodies have a duty to recognize this and promote services to that effect “;
• Promote the undertaking of regular continuous professional development (CPD) courses on ethics, recognizing ethics as being at the core of everything we do; 
  
• Professional organizations provide support and advice to individual dental professionals to understand and work to professional ethics and regulatory frameworks; membership of a national dental association is therefore helpful to ensure ethical compliance.

KEYWORDS

ethics, dentistry

DISCLAIMER

The information in this Policy Statement was based on the best scientific evidence available at the time.  It may be interpreted to reflect prevailing cultural sensitivities and socioeconomic constraints.

REFERENCES

1. FDI Dental Ethics Manual 2

2. Beauchamp T, Childress J. Principles of Biomedical Ethics, 8th Ed. OUP: 2019

3. World Health Organization, Ottawa Charter for Health Promotion. Regional Office for Europe; 1986

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