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Background: The increasing societal emphasis on physical appearance, particularly influenced by social media, has led to a significant rise in demand for aesthetic dentistry procedures. This study aims to explore the ethical dimensions of marketing practices and the phenomenon of overtreatment in cosmetic dental procedures, highlighting the implications for patient care and professional integrity. Methods: A systematic literature review was conducted across four databases, yielding an initial 76 articles. After applying inclusion and exclusion criteria, 12 articles were selected for analysis. The review focused on ethical considerations, marketing practices, and overtreatment in aesthetic dentistry, employing narrative synthesis to extract relevant data. Results: The findings indicate that social media is a primary driver of patient expectations, often prioritizing aesthetic outcomes over health considerations. This trend raises ethical concerns about informed consent and autonomy. The commodification of dental care, fueled by aggressive marketing strategies, has resulted in a notable increase in overtreatment, where unnecessary procedures are performed to satisfy commercial pressures and idealized beauty standards. The review highlights a lack of robust ethical guidelines governing marketing practices in aesthetic dentistry, exacerbating these issues. Conclusions: The study underscores the urgent need for clear ethical frameworks to guide dental practitioners in balancing patient welfare with business interests. Recommendations include the implementation of ethics education in dental curricula, the development of comprehensive ethical guidelines, and fostering open communication between practitioners and patients. These measures are essential for enhancing informed decision-making and ensure that patient care remains the priority in aesthetic dentistry. [ABSTRACT FROM AUTHOR]

Background: Respect for patient autonomy, the principle that patients are capable to make informed decisions about medical interventions, is fundamental in present-day medicine. However, if a patient's request is medically not indicated, the practitioner faces an ethical dilemma represented by the conflict of the principles of patient autonomy, beneficence, and maleficence. Adjacent to topics such as medical assistance in dying and healthy limb amputation, this ethical dilemma also manifests in the care of the maxillofacial region (the oral cavity and its surroundings), an area crucial to esthetic appearance, but also to everyday functions including mastication, speech, and facial expression, all of which are related to well-being. Our aim was to explore the manifestations and resolutions of the conflict between oral health and patient autonomy in relevant literature in order to contribute to the discourse of ethical challenges concerning patient autonomy, beneficence, and nonmaleficence. Methods: We screened all journal articles discussing the researched ethical dilemma obtained from three databases. Two researchers developed a hierarchical coding scheme, where the parent and grandparent codes were designated deductively as: Case (situations involving the researched ethical dilemma), Judgement (decisions made in the ethical dilemma), and Principle (ideas, rules, propositions explaining the judgements); child codes were developed inductively. After coding the sources, we utilized thematic analysis to construct code constellations. Results: Most themes identified in our sources advocated for the practitioner to choose the alternative that benefits the patient from a medical perspective, although no theme excluded the consideration of patient autonomy. Instances where respect for patient autonomy was encouraged concerned oral preventive care or when the requested intervention was expected to have an insignificant impact on oral health. Conclusions: Ethical conflicts concerning patient autonomy, beneficence, and nonmaleficence have a marked presence in oral care. These conflicts arise through the issue of body modification, evident in cosmetic dentistry and requests for tooth extraction. Our sources generally support the argumentation for beneficence, despite the rise of cosmetic procedures in dentistry. [ABSTRACT FROM AUTHOR]

Objectives: Modified Dental Anxiety Scale (MDAS) is a frequently used psychometric tool to evaluate the dental anxiety level of dental patients or the general population. However, it was largely unclear if MDAS was consistently administered in the original format in the academic literature. This work aimed to survey the literature published in the last 10 years to reveal the current usage of MDAS. Methods: Web of Science and Scopus were queried to identify papers that mentioned the use of MDAS. Results: Among a total of 260 analyzed papers, 101 papers included comprehensive information regarding both the questions posed and the response format employed. Two papers only used an explicitly renamed MDAS with modified contents. Among the 258 papers that used MDAS that were supposed to be standardized, many discrepancies from the original version were discovered. There were only 39 papers that strictly followed the recommended scoring scheme: if a participant had a score of ≥ 19, he or she might be highly dentally anxious. Notable modifications included the use of a cut‐off score different from the original recommendation, the use of multiple cut‐off scores, modifications of the response format or descriptors, and modifications to the question items especially adding extra questions. Conclusions: These modifications would create confusion when researchers and clinicians tried to compare data across studies. Researchers are recommended to administer MDAS in its original format. [ABSTRACT FROM AUTHOR]

Abstract Background Respect for patient autonomy, the principle that patients are capable to make informed decisions about medical interventions, is fundamental in present-day medicine. However, if a patient’s request is medically not indicated, the practitioner faces an ethical dilemma represented by the conflict of the principles of patient autonomy, beneficence, and maleficence. Adjacent to topics such as medical assistance in dying and healthy limb amputation, this ethical dilemma also manifests in the care of the maxillofacial region (the oral cavity and its surroundings), an area crucial to esthetic appearance, but also to everyday functions including mastication, speech, and facial expression, all of which are related to well-being. Our aim was to explore the manifestations and resolutions of the conflict between oral health and patient autonomy in relevant literature in order to contribute to the discourse of ethical challenges concerning patient autonomy, beneficence, and nonmaleficence. Methods We screened all journal articles discussing the researched ethical dilemma obtained from three databases. Two researchers developed a hierarchical coding scheme, where the parent and grandparent codes were designated deductively as: Case (situations involving the researched ethical dilemma), Judgement (decisions made in the ethical dilemma), and Principle (ideas, rules, propositions explaining the judgements); child codes were developed inductively. After coding the sources, we utilized thematic analysis to construct code constellations. Results Most themes identified in our sources advocated for the practitioner to choose the alternative that benefits the patient from a medical perspective, although no theme excluded the consideration of patient autonomy. Instances where respect for patient autonomy was encouraged concerned oral preventive care or when the requested intervention was expected to have an insignificant impact on oral health. Conclusions Ethical conflicts concerning patient autonomy, beneficence, and nonmaleficence have a marked presence in oral care. These conflicts arise through the issue of body modification, evident in cosmetic dentistry and requests for tooth extraction. Our sources generally support the argumentation for beneficence, despite the rise of cosmetic procedures in dentistry.

Every dental practitioner makes decisions about how to manage the various clinical and ethical challenges that patients present. There is a need to balance the demands of the patient with the ethical requirements of the profession and the moral position of the practitioner. It is essential to establish with the patient, before any treatment is carried out, what outcomes are required so that a mutually agreed care plan can be drawn up and acted upon. This article explores the clinical and moral and ethical challenges that can arise in the patient–practitioner relationship. CPD/Clinical Relevance: All practitioners will be faced with the issues raised in this article. [ABSTRACT FROM AUTHOR]

Dental ethics mean the obligations and moral responsibilities towards the patients, professional peers, and society as large. In Orthodontic Clinical Practice all information should be given to the patients before orthodontic treatment like the risk and benefit of therapy and the treatment duration also all the patients have the right to choose and determine the type of orthodontic therapy by application of American dental association Principles of Ethics (ADA Code), all these elements involved under the term of orthodontic ethics .This review article elucidates the ethical dilemmas encountered by orthodontists in their regular clinical practice, with the aim of providing optimal treatment to their patients. [ABSTRACT FROM AUTHOR]

Oral healthcare is attracting much attention after decades of neglect from policymakers. Recent studies have shown a strong association between oral and overall health, which can lead to serious health problems. Availability of oral healthcare services is an essential part of ensuring universal healthcare coverage. More importantly, current gaps in its accessibility by minority or marginalized population groups are crucial public health as well as ethical concerns. One notable effort to address this issue comes from Non-Governmental Organizations (NGOs), which offer oral healthcare services for non-insured refugees. However, the challenge remains that these care services are not comprehensive, which has implications for the refugees' oral and general health. In this article, we discuss this complex issue in the German healthcare context by including ethical reflections. Therefore, the purpose of this article is to discuss the ethical challenges related to oral healthcare services provided by NGOs for refugees in Germany. First, we will introduce the general oral healthcare context worldwide and in Germany. Second, we will provide a general description of the oral healthcare services provided by NGOs for refugees in Germany, as well as an overview of existing gaps. This will provide us with the context for our third and most important task—discussing the ethical implications of the gaps. In doing so, and since the ethical implications can be several, we demarcate the scope of our analysis by focusing on the specific ethical issues of justice, harm, and autonomy. Finally, we offer some recommendations for how to move forward. [ABSTRACT FROM AUTHOR]

Abstract Background The risk assessment of dental erosion among children and adolescents is an important aspect of dental care, as dental erosion constitutes a rapidly growing, global problem. Dental professionals rely solely on their own perception, as the current risk assessment process is not completely automatized, which affects the risk assessment reliability. Aim To explore dental professionals’ experiences with risk assessment of dental erosion among children and adolescents. Method In-depth interview was used as data collection method. A total of 11 dental professionals were interviewed. The interviews were analyzed using qualitative content analysis. Results The findings were summarized in the categories Professionals’ responsibility, Systematic approach , and Collaboration and communication. Dental staff perceived that their basic knowledge regarding erosion should be improved, and skills development was desired to reduce the knowledge gaps around the risk assessment of dental erosion. They alleged that the systematic approach could be improved by reducing workplace stress, implementing a universal dental erosion index, improving the existing risk assessment software, and automating the risk assessment of the condition. Dental professionals also experienced a need to calibrate and collaborate with each other and with other healthcare professionals to improve patient care. Conclusion Dental professionals experienced their basic knowledge of dental erosion and their risk assessment as good, but a more advanced skill development was required. Furthermore, they experienced the risk assessment software as a good tool that should be improved to compile more objective risk assessment. A universal erosion index was also requested.

Background: Lack of professional integrity among dental students can greatly impact the safety of future patients. Currently, there are no established learning outcomes for dental professionalism. Aim: The aim of the study is to assess the perceptions of Indian educators (DE) and residents (DR) towards the attributes and methods to learn/teach dental professionalism. Materials and Methods: A cross-sectional descriptive study was conducted among Indian DE and DR from April 1, 2022, to July 31, 2022. A 31-item questionnaire was developed to evaluate the demographic data, perceptions of learning/teaching methods, and attributes of professionalism. The sample size was calculated to 446 subjects. Descriptive statistics were carried out. Results: Of the 428 participants, 287 were DE and 141 were DR. Most participants are aware of the attributes and have a positive attitude toward professionalism. Role modeling and mentoring were the most effective ways to learn professionalism. About 97.9% of DE and 97.9% of DR felt it was important to teach dental students about professionalism. About 85.7% of DE and 73% of DR felt the need for an additional program in the current BDS curriculum. Most participants selected contact with role model teachers, clinical experience with patients, and discussion with peers as methods by which they learned dental professionalism. Conclusion: The majority of the participants are aware and have a positive attitude toward dental professionalism.

In 1976, Marbach first described in the literature a clinical entity that he called "the phantom bite," now known as "occlusal dysesthesia" (OD). Most patients suffering from OD are going through an unusually stressful period in their lives and have undergone dental therapy at the same time, resulting in a mental fixation on their teeth. They perceive clinically unremarkable occlusal contacts as bothersome or uncomfortable and TMD is a common comorbidity. Although there is no apparent relationship between the clinical findings and the nature and severity of the reported occlusal complaints, patients search for their "ideal" occlusion or to regain their "lost bite." As a result, they suffer from persistent and severe emotional distress. The co-occurrence of depression, anxiety and/or personality disorders is common. The primary therapeutic goal is to improve oral health-related quality of life. Occlusal adjustments are contraindicated. Instead, professional counseling and education as information therapy, psychological therapy, oral splints as a form of occlusal therapy with the goal of defocusing effects and medication are recommended forms of therapy. Unfortunately, the acceptance of the diagnosis of OD and the therapeutic recommendations is usually low among these patients and a large proportion reject therapeutic efforts out of conviction and continue their journey in search of "healing" invasive therapy. [ABSTRACT FROM AUTHOR]

Background: Lack of professional integrity among dental students can greatly impact the safety of future patients. Currently, there are no established learning outcomes for dental professionalism. Aim: The aim of the study is to assess the perceptions of Indian educators (DE) and residents (DR) towards the attributes and methods to learn/teach dental professionalism. Materials and Methods: A cross-sectional descriptive study was conducted among Indian DE and DR from April 1, 2022, to July 31, 2022. A 31-item questionnaire was developed to evaluate the demographic data, perceptions of learning/teaching methods, and attributes of professionalism. The sample size was calculated to 446 subjects. Descriptive statistics were carried out. Results: Of the 428 participants, 287 were DE and 141 were DR. Most participants are aware of the attributes and have a positive attitude toward professionalism. Role modeling and mentoring were the most effective ways to learn professionalism. About 97.9% of DE and 97.9% of DR felt it was important to teach dental students about professionalism. About 85.7% of DE and 73% of DR felt the need for an additional program in the current BDS curriculum. Most participants selected contact with role model teachers, clinical experience with patients, and discussion with peers as methods by which they learned dental professionalism. Conclusion: The majority of the participants are aware and have a positive attitude toward dental professionalism. [ABSTRACT FROM AUTHOR]

Aims: Medicines, which have an important place in health services, are the greatest weapon of societies in preventing and combating diseases. If medicines are not used properly, they may not provide the expected effect and may lead to recurrence of some diseases, development of resistance or some side effects. In recent years, there has been a rapid increase in the number, variety and utilization rates of medicines. This situation has necessitated more rational behavior in the use of medicines, especially by healthcare professionals. Rational drug use can be briefly defined as the administration of appropriate medication in the light of anamnesis and clinical symptoms. Education on rational drug use remains as current in the dental profession as it is in the medical world. In order to determine the extent to which dentists meet the expectations regarding rational drug use and to eliminate possible problems, it is first necessary to determine their knowledge, attitudes, and behaviors on the subject. In this study, it was aimed at comparing and evaluating the attitudes and behaviors of dentists towards rational drug use. Methods: Our study, which was approved by the ethics committee, was conducted with the participation of 399 volunteer dentists actively working in public hospitals and the private sector in different provinces of our country. The data for the study were obtained through an online questionnaire consisting of 15 questions. The IBM SPSS 25.0 package program was used for data analysis of the survey results. A frequency distribution table was created for general characteristics. A chi-square test was used to compare the relationship between categorical variables. Results: It was determined that 50.6% of the participants received rational drug use training, 91.5% utilized different sources of information while prescribing, 73.4% did not prescribe drugs requested by patients, and 43.6% did not find the information given to patients about drugs sufficient. When the reasons for this were questioned, lack of information and lack of time were mostly cited. It was found that the level of knowledge of the participants about drugs was mostly focused on indications, route of administration, special conditions, and contraindications. When prescribing medications, the participants generally questioned whether the patients had chronic diseases, drug allergies, and other medications. It was observed that dentists mostly provided information about the duration of treatment, daily dosage, and method of administration regarding the drugs they prescribed. Conclusion: The basis of irrational drug use in dentistry lies in a lack of knowledge and education. In order to obtain the expected benefit from drugs, we believe that, in addition to instilling awareness of rational drug use in society, the attitudes and behaviors gained, especially by physicians through undergraduate education and in-service training after graduation, should be supported by health policies. [ABSTRACT FROM AUTHOR]

Aim: (1) To determine the repartition of criteria which can be considered as marks of lack of assent by the child with intellectual disabilities from the dentist's point of view and whether that influences the decision to examine the patient or not. (2) To explain the decision of practitioners and determine the ethical implications of these practices. Methods: An anonymous and structured questionnaire was distributed online using the scenario of a 9‐year‐old child with moderate cognitive impairment with eight different oppositional behaviours. The practitioners were asked about their perception of the patient's lack of assent and about their decision to perform the dental examination or not. Results: The proportion of them who performed a dental examination despite the patient's refusal represented between 13% and 28.8% of the population of respondents. Conclusion: There was an ambivalence among the practitioners who carried out a dental consultation when children were uncooperative. They adopted a teleological point of view. It calls for us to reflect on the ethical principles of autonomy and beneficence. [ABSTRACT FROM AUTHOR]

Contemporary medicine views health as the individual's physical, mental, and social well-being. Oral health plays a crucial role in one's well-being, as the oral cavity and its surrounding regions execute essential functions in verbal and nonverbal communication, sensing, digestion, and significantly contribute to aesthetic appearance. The multifaceted nature of the notion of oral health, as well as the patient's needs and autonomous will result in various treatment options for the same oral state, favouring often contrasting ethical values and different aspects of oral health. The objective of this article is to suggest alternative treatment strategies in dentistry with respect to the following factors: extent of rehabilitation, preserving one's anatomical structures, aesthetic outcome, number of sessions, patient autonomy. Additionally, this article describes the suggested treatment strategies in an ethical context and determines the conditions of their employment. The suggested treatment strategies are divided in two categories, extensive treatment strategies focusing on the patient's entire craniofacial complex, while specific treatment strategies focus on specific paramount issues. [ABSTRACT FROM AUTHOR]

Background: Dentists have a legal and ethical obligation to obtain informed consent from patients before carrying out treatment. In Uganda, the process of obtaining informed consent in dentistry is not well documented. The aim of the present study was to determine dentists' perspectives and practices regarding informed consent to fixed prosthodontic treatment (FPT) in Kampala Metropolitan, Uganda. Methods: A quantitative cross-sectional study was conducted among 153 dentists from July to September 2023. Data were collected using a semi-structured self-administered questionnaire that included both closed- and open-ended questions. The questionnaire included items on participants' sociodemographic information, perspectives, and practices about informed consent for FPT. Perspectives were rated using ten items on a five-point Likert scale. The minimum possible total score was 10, and the maximum possible score was 50. Descriptive statistics and Poisson regression were used to summarize and analyze the quantitative data, and the significance level was set at p < 0.05. Open-ended items were analyzed using content analysis. Results: The majority (83.9%) of the participants were general dentists with working experience ranging from 1 to 38 years and a median of 8 years. The majority were familiar with the concept of informed consent and had positive perspectives regarding its use for FPT. The mean score for perspectives was 39.27 (SD, 5.42). However, there were variations in the practices of the dentists. More than three-quarters (87.6%) reported that they always obtained the patient's informed consent before FPT. Less than a third (29.4%) obtained written consent for FPT. About half of the dentists provided information regarding the procedure, benefits, and risks of treatment during the consent process. Bivariate analysis showed that the use of written consent for FPT was significantly (p < 0.05) associated with having a work experience of more than 10 years and having had training involving informed consent after undergraduate studies. Conclusion: The present study provides baseline data regarding perspectives and practices regarding informed consent for FPT among dentists in Uganda. It is recommended that regular training courses be developed to highlight the importance of improved informed consent practices for patient protection and to instruct dentists about obtaining valid informed consent. There is a need for future research to streamline guidelines for the informed consent process in dental care in Uganda. [ABSTRACT FROM AUTHOR]

Periodontal instrument fractures are rare events in dentistry, with limited literature available on their occurrence and management. This case report highlights an incident involving the fracture of a periodontal sickle scaler blade during manual instrumentation for the removal of calculus. The fracture occurred during instrumentation on the mesial surface of the maxillary right second molar, and the separated blade was subsequently pushed into the sulcus. A radiographic assessment was performed to verify the precise location of the fractured segment. Following confirmation, the broken blade was subsequently retrieved using curved artery forceps. The case report highlights factors contributing to instrument fractures, emphasizing the importance of instrument maintenance, sterilization cycles, and operator technique. Ethical considerations regarding patient disclosure, informed consent, and instrument retrieval methods are well discussed. This case underscores the importance of truthful communication, the proper use of instruments, equipment maintenance in dentistry, and the significance of ongoing professional development to enhance treatment safety, proficiency, and ethical standards in dental care. [ABSTRACT FROM AUTHOR]

Background: Dentists bear the burden of responsibility for antimicrobial resistance since antibiotics are the drugs most prescribed by dentists. Often, "inappropriate" antibiotic use is considered as a "gray area" by dentists mainly due to ethical challenges associated with the clinical judgement depending on patients and/or prescribers. Aim: The study aimed to assess whether and in what way dental ethical principles underpin rational antibiotic use by investigating perceptions of postgraduate and undergraduate dental students without formal knowledge of dental ethics. Method: A cross-sectional anonymous survey comprised nine close-ended questions and was conducted among dental students (n = 125). The investigated practice of appropriate antibiotic prescribing in the survey relied on the respect of three basic principles of ethics: autonomy, non-maleficence, and beneficence. Results: Results show that dental students exhibit a lack of dental ethics knowledge that results in an inappropriate antibiotic-prescribing practice: prescribing an antibiotic when it is not necessary, without examination, or for indications that are not within the competence of the dentist. Multivariate regression analysis revealed that there was a significant difference between under- and postgraduates. Conclusions: Within the pharmacology course, a review of the clinical scenarios which cover both ethical and clinical complexities regarding the appropriate use of antibiotics should be introduced as an educational approach. [ABSTRACT FROM AUTHOR]

The author talks about acknowledging and embracing ideals of trust and ethical standards of care into professional daily activities. He discusses the important factor to consider about ethics and trust, the fundamental principles of the foundation of the American Dental Association (ADA) Principles of Ethics and Code of Professional Conduct (ADA Code), and ethical considerations that dental practitioners must take into account.

Purpose: To investigate patient and clinician perspectives on what is considered important to include in a decision aid for replacement of a missing tooth with an implant. Methods: An online modified Delphi method with pair comparisons technique was used to survey participants (66 patients, 48 prosthodontists, 46 periodontists, and 31 oral surgeons) in Ontario, Canada from November 2020 to April 2021 regarding the importance of information provided during an implant consultation. Round one included 19 items derived from the literature and informed consent protocols. The decision to retain an item was based on group consensus, defined as at least 75% of participants identifying the item as "important" or "highly important." After analysis of round one results, a second‐round survey was sent to all participants to rank the relative importance of the consensus items. Statistical testing was completed using the Kruskal–Wallis one‐way analysis of variance test and post hoc Mann–Whitney U tests with a significance level set at p ≤ 0.05. Results: The first and second surveys had response rates of 77.0% and 45.6%, respectively. In round one, all items except purpose of steps reached group consensus. In round two, the highest group ranked items were patient responsibilities for treatment success and follow‐ups after treatment. The lowest group ranked items were cost factors and restorative steps. Significant differences between the stakeholder groups were found on several items, including diagnosis (p ≤ 0.00), non‐implant options (p ≤ 0.00), and cost (p ≤ 0.01). In general, patients' opinions were significantly different than clinicians' opinions on the relative importance of items. Conclusions: Clinicians and patients feel that multiple items are important to include in a decision aid for implant therapy; however, differences exist between patients and clinicians on the relative importance of items. [ABSTRACT FROM AUTHOR]

Objectives: "Ethics in dentistry" seems to be gaining importance as more and more dental institutions, professional associations and dental schools are addressing ethical issues. The aim of this paper is to highlight this ongoing development and to analyze and evaluate its relevance for future dentistry and the dental profession. Materials and methods: A qualitative analysis of literature and Internet sources served as the methodological basis. Recent trends were first illustrated using striking examples and then compared with the status quo in medicine and the medical profession, where ethics have a long professional tradition. It is discussed to what extent it seems worthwhile to transfer existing structures and initiatives in medicine to dentistry. Results: There is a broad variety of ethical announcements and initiatives in international dentistry (e.g., dental codes of ethics, adjustments to dental licensure regulations, professional publications, textbooks, awards, podcasts). It should be noted that ethical issues arise not only in life-threatening situations, but also in everyday dental practice. Existing ethical structures in medicine can be adapted or provide guidance for education, clinical practice and research. Conclusions: Teaching ethical competence in dental education, clinical practice and research can make an important contribution to the professionalization of dentists—quite similar to medicine. Furthermore, a broad integration of ethics in dentistry strengthens the public image of dentists. Clinical relevance: Dealing confidently with ethical issues is a key competence for successful work as a dentist—both in practice and in science. [ABSTRACT FROM AUTHOR]

Background: Dental ethics apply moral principles and virtues governing the character and conduct of an individual to the practice of dentistry. In dental practice, various ethical issues rises which need to be dealt with extreme sensitivity and professionalism according to the various codes of dental ethics. Objective: To determine the knowledge, attitude, and practice (KAP) of dental ethics among dental graduates and to compare the KAP of dental ethics between House officers (HOs) and Postgraduate students (PGs). Methods: A questionnaire-based cross-sectional study was conducted at four different dental colleges in Karachi during JanuaryJune, 2022. The questionnaire consisted of 13 self-administered closed-ended questions. Questionnaires were distributed for the face-to-face survey among target participants. Knowledge, attitude, and practices of dental ethics principles about the routine dental clinical practice were inquired. Data were analyzed using SPSS version 23. Results: A total of 390 complete responses were received. 65.7% of respondents were HOs, and 34.3% were PGs. 74% of dental graduates exhibited inadequate knowledge. 52.7% of dental graduates displayed poor attitudes. Fair to poor practices were recorded largely in our study as only 45.6% of overall respondents depicted favorable responses to the asked questions. The frequency of inadequate knowledge among HO and PGs was 84% and 64% respectively. 50% of HOs and 44.5% of PGs showed poor attitudes. 45.6% overall respondents (HOs and PGs) depicted favorable responses to the asked questions comparatively higher poor practices. Conclusion: Inadequate knowledge, poor attitude, and comparatively higher poor practices related to dental ethics are noted by dental graduates in our study. Years of experience and learning have an impact on responses.

Empathy is fundamental to the physician-patient relationship and influences the clinical outcomes. The aim of this study was to determine the dental students’ empathy levels and to compare their opinions on attributes of a “good dentist”. This cohort research was included 79 dental students volunteering to participate in the study at a public university. The data were collected by the Dökmen’s Empathic Tendency Scale (ETS) and Empathic Skill Scale (ESS). In this study, from the orientation day to the end of the third-year, the dental students’ ETS mean scores (respectively 69.59 and 68.34) and ESS mean scores (respectively 142.53 and 140.00) showed a decline. At the end of the third-year, starting clinical rotations and taking patient responsibility may lead to decrease the empathy levels of students. The findings of our study show that female students have higher empathy tendency and skill scores compared to male students (p<0.001). In the ranking of the attributes required to be a good dentist, empathy was ranked 4th by the first-year students, while final-years students placed empathy in second rank (p<0.05). According to these results, it is possible to claim that the dentist candidates realized that being empathetic is necessary to be a good dentist. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, restrictive measures were imposed that significantly impacted the healthcare system in general, and the dental healthcare system in particular. The literature cites a possible association between mental and oral health, as psychiatric patients have decreased awareness of their oral health and, therefore, poor dental status. Moreover, several studies have found a positive association between SARS-CoV-2 infection and oral health conditions, as well as between SARS-CoV-2 infection and mental health status. This context generated multiple ethical dilemmas in the case of persons with mental health disorders who require dental treatment because they are more vulnerable in this respect. This article aims to analyze the ethical issues in dental care for patients with mental disorders concerning the COVID-19 restrictive measures. The ethical aspects involved here are the basic principles of bioethics and the related elements of accessibility, equity, consent, and confidentiality. [ABSTRACT FROM AUTHOR]

Background: Dentists bear the burden of responsibility for antimicrobial resistance since antibiotics are the drugs most prescribed by dentists. Often, “inappropriate” antibiotic use is considered as a “gray area” by dentists mainly due to ethical challenges associated with the clinical judgement depending on patients and/or prescribers. Aim: The study aimed to assess whether and in what way dental ethical principles underpin rational antibiotic use by investigating perceptions of postgraduate and undergraduate dental students without formal knowledge of dental ethics. Method: A cross-sectional anonymous survey comprised nine close-ended questions and was conducted among dental students (n = 125). The investigated practice of appropriate antibiotic prescribing in the survey relied on the respect of three basic principles of ethics: autonomy, non-maleficence, and beneficence. Results: Results show that dental students exhibit a lack of dental ethics knowledge that results in an inappropriate antibiotic-prescribing practice: prescribing an antibiotic when it is not necessary, without examination, or for indications that are not within the competence of the dentist. Multivariate regression analysis revealed that there was a significant difference between under- and postgraduates. Conclusions: Within the pharmacology course, a review of the clinical scenarios which cover both ethical and clinical complexities regarding the appropriate use of antibiotics should be introduced as an educational approach.

Objective: Scientific papers and books on digital dentistry are in vogue. In most cases, these publications focus clearly on the - undoubted - potentials and possibilities offered by digitalization. The fact that digital dentistry necessarily entails risks and ethical challenges, by contrast, is rarely discussed. This paper aims to complement the discourse on digitalization in dentistry by analyzing precisely these challenges. Method and materials: The study is based on an analysis of international publications and specialist writings on digitalization and its applications in the fields of dentistry and medicine, as well as on the analysis of specific contributions from the disciplines of medical ethics and medical law, and from the public media. Results: The paper identifies and discusses eight core challenges: (1) big data ("digital double" and falsification in den- tistry), (2) the dental practitioner-patient relationship, (3) digital literacy, (4) the assumption of responsibility in complex systems, (5) accompanying changes in the dental professions, (6) cost trap and risks of overtreatment in dentistry, (7) consumption spiral and ecologic footprint, and (8) clinical evidence in dental treatments. In addition, a catalog of criteria for assessing the effects of digitalization in dentistry is developed. Conclusion: It is crucial to closely monitor both the potentials and the challenges posed by digitalization in dentistry. Ultimately, it is only those problems that are identified as such that can be resolved and only those technologies that are accepted by dentists, patients, and society that will prevail in the long term. [ABSTRACT FROM AUTHOR]

Emma Wilson reviews the importance of accurate dental translations for patient trust. [ABSTRACT FROM AUTHOR]

Objective: Professionalism is a hallmark of health professions education. Professional identity formation is a growing field of exploration in medical education, and the dental literature is sparse on just how professional identity formation is developed and assessed within dental education. Methods: The validated professional role orientation inventory (PROI) was administered to 2nd year dental students during a spring semester ethics course. The PROI includes four 10‐item scales representing four attitudinal factors: Authority, Responsibility, Agency, and Autonomy. Results: When compared to a historical sample of dental students in the early 1990s, dental students today scored significantly higher on Responsibility (p = 0.0309) and lower on the Agency factor (p = 0.0001). Authority scores in the current sample of dental students were significantly associated with age and race, with an increase in age associated with a decrease in Authority (p = 0.0504) and Caucasian respondents demonstrating significantly higher scores than Asian or Other races. Debt was associated with differences in Autonomy (p = 0.0683) and Agency (p = 0.0106), with those in the 100k–300k anticipated debt range demonstrating lower levels of both Autonomy and Agency. Race was marginally associated with Responsibility with those in the Other race category (Hispanic, Black/African American, Other/Multiracial) demonstrating higher levels than Caucasian (p = 0.0513). Conclusion: Dental students' scores denote a continued commitment to others yet a feeling of less sense of control as a practicing professional. A redefining of professionalism to include social activism and advancing health equity is required given their altruism and commitment to others, which remains high. [ABSTRACT FROM AUTHOR]

Professional dental ethics for students are based on promoting oral health for dental patients and reinforcing an anthropocentric approach to communication and dental services. A total of 133 dental students (males 33.8% N1 = 46, females 66.2% N2 = 87) completed the study questionnaire. Descriptive statistics were applied, and non-parametric Kruskal–Wallis tests were used (p < 0.05). Students refuse services to patients that misbehave (37.6%), have irrational demands (18%), and when clinical cases exceed their capabilities (36.8%). Of the participants, 50.4% want to waive confidentiality when abuse is declared. Ethical role models are educators (33.8%), other qualified dentists (25.6%), and their parents (21.8%). Female gender positively affects integrity (p = 0.046), altruism (p = 0.032), and difficulty in conversations among colleagues (p = 0.036). Students outside the capital are less interested in esthetic issues (p = 0.007), in giving more than one treatment plan (p = 0.006), and in being confronted with inadequate treatments from other colleagues (p = 0.005). Family income positively affects clinical skills (p = 0.003), trust issues (p = 0.008), and moral insight and intuition (p = 0.02). Presentation with clinical scenarios is the preferred educational method (49.6%). Dental students show compassion for poor patients, respect patients' autonomy, and guide patients to choose the best treatment plan before receiving dental ethics seminars. There is a positive relationship between the ethical footprints of students and gender, origin, family income, postgraduate studies, and future professional plans. Factors and ways to incorporate ethics in the dental curriculum could be considered when planning relevant courses. [ABSTRACT FROM AUTHOR]

Background: With the need to strengthen conative domain competencies, the medical council has introduced the attitude, ethics, and communication (AETCOM) module in the new competency-based medical education. Similar competencies exist in the curriculum prescribed by the Dental Council of India (DCI). Aim: This study aimed to collect the data regarding the perception of dental interns and their awareness of the existing curriculum. Materials and Methods: Eighty-six interns of a single batch participated in the survey. The survey included declaration, voluntary consent, basic knowledge regarding curriculum, their perception regarding DCI and AETCOM competency, and their assessment. Collected data were presented descriptively in figures and scores of perception were analyzed using the single sample Student's t-test. Results: Out of the 78 competency statements, only two DCI competency statements and nine AETCOM competency statements had P values higher than 0.05. Conclusion: Students perceive the increased emphasis on preclinical work and minimal emphasis on interpersonal skills in the curriculum. Students lack confidence in research projects and practice management competency and need additional training after BDS for setting up a practice. [ABSTRACT FROM AUTHOR]

Background: the use of electronic social networks (ESN) enables healthcare professionals to establish relationships through electronic devices, transforming social practices. Facebook, Twitter, and Instagram are platforms whose behavior patterns favor the exchange of professional information, which is classified as inappropriate conduct compromising professionalism and ethics, violating the privacy and confidentiality of patients. Purpose: to assess the ethical behavior on ESN of dentists and oral health specialists regarding the publication of clinical case photographs. Methods: a descriptive observational study evaluated the ethical behavior on ESN of dentists and oral health specialists regarding the publication of clinical case photographs. A structured survey was conducted to gather information about the use of Facebook, Twitter, and Instagram. A p-value < 0.05 was considered statistically significant. Results: out of 127 participants, 60 % publish photographs of clinical cases on their ESN without knowledge of any ethical protocol. 18.11 % have read the Code of Ethics of the Colombian Dentist, and 18 % have read the internal policies of ESN. 7 % do not believe they are committing any ethical breach when publishing photographs that could identify the patient. Conclusions: some participants in this study are unaware of the ethical and legal implications of publishing clinical case photographs on Facebook, Twitter, and Instagram, associated with the violation of privacy, confidentiality, and the professional medical secret. [ABSTRACT FROM AUTHOR]

Dental implantology is one of the most attractive and dynamic fields of work within clinical dentistry. It provides many patients with new and improved opportunities for stable (implant-supported) rehabilitation and also offers dentists a field that is interesting in both technical and economic terms. Adverse clinical outcomes are, however, often the subject of discussion. These relate both to prosthetic failure and to biologic complications and side effects, namely persistent infections surrounding implants. A further point of discussion relates to the question as to how far the triumphant march of implantology is accompanied by a reduction in the willingness to retain teeth. It thus appears all the more important to ask some questions regarding the normative overall conditions of responsible implantologic care on the basis of the present state of research and currently available studies. In line with this, this paper deals with both existing preconceptions and ethically relevant parameters of responsible implantology. These function simultaneously as concrete clinical-ethical guidelines for dentists practicing implantology. [ABSTRACT FROM AUTHOR]

The article explores the impact of augmented intelligence (AI) technologies on dental practices. Topics discussed include the ethical implications of integrating AI in dentistry, the need for updated guidelines to navigate these technologies, and the potential benefits and challenges associated with AI adoption in dental care.

Forward migration of the upper incisors can be very distressing for patients and difficult for the dentist to manage and treat. We summarize the aetiology of this condition in older patients and discuss how this can be managed with a combined orthodontic and restorative approach. CPD/Clinical Relevance: A combination of orthodontics and restorative dental treatment may be useful in managing migration of the upper maxillary teeth. [ABSTRACT FROM AUTHOR]

Introduction: Assessment plays a central role in formal education. Unstructured oral examinations are the status quo in dental education in India but have some drawbacks, including a lack of inter-rater reliability. It is not known whether structured oral examinations provide different scores nor how they will be accepted by students or examiners. Materials and Methods: A sample of 20 students were randomly selected from a group of third-year BDS students who had scored 65% and above in the 2nd year university examination in Bapuji Dental College and Hospital. They were exposed to a total of 4 h of lecture and problem-solving sessions on dental ethics. Four raters (teaching faculty), having similar academic experience and designation, were selected and they were trained to conduct structured oral examinations according to a format, especially designed for the same purpose. Half the students underwent structured examination followed by unstructured examination while half the students underwent unstructured examination followed by structured examination. Paired t-test was applied to find out the statistical difference between structured and unstructured oral examination formats. Results: The students obtained a mean score of 13.35 ± 3.8 out of a total score of 20 in the unstructured oral examination when compared to a mean score of 14 ± 3.76 in the structured oral examination. The difference was not statistically significant (P = 0.69). The acceptance trended favorable for structure examination but was not statistically significant. The structured examination had higher inter-rater reliability than the unstructured examination. Conclusion: The results showed good reliability and repeatability of the structured oral examination format with an inter-rater reliability of 0.82. Structured viva voce was not found to improve the performance of students when compared to unstructured viva voce. [ABSTRACT FROM AUTHOR]

Introduction: This study introduces the curriculum of a discussion‐based learning class for dental hygiene ethics education and evaluates the educational effect of discussion‐based learning as applied to a dental hygiene ethics class. Materials and methods: This study was conducted with 48 sophomores from the Department of Dental Hygiene who took dental hygiene ethics in the second semester of 2019. For the DBL class, the following steps were conducted: (1) a pre‐class group activity (discussion); (2) a group presentation and team discussion; and (3) a discussion among all groups. To improve the ability to aggregate, organise, and prepare the learner's resources, data, information search skills, and opinions by the team and to improve communication skills by actively listening to other people's opinions, the presentation team's opinions were modified after the discussion, and the performance of rational opinions on topics was added. The professor provided feedback and summarised and ended the discussion. The survey was conducted before and after the DBL class. Results: Concerning critical thinking ability, critical objectivity increased significantly from 8.88 before to 9.38 after the DBL class, and critical confidence also increased significantly. The change in professional attitude significantly increased from 3.21 out of 5 points before the DBL class to 3.53 after the DBL class in the logical and critical thinking skills category and significantly increased from 3.27 to 3.66 in decision‐making skills. Conclusion: Teaching methods applied in DBL classes, not traditional lecture‐style classes, consistent with changing educational paradigms, are very effective and should change gradually. These results will be particularly helpful to faculty members who are inexperienced in DBL courses and performance but interested in them. [ABSTRACT FROM AUTHOR]

Introduction In this modern era, there has been mounting public concern regarding the ethical conduct of healthcare professionals. Dental ethics is a moral responsibility that incorporates professional conduct and judgment imposed by the members of dental profession. It is necessary for the dental students to become well equipped to resolve ethical dilemmas. The present study was conducted to assess the knowledge of dental students about professional ethics in dentistry.. Materials and Methods A questionnaire based cross-sectional study was conducted among 425 dental students in Ghaziabad. The knowledge of dental students about professional ethics in dentistry was assessed using Chi square analysis and p value =0.05 was considered statistically significant.. Results Out of 425 dental students, 401 completed the entire questionnaire. The response rate is 94.35%. Most of the dental students were aware about the Hippocratic Oath while only a minor percentage had knowledge about Nuremburg code, ICMR guidelines and Helsinki declaration. A higher percentage of dental students felt that knowledge of ethics is moderately important for them in their work but only a minor population attended training in ethics.. Conclusion Dental students in this study have less knowledge of healthcare ethics. This can result in the lack of their sensitivity to resolve the ethical dilemmas they encounter. Hence, it is essential to improve the knowledge and awareness regarding ethical aspects among dental students. [ABSTRACT FROM AUTHOR]

Dental treatment is contraindicated by some health conditions. As patients live longer and dentists treat more patients with underlying disease, patients often need general medical care before dental care can proceed. For US patients without access to health care and their dentists, lack of medical-dental integration can generate inequity, poor outcomes, and ethical questions. Individual dentists should advocate for patients who need general health care prior to dental care, but the professions of dentistry and medicine must also respond to macro-level health system gaps and failures. [ABSTRACT FROM AUTHOR]

The article presents the discussion on bone grafting in preparation for the placement of endosseous dental implants or other restorative dental therapy. Topics include obligating a moral commitment towards the welfare of the patients and oral health care team; and bone grafts used commonly in conjunction with dental implants for enhancing the regenerative capacity of bone after tooth loss.

Aim: The aim of our study was to analyze the content related to dentistry published on Instagram® and to investigate the students' profiles related to the use of social networks in a sample from a Dentistry School. Methods: This study was carried out in two stages. First, research was conducted to analyze content published on Instagram® related to dentistry. The second part investigated the profiles of students' from a dental school in relation to the use of social networks through a questionnaire. A descriptive analysis was performed and associations between the variables were tested using Fisher's exact test. Results: We found a diversified and large amount of content related to dentistry published on Instagram®, and publications that involved advertising were more prevalent in our study. There are also many publications that are violating the Code of Dental Ethics. In addition, in the second part of our study, we observed an enormous use of social networks by dental students (98.4%). Conclusions: As a result, we believe that it is important to update professionals about the ethical infractions related to social networks which could be approached during graduate courses in universities. Finally, the analyzed social network seems to be an interesting alternative for disseminating health information in order to dialogue with greater proximity to the large number of users who participate in it. [ABSTRACT FROM AUTHOR]

Dentistry increasingly integrates artificial intelligence (AI) to help improve the current state of clinical dental practice. However, this revolutionary technological field raises various complex ethical challenges. The objective of this systematic scoping review is to document the current uses of AI in dentistry and the ethical concerns or challenges they imply. Three health care databases (MEDLINE [PubMed], SciVerse Scopus, and Cochrane Library) and 2 computer science databases (ArXiv, IEEE Xplore) were searched. After identifying 1,553 records, the documents were filtered, and a full-text screening was performed. In total, 178 studies were retained and analyzed by 8 researchers specialized in dentistry, AI, and ethics. The team used Covidence for data extraction and Dedoose for the identification of ethics-related information. PRISMA guidelines were followed. Among the included studies, 130 (73.0%) studies were published after 2016, and 93 (52.2%) were published in journals specialized in computer sciences. The technologies used were neural learning techniques for 75 (42.1%), traditional learning techniques for 76 (42.7%), or a combination of several technologies for 20 (11.2%). Overall, 7 countries contributed to 109 (61.2%) studies. A total of 53 different applications of AI in dentistry were identified, involving most dental specialties. The use of initial data sets for internal validation was reported in 152 (85.4%) studies. Forty-five ethical issues (related to the use AI in dentistry) were reported in 22 (12.4%) studies around 6 principles: prudence (10 times), equity (8), privacy (8), responsibility (6), democratic participation (4), and solidarity (4). The ratio of studies mentioning AI-related ethical issues has remained similar in the past years, showing that there is no increasing interest in the field of dentistry on this topic. This study confirms the growing presence of AI in dentistry and highlights a current lack of information on the ethical challenges surrounding its use. In addition, the scarcity of studies sharing their code could prevent future replications. The authors formulate recommendations to contribute to a more responsible use of AI technologies in dentistry. [ABSTRACT FROM AUTHOR]

Cosmetic & aesthetic procedures are usually accompanied by ethical considerations toward the patient such as, whether they need to have this procedure or not or whether will it be beneficial and long-lasting for their case. The study aims to have a better understanding of the ethical values & views of dentists toward cosmetic dentistry, in particular: laminate veneers. This is a descriptive cross-sectional study of dentists working at hospitals & clinics in Riyadh in both private & public sectors. After receiving ethical approval (RC/IRB/2018/1155), data was collected through a selfadministered questionnaire after validation & conducting the pilot study. A total of 351 dental practitioners gave their consent to participate in this study and filled the questionnaire, 196(55.8 %) were males and 155(44.2 %) were females. The study included 74.1% of GP's and 25.9% in dental clinics in Riyadh. The findings in our study suggest that the overall aesthetic dental practice among the participants in this study runs within the relevant ethical rules and guidelines cited by national and international dental regulatory. [ABSTRACT FROM AUTHOR]