Ethics

Question 1

Autonomy

Answer 1

This is a patient’s right to make their own decisions towards their healthcare. In this case it is respecting that the patient has a right not to use fluoride toothpaste.

Question 2

Non-maleficence

Answer 2

This means that any action the dentist carries out must not harm the patient. Harm could be caused to the patient if they do not use fluoride toothpaste as they may continue to get dental decay, impacting their oral health. However, additionally, by being forced to use fluoride toothpaste they could experience psychological harm if they strongly believe that it has negative effects on their health.

Question 3

Justice

Answer 3

The dentist should consider if their actions could have any consequences on the wider community. For example, in this instance if the dentist did not explain the evidence behind fluoride being safe to use in the concentrations found in toothpaste, the patient could go on to influence other members of the public.

Question 4

Beneficence

Answer 4

Any action taken by the dentist should benefit the patient. This could be through decreasing the chances of dental decay by getting the patient to use a fluoride toothpaste or by allowing them to make their own choice and continuing to use a fluoride free toothpaste.

Question 5

Examples

Answer 5

A 25 year old woman comes to your dental practice because she is unhappy with the appearance of her teeth as she feels they look crooked. On examination, there is no clinical indication that she needs braces so she does not fit the criteria for braces on the NHS. The woman explains to you that her teeth make her very self-conscious and is causing her to feel depressed. Do you think this woman should be given braces on the NHS?
◾A patient with dental anxiety comes into your practice. They are refusing to have a dental check-up without sedation. Discuss how you would manage this patient.
◾A five year old patient comes in with severe dental decay and requires several teeth to be extracted. On speaking to the child’s mother they refuse to give consent for the child’s teeth to be extracted and do not believe that the child has any dental decay. Discuss how you would deal with this situation.

Question 6

is fluoride safe?

Answer 6

There have been some concerns that fluoride may be linked to a variety of health conditions. Reviews of the risks (see above) have so far found no convincing evidence to support these concerns.

However, a condition called dental fluorosis can sometimes occur if a child’s teeth are exposed to too much fluoride when they’re developing. Read more about looking after children’s teeth and looking after your baby’s teeth.

Mild dental fluorosis can be seen as very fine pearly white lines or flecking on the surface of the teeth. Severe fluorosis can cause the tooth’s enamel to become pitted or discoloured.

It’s uncommon in the UK for fluorosis to be severe enough to seriously affect the appearance of teeth. This is because fluoride levels in water are carefully monitored by the Drinking Water Inspectorate (DWI) and adjusted if necessary.