The ethical statements place the patient’s welfare above any other consideration. The dental profession holds a special position of trust within society (Fig.1-1). As a consequence society affords the profession certain privileges that are not available to members of the public. In return the profession makes a commitment to the society that its members will adhere to high ethical standards of conduct. These standards are embodied in the principles of ethics and code of professional conduct. This code is, in fact a written expression of obligation arising from unpiled and contract between the dental profession and the society.

The code has three main components: the principles of ethics, the code of professional conduct and the advisory opinions.

Principles can overlap each other and compete each other for priority, also it must be known that although ethics and law are closely related, they are not the same. Ethical obligations may, and often do exceed legal duties. It is always expected and required that the dentists will follow high ethical standards, which have the benefit of the patient as their primary goal. It is believed that the dentist should posses not only knowledge, skill and technical competence, but also these traits of character that fustian adherence to ethical principles. Qualities of compassion, kindness, integrity, fairness and charity complement the ethical practice of dentistry. The ethical dentist strives to do that which is right and good.

• The code of ethics and professional conduct is organized into five sections. These are: Patient’s autonomy
• Nonmaleficience
• Beneficence
• Justice
• Veracity.

“The dentist has a duty to treat the patient according to the patient’s desires, within the bounds of accepted treatment modalities”

Under this principle the dentist primary obligation includes involving the patient in treatment discussions, with consideration to the patients desire, needs and abilities.

Patient involvement: The dentist should inform the patient of proposed treatment and any reasonable alternatives in a manner that allows the patient to become involved in the decisions.

Patient records: Dentists are obliged to keep full records to his patients and to safe guard the confidentiality of these records. Upon request of the patient or his new dentist, dentist should provide any information that will be beneficial to the future treatment of the patient.

Confidentiality of patient’s records: The dentist is not allowed to give any information from the patient’s records or copies of these records except upon request of the patient. However, in emergency situations, the dentist may give the dentist or physician on charge the necessary information for the welfare of the patient.

Physicians of all specialties are obliged to keep their knowledge and skill up-to-date through continuous education and training.

“The dentist has a duty to refrain from harming the patient”

To fulfill this principle the dentists primary obligation include:

• Keeping knowledge and skill up to date
• Knowing ones own limitations and when to refer the case to a specialist and other professional
• When and under what circumstances assistance is requested

Education: All dentists have the obligation of keeping their knowledge and skill current and up to date.

Consultation and referral: Dentists are obliged to seek consultation whenever the welfare of the patient will be safe guarded or advanced by utilizing those who have special skills, knowledge and experience. However, when the patient is referred to a consulting dentist for consultation upon completion of treatment, the consulting dentist should return the patient to the referring dentist for future care, unless the patient reveals a different preference.

Use of auxiliary personnel: Dentists are obliged to protect the health of their patients by assigning the assistance of qualified auxiliaries. Dentists are also obliged to prescribe and subversive the patient care provided by all auxiliary personnel working under their directions.

Personal impairment: It is unethical for a dentist to practice while under the effect of alcohol or other chemical agents which impair the ability to practice.

Ability to practice: A dentist who becomes ill from any disease or impaired in any way should, with consultation and advice from a qualified physician, limit the activities of practice to those areas that do not endanger the safty of patients or members of the dental staff.

Patient abandonment: Once the dentist has undertaken a course of treatment, he is not allowed to discontinue that treatment without giving the patient adequate notice and the opportunity to obtain the services of another dentist. Care should be taken not to jeopardize the patient’s oral health in this process.

“The dentist has the duty to promote the patient’s welfare”

Under this principle, the dentist’s primary obligation is service to the patient and the public in general.

Community service: As dentists have an obligation to use their skills, knowledge and experience for the improvement of the public, so dentists must conduct themselves in such a manner as to maintain or elevate the esteem of the profession.

Government of a profession: Every profession owes the society the responsibility to regulate itself. Such regulation is achieved through the influence of the professional societies (Fig. 1-3 to 1-6). All dentists, therefore, have the dual obligation of making themselves a part of a professional society and of observing its rules of ethics.

Research and development: Dentists have the obligation of making the results and benefits of their investigations available to all when they are useful in safeguarding or promoting the health of the public.

Patent and copyrights: Dentists may secure these providing that they shall not be used to restrict research or practice.

Child-abuse: Dentists are obliged to be familiar with the preoral signs of child abuse and to report suspected cases to the proper authorities.

“The dentist has a duty to treat people fairly”

Under this principle dentists are obliged to deal with people justly and to deliver dental care without prejudice.

Patient selection: Dentists should not refuse to accept patients into their practice or to deny dental service to patients because of the patients race, color, sex, or national origin.

HIV positive patients: A dentist has the general obligation to provide care to those in need. A decision not to provide treatment to an individual because he has AIDS, based only on this fact, is unethical.

Emergency service: Dentists are obliged to make reasonable arrangements for the emergency care of their patients.

Justifiable criticism: Dentists are obliged to report to the appropriate, reviewing agency cases of gross or continual faulty treatment by other dentists. The patient should be informed about their present oral health status without disparaging comment about prior services. The dentist should exercise care that his comments are justifiable. For example difference in opinions as to preferred treatment should not be communicated to the patient in a manner which would imply mistreatment.

Rebates and split fees: Dentists should not accept tender rebates or split fees with others.

“The dentist has the duty to be honest and truthful in his dealing with people”

He should respect the position of trust inherent in the dental-patient relationship.

Care representation: The dentists should not represent the care being rendered to their patients in a false or misleading manner. Any recommended treatment should be based on accepted scientific knowledge and research.

Fees presentation: Dentists should not present the fees being charged for providing care in a false or misleading manner.

- Overbilling: It is unethical for a dentist to increase the fees to a patient solely because the patient is wealthy or covered under dental insurance.

- Unnecessary services: A dentist who recommends or performs unnecessary dental service or procedure is engaged in a unethical conduct.

Professional announcement and advertising: Dentists should represent themselves in a respectable manner (Fig.1-6). No dentist should advertise in any form of communication in a manner that is false or misleading or unrespectable in any manner.

• Unearned and nonhealth degrees: The use of unearned, nonhealth and honorary degrees in any general announcement to the public by a dentist is a false and misleading representation. The use of honorary and nonhealth degrees should be limited to scientific papers and curriculum vita. (Fig. 1-7)

Name of practice: The name under which the dentist conducts his practice may be a factor in the selection process on the part of the patient. The use of trade names or an assumed name that is false or misleading in any respect is unethical.

• Dentists leaving practice: The use of the name of a dentist no longer actively associated with the practice may be continued for a period not to exceed one year.

Announcement of specialization: The dentist is allowed to announce to the public his area of speciality providing that he has successfully fulfilled the requirements of such speciality.

Approved specialities: The special areas of dental practice approved by the American dental association (ADA) are:

• Dental public health.
• Endodontic.
• Oral and maxillofacial pathology.
• Oral and maxillofacial surgery.
• Orthodontic.
• Pediatric dentistry.
• Periodontics.
• Prothodontics.
• Conservative dentistry.

Dentists who choose to announce specialization should limit their practice exclusively to the announced special areas of dental practice.