Ethical Marketing in ‘ Aesthetic ’ ( ‘ Esthetic ’ ) or ‘ Cosmetic Dentistry ’ Part 2

This is the second article in a series of three. It is essential to find out from patients what it is that they hope to achieve when requesting an improvement in their dental appearance. Their expectations, hopes and fears need to be explored in detail. The longterm biologic costs of some invasive procedures need to be explained to patients in advance so that they can make properly informed decisions. Failure to do so renders the practitioner vulnerable to a charge of behaving unethically. The differences between ethical marketing and selling are explained including the historic development of marketing. Clinical Relevance: A practical approach, using a modification of the Edward de Bono Six Thinking Hats model is described to help ethical practitioners to develop sound treatment plans when dealing with complex aesthetic problems. Dent Update 2012; 39: 390–406 Ethics and aesthetic dentistry Ethics relate to a voluntary framework of guiding principles which fills the void between laws on one hand and a ‘free for all’ on the other. In essence, ethics involve a moral code, or a set of principles, to guide behaviour when dealing with aesthetic dental problems. Ethics are different from laws and have sometimes been described as an ‘allegiance to the unenforceable’. In the case of dentistry, Dental Councils and Dental Boards in various countries have the power to suspend or to remove a dentist’s registration, even when no law has actually been broken. Professional ethics and conduct are therefore enforceable indirectly because a dentist’s registration with his/ her regulatory body is at stake. Ethical behaviour is essential, not optional, if one is to have a successful career in aesthetic dentistry. Patient expectations, hopes, fears and aspirations In general terms, patients, when they ask for help with what they might describe as ‘an appearance problem’ with their teeth would expect to be treated with fairness, decency, respect, honesty, truth and trustworthiness by their dentist. In seeking any aesthetic dental treatment to solve their perceived problems they would hope that their dentist would treat them as they would wish to be treated themselves. They would also appreciate being treated with kindness, reasonableness, tolerance and responsibility. They would, probably, also desire understanding, empathy, courtesy, politeness, consistency and openness but would generally expect their dentist to Martin G D Kelleher, BDS, MSc, FDS RCPS, FDS RCS, Consultant in Restorative Dentistry, King’s College Hospital, London SE5 9RS, Serpil Djemal, BDS, MSc, FDS RCS, MRD RCS, Consultant in Restorative Dentistry, King’s College Hospital, London SE5 9RS and Nicholas Lewis, BDS, MSc, MFDS(Edin) FDS(Rest Dent) RCS, Consultant in Restorative Dentistry, The Eastman Dental Hospital, London WC1X 8LD, UK. have an appropriate and reasonable range of skills to help solve their aesthetic problems. Patient and public expectations in relation to ‘cosmetic’ dentistry The public at large and patients in particular expect certain things from dentists. Maintaining ethical standards within the dental profession is a duty for all dentists because ethics represent a voluntary code of principles generated from within the dental profession for the members of the dental profession to follow. The fundamental principles on which healthcare relies are ‘doing good’ and ‘acting in the patient’s best interest’ (‘beneficence’) and ‘doing no harm’ (‘non-maleficence’). In seeking aesthetic or ‘cosmetic’ dentistry, the presumption by patients is that they will benefit from any such intervention rather than being harmed by it. If it becomes evident later on that they have been damaged in the long-term by the provision of ‘cosmetic’ or ‘aesthetic’ dentistry, then it is understandable that they will feel disappointment, anger and possibly become litigious. Serpil Djemal and Nicholas Lewis