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Forum Category: General Dentistry

Moderated by:
Todd Snyder

Considering Overtreatment

Patients who are dissatisfied with the appearance of crowded and/or rotated teeth are often reluctant to receive orthodontic therapy due to the duration of this treatment, or a host of similar such factors.  While it is always important to stress that a noninvasive, orthodontic means of improving the arch form and position is the best means of improving such a condition, if the patient is fully informed of the treatment options available yet he or she still desires to avoid an extended treatment period, contemporary restorative techniques--including the placement of crowns or veneers--can provide exceptional results that address the patient's original concern.  How, though, does a responsible and ethical practitioner sift through the patient's motivations and related clinical factors to determine the means of treating a patient with crowded or rotated dentition without being too invasive?
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Considering Overtreatment

08:30 PM | Apr 11,2016
The question raised is extremely interesting, particularly with my residency in orthodontics beginning soon. I see the ethical concern but I do believe that at the end of the day, you must respect the patient's autonomy. That being said, the treatment selected must also be within the realms of accepted treatment and uphold the ethical principles of beneficience and nonmaleficence. I agree with Dr. Touati stating that an orthodontic consult should be obtained prior to the decision so the patient is fully informed so they can make an educated choice. I definitely would strongly suggest orthodontics and even educate the patient about treatment that would be less visible, such as Invisalign or clear braces. I would also look into practices in which the orthodontists used expedited processes such as Suresmile or another computerized way of placing and adjusting braces. This would address the patient's concern with having braces for an extended treatment period.

Considering Overtreatment

08:34 AM | Mar 07,2012

Considering Overtreatment

09:49 AM | Aug 10,2011
Thanks for the insight Dr. Snyder, looking forward to more posts

Considering Overtreatment

01:04 PM | Aug 04,2011
Is it ever acceptable to refuse a patient treatment? I think of the "do no harm" guidepost but this can be difficult to define!

Considering Overtreatment

08:05 AM | Jun 23,2011
An excellent, topic, and an important one for dentists at every level of the profession. It is always a careful balance among patient demand, the clinician's ability and experience in managing such conditions, and discussion among other specialists. It would be important to have this patient visit an orthodontist's office first before further prosthodontic treatment is really considered.