The Scriptures of the Old and New Testaments are “…living and active, and sharper than any two-edged sword…able to judge the thoughts and intentions of the heart” (Hebrews 4:12, NASB). They were written “…that the servant of God may be thoroughly equipped for every good work” (2 Timothy 3:17, NIV). If dentistry is a “good work,” then we are to pursue our professional calling in light of the incomparable wisdom of God’s Word.

Perhaps the most pervasive of the ethical challenges in dentistry is related to the area of treatment recommendations. This topic is challenging by virtue of the simple fact that almost all clinical problems in dentistry can be treated in multiple ways. For example, an abscessed tooth can be removed or can receive root canal treatment. A tooth with significant decay can be treated with a large filling or with a crown. Missing teeth can be replaced by a partial denture, bridges or implants. Cost and longevity of treatment options are quite often inversely related. How is a dentist to ethically provide their patient with the information needed to make a good decision?

1. Treatment Planning – A dentist’s ability to develop and provide the most effective treatment is dependent upon their knowledge, skill and experience. For this reason, it should be an ongoing pursuit for every dentist to be a lifelong learner, seeking to constantly develop their awareness of the most advanced treatment options and the most effective equipment and instruments. Dental advancements over my four decades in dentistry have yielded phenomenal progress in what can be done to help patients, and keeping up with progress is an inherent part of being able to do what is best for our patients. This is not to say newer is always better, but we owe it to our patients to be aware of the most modern available treatment modalities.

2. Best for Whom? – I have attended dental seminars when the lecturer said something like, “I would never put in my patient’s mouth what I would not want in my own mouth.” While this might sound altruistic, the underlying assumption is oblivious to the fact that not everyone has the same financial capacity to elect the better, and often more expensive, options. They might even try to justify this “my way or the highway” approach by quoting Jesus’ Golden Rule from Matthew 7:12: “…treat people the same way you want them to treat you…” (NASB). However, a more careful application of this verse will reveal the fact that patients have a right to know what their options are so they can choose the option they believe is best for them. Whether the patient is limited in their ability to afford the best treatment options, or perhaps just doesn’t value their dental health enough to pay the price for higher quality dentistry, they still deserve to make that call. They are obligated by their Creator to take care of the bodies God has given them, but the patient’s obligation is to Him, not to us.

3. Informed Consent – An inherent part of Christ-honoring treatment recommendations is giving our patients realistic expectations regarding the likely result of their treatment options. This can often be a joyful event as we share with patients that well-done dentistry, when coupled with excellent home care and regular preventive treatment, can last for decades. When the prognosis is less than ideal, though, we dentists need to speak up in these instances so patients will be aware of their likely dental future. For example, many patients who have had frequent dental challenges over the years are prone to state, “Doc, just pull ’em all out and make me some dentures.” Those of us who have delivered more than a few sets of dentures know there is a huge difference between dentures and natural teeth, and patients deserve to know of this difference prior to going down the road to edentulism. As we paint the picture for our patients of their likely dental future with various treatment options, “May the words of my (our) mouth and the meditation of my (our) heart Be acceptable in Your sight…” (Psalm 19:14, NASB, words added).

4. Comprehensive Evaluation – We in dentistry need to take a broad look at a patient’s situation prior to making our treatment recommendations. I have seen several patients over the years who had arrived at a point of needing all of their teeth removed, yet they may have had one or two teeth which received extensive care, perhaps root canal therapy and a crown. It seems likely a prior dentist encouraged the patient to invest heavily in the best long-term option for the acute problem, while ignoring the well-being of the rest of the dentition. This narrow view of treatment planning is a classic example of not seeing the forest for the trees. Instead, even in an emergency toothache situation, the patient deserves at least a cursory evaluation of the rest of the mouth, so a patient can make the best investment in their overall dental health.

5. Referrals – How does a dentist decide which treatment options to provide for their patients versus when to refer the patient to a specialist? For a couple of decades, I performed most of the root canal therapy required by my patients, only referring out the more challenging cases. I regularly attended endodontic courses along the way in an effort to provide excellent care. Then I realized my long-term success rate was not as high as that of a specialist, and at that point I began to refer my patients’ endodontic needs to the local specialists. Our patients should benefit from the wisdom of a multitude of counselors (Proverbs 11:14).

6. Benevolent Care – A dentist in the U.S. receives a high level of compensation in return for the treatment they provide. This can be a blessing or a curse, depending on whether it increases one’s gratitude to the Lord or just increases pride and a sense of self-sufficiency. If we truly believe “Every good and perfect gift is from above…” (James 1:17, NIV), then God’s kindness will create in us a desire to be a blessing to others, especially those who cannot afford our services. Each of us probably have dentally underserved individuals in our own localities, thereby giving us an opportunity to provide free or low-cost treatment, either in our practices or in local benevolent clinics. Several dentists also elect to reach out to international communities, where the needs can be far greater than what we typically see in the U.S. The dental care we provide to those who cannot afford the treatment they need can be a powerful reminder that all we have comes from the Lord, and it can help to prevent us from falling prey to “…the love of money” which is described as “…a root of all kinds of evil…” (1 Timothy 6:10, NIV). Our benevolent efforts are also a tangible way for us to “…let your (our) light shine before others, that they may see your (our) good deeds and glorify your (our) Father in heaven” (Matthew 5:16, NIV, words added). We learn dentistry’s true worth by giving it away.

7. The Heart of the Matter – Each of the above items listed could likely be helpful to any dentist, whether they belong to Christ or not. The most important motivating factor for those of us seeking to honor the Lord is the heart change the gospel accomplishes in each of our lives. Because Christ put our well-being ahead of His own (Philippians 2:5-8), the love of Christ is to control us (2 Corinthians 5:14). Therefore, we don’t bill for procedures we have not performed, we don’t slightly increase a patient’s periodontal readings in order to justify more profitable treatment and we do not include or exclude treatment recommendations merely because they are or are not covered by a patient’s dental benefits. We are empowered by the Holy Spirit to do the right thing for our patients, regardless of the consequences. The beautiful result we will experience is we will know the peace of Christ in increasingly greater measure as we provide dental care “…as for the Lord…” (Colossians 3:23, ESV).

In summary, we recognize our involvement in dentistry is not ultimately because one or more family members were dentists, or because of a positive dental experience we had growing up. Though these might have been secondary causes, we know the primary cause was God’s calling upon our lives—His desire to bless us with the opportunity and ability required to become dental professionals. As we seek to respond with gratitude and faithfulness to His great kindness toward us, may He use our temporal dental efforts to accomplish His eternal purposes in those we serve.