Ethics Corner: What Would You Do?

Kelsey CreehanFeatured News

From the Spring/Summer 2020 Journal of the Colorado Dental Association

Q: A new patient came into our office for a second opinion. I could see that the previous dentist was treatment planning for a crown, but I feel like a filling is the correct procedure. In my opinion, the crown is inappropriate. What should I do? What should I say to the patient?

A1: When seeing a patient for a second opinion for any reason, I treat them the same as any patient of record. I discover the issues and possible treatment options that are available and discuss the pros and cons for each option. Whether there is a discrepancy or not in the proposed treatment, the reasons behind the decisions are discussed. Opinions on treatment can be different from one dentist to another but with honest information the patient can make an informed decision.

Usually the reason for a second opinion is that the trust has been lost.

A2: When I am approached for a second opinion, I complete a comprehensive exam and simply tell the patient what they need. Many times, the patient won’t even ask about a change of treatment, but if they do, then I’m very direct with my findings. In this scenario, I would tell the patient that it looks like I can do a filling instead of a crown right now and that we’ll keep an eye on the tooth in the future in case anything changes.  

A long time ago, there was a TV show that sent a patient to multiple dental offices. The patient received multiple dental treatment options from the offices and then the show vilified dental offices for having different treatment standards. The truth is that there are many factors to consider with treatment decisions, like occlusion, function, lifestyle, etc. There will always be differences in treatment.


The CDA Council on Ethics and Professional Conduct will be presenting common ethical questions that arise in dental practices, in each issue of the Journal. Two members of the council will answer each question. Have a scenario that you would like the council to address? Please submit your questions to