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Ethical Considerations in Paediatric Dentistry

Recommendations

Foundational Articles

American Academy of Pediatric Dentistry. Policy on the Ethical Responsibilities in the Oral Health Care Management of Infants, Children, Adolescents, and Individuals with Special Health Care Needs, 2018. Available at: https://www.aapd.org/globalassets/media/policies_guidelines/p_ethical.pdf. Accessed May 1, 2020.

American Academy of Pediatric Dentistry. Best Practices: Informed consent, 2019. Available at: https:// www.aapd.org/research/oral-health-policies–recommendations/informed-consent/. Accessed May 1, 2020.

Mouradian WE. Ethics and leadership in children’s oral health. Pediatric Dent. 2007;29:64-72.

Adewumi A, Hector MP, King JM. Paediatric dentistry: Children and informed consent: A study of children’s perceptions and involvement in consent to dental treatment. Br Dent J 2001;191:256-9.

Background

Ethics, defined as the moral principles governing our decisions and actions, should guide us in how we behave and relate to each other as human beings. The four principles of ethics: autonomy, beneficence, Background non-maleficence and justice should therefore be the foundation of our decision-making processes and be applied in all aspects of the management of paediatric patients.

IAPD Recommendations

  1. Each patient should be treated fairly, without bias, judgement or discrimination based on their culture, religion, beliefs, behaviour, race, gender, special needs or health status. Consensus-based statement > Global agreement 100%

  2. Dental professionals ethical obligation is to provide necessary treatment. Patients should be referred to other health professionals who can provide proper treatment if the needs of the patient are beyond the practitioner’s scope or skills. Consensus-based statement > Global agreement 100%
    non-maleficence and justice should therefore be the foundation of our decision-making processes and be applied in all aspects of the management of paediatric patients.

  3. Informed consent should always precede dental treatment. A parent or legal guardian should consent on behalf of minors and patients with intellectual disabilities. Informed consent should include the following information: diagnosis, treatment options (including no treatment), the risks and benefits, costs and burdens (social and other) associated with each option, as well as the opportunity for questions. Consensus-based statement > Global agreement 91%

  4. Except for child abuse or a child of the age of emancipation, a practitioner must obtain consent for IAPD Recommendations How to cite: IAPD Foundational Articles and Consensus Recommendations: Ethical Considerations in Paediatric Dentistry, 2022. http://www.iapdworld.org/2022_09_ethical-considerations-in-paediatric-dentistry. treatment from the parent/legal guardian. Consensus-based statement > Global agreement 91%

  5. If possible, assent for treatment should be obtained from the patient. At a level appropriate for a child’s understanding, the child should be involved in the treatment planning and treatment processes. Consensus-based statement > Global agreement 82%

  6. The benefit of the treatment should outweigh the risks the child is subjected to, including radiation and behaviour management techniques. Consensus-based statement > Global agreement 96%

  7. Dentists are responsible for their clinical and ethical decisions regardless of opinions or influence of parents/legal guardians or business owners. Consensus-based statement > Global agreement 100%

Other Recommendations