regards,

dr veerendra darakh

3) Right and wrong is as different as black and white

It turns out there is a lot of grey.  I consider myself to be an ethical dentist.  I don’t lie, cheat, or steal, which is a good start.  I heard in dental school about unethical dentists who committed insurance fraud or broke the law in some naughty way.  “I would never do that,” I told myself.  And I haven’t.

But I didn’t realize that there are numerous scenarios that I would be faced with that were on vague moral ground.  For example:

A patient presents with a two surface amalgam with small recurrent decay.  You treatment plan a two surface resin restoration but the owner dentist tells you that the tooth should get a crown.  The width of the amalgam is a little more than a third of the occlusal plane; not massive, so you thought a resin would be fine.  But the owner dentist insists that a crown is the better choice.  He explains that he’s been around a long time and medium-sized composite resins tend to fail in a few years.  Why not do a restoration that has a better prognosis and will ultimately save the patient money, assuming the failed resin would then require a crown in a few years anyway?

I’ll go into my solution to this problem in future post, but suffice it to say that each of us must face decisions like this where there is no clear cut, “correct” answer.  We must rely upon our clinical judgment and personal moral compass to guide us through the grey areas.  And when all else fails, contact your fellow dentists and dental society for advice.  By the way, check out this post for some scary associate stories.