• Jonsen AR: The Sins of Specialists. pp. 113-118
• Newbrun E: Professional Ethics and Professional Etiquette in Dentistry: Are they compatible? pp. 119-125
• Dolan B: What have Teeth Taught us about Culture? Practice, Patienthood and Ethics in the History of Dentistry and Public Health. pp: 126-133
• Zinman EJ: Ethics versus Legal informed Consent - A Distinction with Little Difference. pp. 134-138
• Meyerhof PG: Early Struggles to Identify Ethical Standards in Dentistry: Dr. Benjamin Brown and the Amalgam War of the 1840s. pp. 139-149
• Peltier B: Painless Parker’s legacy: Ethics, Commerce, and Advertising in the Professions. pp. 150-159
• Christen AG & Christen JA: An Ethical Lesson Learned from the Equestrian Sculpture, "The Torch Bearers," at the University of Madrid Dental School. pp. 160-164.
• Baumrind S: Dental Ethics in a Larger Context: One Point of View. pp. 165-170.
• Addendum: Ethics in Dentistry Colloquium - Discussion and Questions. pp. 171-185

Black RC. Is it ethical for dentists to treat their own children? J Am Dent Assoc. 2007 Oct;138(10):1379-80.

Boden DF. What guidance is there for ethical records transfer and fee charges? J Am Dent Assoc. 2008 Feb;139(2):197-8.

Boyd MA, Roth K, Ralls SA, Chambers DW. Beginning the discussion of commercialism in dentistry. J Calif Dent Assoc. 2008 Jan;36(1):57-65.
There is increasing concern over commercialism in dentistry. Multiple factors contribute to this trend, which has the potential for fragmenting the profession, exacerbating the access issue, and eroding the public's confidence in dentistry. There are both positive and negative aspects of commercialism. Positive approaches for promoting oral health in the face of commercialism hold the greatest promise. The core theme in the recommendations from Ethics Summit on Commercialism is that competent, comprehensive, and continuous oral health care is appropriate and should be promoted to the American public.

Brown KA. Procedures for the collection of dental records for person identification. J Forensic Odontostomatol. 2007 Dec;25(2):63-4.
Dental treatment records offer a valuable resource for establishing the identification of deceased persons by means of dental comparison as required for forensic purposes. The creation, maintenance, storage and custody of such records is a legal and ethical duty of each dental practitioner. Dentists in Australia are also bound by federal and state legislation to protect their patients' confidentiality at all times. They are also required by law to note and report evidence of child abuse observed in the course of their treatment. When dental records are required for forensic purposes certain procedures should be followed for their release and collection. This paper discusses these procedures, and illustrates by reference to an actual case the possible consequences of deviating from established protocols.

Dharamsi S, Pratt DD, MacEntee MI. How dentists account for social responsibility: economic imperatives and professional obligations. J Dent Educ. 2007 Dec;71(12): 1583-92.
This study explores how dentists explain the concept of social responsibility and its relationship to issues affecting access to oral health care by vulnerable segments of the population. Analysis of open-ended interviews with thirty-four dentists, including dental educators, and administrators and officials of dental public health programs in Canada and the United States revealed that four main themes-economics, professionalism, individual choice, and politics-influenced the respondents' sense of social responsibility in dentistry. There was a belief that social responsibility in dentistry is dominated by economic imperatives that impact negatively on the policies and practices directing access to care. Yet, despite the highly critical stance on dentistry as a business, there was practical recognition of the economic realities of dental practice. Nevertheless, those who focused on social responsibility as a professional obligation highlighted the privileges of self-governance along with the accompanying duty to serve the welfare of everyone and not just those who are socioeconomically advantaged.

Emmett C. The Mental Capacity Act 2005 and its impact on dental practice. Br Dent J. 2007 Nov 10;203(9):515-21.
In 1995, the Law Commission was given the task of investigating 'the adequacy of legal and other procedures for decision-making on behalf of mentally incapacitated adults'. It concluded that the law was fragmented and confusing and called for a single statute to govern decision-making on behalf of mentally incapable adults regarding welfare, healthcare and financial matters. There followed a 15 year period of consultation, resulting in the new Mental Capacity Act 2005 which came into full force in October 2007. Dentists who administer treatment to patients suffering from mental incapacity due to dementia, learning disabilities, depression, brain injury and other forms of mental disorder, need to be familiar with the Act and its accompanying Code of Practice. This article looks at how the new Act impacts upon the treatment of incapable patients by dentists, whether they are in general surgery, community or hospital settings. In particular, this article focuses on the provisions of the Act which relate to how and when capacity should be assessed prior to the dentist carrying out treatment and the consequences of a finding of incapacity for both the dentist and the patient in his or her care.

Escribano Hernández A, Hernández Corral T, Ruiz-Martín E, Porteros Sánchez JA. Results of a dental care protocol for mentally handicapped patients set in a primary health care area in Spain. Med Oral Patol Oral Cir Bucal. 2007 Nov 1;12(7):E492-5.
OBJECTIVE: Disabled people have the same right as other people to receive the health care they need, but they sometimes have difficulties to achieve it. In Castilla y Leon it has come into effect a law to guarantee Primary and Secondary Care coordination to provide dental treatment under sedation or anaesthesia to mentally disabled people who need it. Our aim is to evaluate the results of the implementation of such a law through a specific protocol in our health setting. STUDY DESIGN: Descriptive, made in a Health Area over a year, on mentally disabled people who were sent to hospital for treatment under anaesthesia after Primary Dental Care Units assessment. It has been studied the age, gender, mental disease, dental diagnosis and treatment undergone. RESULTS: 108 patients attended the program (51% male), with a mean age of 31 years. 67% presented profound learning disability, 19% mental illness with disability, 11% presented cerebral palsy and another 3% had autism. Most frequent dental pathologies were caries (86%) and dental plaque (71%). Most common dental procedures were tooth extraction (78%), professional tooth cleaning (75%) and fillings (67%). CONCLUSIONS: We achieved to provide necessary dental treatment to a large number  of disabled people, who would not have received it otherwise. It was a challenge to plan and implement the protocol coordinating Health Care Levels and workers. It still has to be done an economic and efficiency analysis of procedures and a patient satisfaction study.

Griffin M, Shickle D, Moran N. European citizens' opinions on water fluoridation. Community Dent Oral Epidemiol. 2008 Apr;36(2):95-102.
OBJECTIVES: To understand European citizens' opinions on water fluoridation, as part of research on their attitudes to the tensions between private and public interest. METHODS: Sixty-eight focus groups held (with an average of eight people per group) in September and October 2003 in 16 countries (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, the Netherlands, Poland, Portugal, Spain, Sweden and the UK). RESULTS: Most participants were against water fluoridation, although groups in Greece, Ireland, Poland and Sweden were more in favour. Many felt dental health was an issue to be dealt with at the level of the individual, rather than a solution to be imposed en masse. While people accepted that some children were not encouraged to brush their teeth, they proposed other solutions to addressing these needs rather than having a solution of unproved safety imposed on them by public health authorities whom they did not fully trust. They did not see why they should accept potential side effects in order that a minority may benefit. In particular, water was something that should be kept as pure as possible, even though it was recognized that it already contains many additives. CONCLUSIONS: While the vast majority of people opposed water fluoridation, this may be indicative of shifts away from public support of population interventions towards private interventions, as well as reduced trust in public agencies. Thus if research were to demonstrate more clear benefits of water fluoridation over and above that which can be achieved by use of fluoride toothpaste, then the public may become more supportive. However, lobby groups are likely to remain influential.

Jerrold L. Litigation, legislation, and ethics. Posttreatment records. Am J Orthod Dentofacial Orthop. 2008 Jan;133(1):124-6.

Jones DW. A Scandinavian tragedy. Br Dent J. 2008 Mar 8;204(5):233-4.
This paper briefly reviews the logic surrounding the controversial banning of dental amalgam by the Norwegian government. The very small contribution from dentistry to environmental mercury pollution and the significant advantages of amalgam as a dental restorative are emphasised.

Schwartz B, Banting D, Stitt L. Perceptions about conflicts of interest: an Ontario survey of dentists' opinions. J Dent Educ. 2007 Dec;71(12):1540-8.
The purpose of this study was to explore the opinions that general dental practitioners in Ontario have regarding various situations that may be perceived as a conflict of interest. Standard quantitative analyses were employed to assess the association of attitudes and opinions concerning conflict of interest with gender, length of practice, and prior interpersonal communication, ethics, and religious training through a survey of general practice dentists in Ontario. Positive associations were found between the recognition of conflicts of interest and the number of years of dental practice, interpersonal communication training, and the reading of ethics-related articles in journals. Opinions vary on what is and is not a conflict of interest. Dental education has shaped a better understanding of these issues; however, for many dentists, previous education has not been totally adequate to guide them through conflict of interest situations.  Age and mode and length of practice appear to have a direct effect on awareness of conflict of interest issues. Dentists need specific instruction and clearer direction regarding conflict of interest issues, so that they can better manage situations deemed to be conflicting and thereby earn and maintain patient trust in the profession.

Shahid SK, Godson JH, Williams SA, Nykol J. Obtaining informed consent for children receiving dental care: a pilot study. Prim Dent Care. 2008 Jan;15(1):17-22.
AIM: To explore the outcome of the consent process with parents/carers of children of different ethnic minority backgrounds in a primary care salaried dental service setting. MATERIALS AND METHODS: One hundred parents of children were recruited to the study. The sample was balanced by ethnicity (White and Pakistani) and type of care (routine and general anaesthesia [GA]). Subjects were interviewed using a questionnaire enquiring about the various aspects of the consent process. RESULTS: For routine care, 53% of parents were unaware of the type of pain relief to be used. The majority (78%) knew of the benefits of treatment but few (7%) were aware of risks or alternative treatment options (5%). Significantly more White parents were able to recall the treatment their child was to receive compared with Pakistani parents (P <0.01). With respect to GA, there were no significant differences according to ethnicity. Most parents (95%)  could recall risks of treatment and 72% of parents could report benefits; however, only 20% could recall discussion of alternative treatment options. CONCLUSION: For procedures involving GA, consent is more likely to be informed. For routine care, a more structured approach is required and Pakistani parents in particular need more support. A third of all parents (routine and GA group) felt  that they had not been involved in the final treatment decision.

Shaw D. Dentistry and the ethics of infection. J Med Ethics. 2008 Mar;34(3):184-7.
Currently, any dentist in the UK who is HIV-seropositive must stop treating patients. This is despite the fact that hepatitis B-infected dentists with a low viral load can continue to practise, and the fact that HIV is 100 times less infectious than hepatitis B. Dentists are obliged to treat HIV-positive patients, but are obliged not to treat any patients if they themselves are HIV-positive. Furthermore, prospective dental students are now screened for hepatitis B and C and HIV, and are not allowed to enrol on Bachelor of Dental Surgery degrees if they are infectious carriers of these diseases. This paper will argue that: (i) the current restriction on HIV-positive dentists is unethical, and unfair; (ii) dentists are more likely to contract HIV from patients than vice versa, and this is not reflected by the current system; (iii) the screening of dental students for HIV is also unethical; (iv) the fact that dentists can continue to practise despite hepatitis B infection, but infected prospective students are denied matriculation, is unethical; and (v) that the current Department of Health protocols, as well as being intrinsically unfair, have further unethical effects, such as the waste of valuable resources on 'lookback' exercises and the even more damaging loss of present and future dentists. Regulation in this area seems to have been driven by institutional fear of public fear of infection, rather than any scientific evidence or ethical reasoning.

Shaw D. Continuous consent and dignity in dentistry. Br Dent J. 2007 Nov 24;203(10):569-71.
Despite the heavy emphasis on consent in the ethical code of the General Dental Council (GDC), it is often overlooked that communication difficulties between patient and dentist can cause problems in maintaining genuine consent during interventions. Inconsistencies in the GDC's Standards for dental professionals and Principles of patient consent guidelines are examined in this article, and it is concluded that more emphasis must be placed on continuous consent as an ongoing process essential to maintaining patients' dignity in dentistry.

Smith V. A patient's perspective on moral issues and universal oral health care. J Am Coll Dent. 2007 Fall;74(3):27-31.

Vernillo AT, Caplan AL. Routine HIV testing in dental practice: can we cross the Rubicon? J Dent Educ. 2007 Dec;71(12):1534-9.
The latest Centers for Disease Control and Prevention (CDC) guidelines recommend routine HIV screening for a large segment of the population, given that the individual understands that an HIV test will be performed unless he or she declines testing (opt-out testing). The CDC recommendation calls for the elimination of formalized requirements for written consent and pretest counseling to encourage more Americans to voluntarily accept testing. Knowledge of HIV infection can increase early access to care and treatment and reduce further transmission. A rapid non-invasive test for HIV infection (OraQuick Advance) from oral fluid has recently become available. It offers two distinct advantages: 1) results are available within twenty minutes, thereby eliminating a long waiting period; and 2) it has high sensitivity and specificity comparable to blood testing. A preliminary positive test result must be confirmed with a Western Blot by an outside laboratory or physician. Important ethical and legal issues must be resolved before the successful implementation of HIV testing in the dental setting. An educational emphasis on broader coverage of HIV testing is also needed within the dental school curriculum. The integration of HIV testing into dental practice is discussed as well. A policy of screening patients in dental offices will contribute to a major advance in public health.