COMMUNICATION IN ORTHODONTIC TREATMENT PLANNING - BIOETHICAL AND INFORMED CONSENT ISSUES

Orthodontic treatment planning is an interactive process in which the patient or parent and the orthodontist serve as co-decision makers. As in most partnerships, there is a natural tension between the orthodon tist and the patient because of differences in their frames of referen ce. The orthodontist generally is influenced more by the objective fin dings (the problem list), whereas patients are guided more by subjecti ve issues related to their perceived needs, desires, and values. The a rt of careful probing and listening to the patient as part of the trea tment planning process is an essential skill. One of the most difficul t situations in contemporary orthodontics is presented by the patient with a jaw discrepancy for which the alternative treatments are orthod ontic camouflage through dental compensation or surgical-orthodontic c orrection. Computer imaging to simulate the probable treatment outcome s can facilitate communication about these alternatives by eliminating misconceptions. Full disclosure and the consideration of ail viable t reatment alternatives have great benefits from a risk management stand point, in addition to their bioethical merits.