Ethics & Law · patient case question
How should the dentist respond to the request for veneers?
Patient case: A Teenager, His Mother, and a Language Barrier
Patient: 14-year-old male, accompanied by his mother
Chief Complaint: “I don't like how my teeth look. I want veneers.”
Background: Orthodontic treatment completed six months ago. His mother speaks only Spanish and the dentist speaks only English. The mother has brought her 16-year-old nephew along, offering to have him interpret.
Medications: None
Vital Signs: BP 108/66 mmHg · HR 76 bpm · RR 16 · T 98.4°F
Findings: Class I occlusion with an excellent post-orthodontic result. Teeth are well aligned, intact, unrestored and caries-free. Shade and morphology are within normal limits. No wear, no discoloration.
Show answer and explanation
Correct answer: A. Discuss the risks and benefits of veneers, including the irreversible tooth reduction, and explore what specifically he dislikes
- A. CORRECT. The teeth are sound and the alignment is excellent, so there is no clinical indication. But dismissing the request outright misses the point — the appropriate response is an informed discussion. Veneers require IRREVERSIBLE enamel reduction on healthy teeth, commit a 14-year-old to a lifetime of replacements, and are being requested at an age when the gingival margins have not yet stabilised. Understanding what he actually dislikes often reveals a concern that whitening, minor reshaping or simply reassurance can address.
- B. A flat refusal without explanation abandons the patient's concern and damages trust. His autonomy is exercised THROUGH information, not by withholding it.
- C. Choosing a material without first establishing whether ANY restorative intervention is justified reverses the order of reasoning. Composite is more conservative, but 'less harmful' is not the same as 'indicated'.
- D. The orthodontic result is described as excellent. Referring back offers nothing and implicitly frames a normal outcome as a failure.
Note: Elective irreversible treatment on a healthy dentition in an adolescent deserves particular caution. Cosmetic dissatisfaction at this age frequently resolves; enamel does not grow back.