Ethical challenges in aesthetic dentistry: a qualitative exploration

BACKGROUND: The rapid expansion of aesthetic dentistry has intensified ethical tensions between professional obligations and patient demands shaped by consumer culture and social media. This conflict is further exacerbated by market-driven healthcare services. Although ethical discussions on aesthetic dentistry are largely theoretical, empirical evidence on everyday ethical dilemmas in clinical practice remains limited. This study aimed to explore ethical problems in aesthetic dentistry, dentists' attitudes toward these challenges. METHODS: A qualitative research design was adopted, utilizing in-depth semi-structured interviews with 19 dentists-including both specialists from various disciplines and general practitioners-in Ankara, Turkey. Participants were selected through purposive and snowball sampling methods. The data were analyzed using an inductive thematic analysis approach, with the entire systematic process managed and organized via MAXQDA Analytics Pro 2024. RESULTS: Thematic analysis identified four main themes: Ethical Responsibility, Perceptions Regarding Aesthetic Dentistry, Transition from Healthcare Provision to Commercial Practices, and Reflections of Systemic Dynamics on Dental Service Delivery. Each of these themes consisted of several subthemes. CONCLUSION: In conclusion, this study identifies that the primary ethical tension in aesthetic dentistry stems from the interaction between non-maleficence and autonomy. The findings highlight the emergence of a potentially vulnerable patient profile and suggest that increasing commercialization-particularly within the context of health tourism-poses significant ethical and professional challenges; therefore, these issues may require more extensive discussion, as well as the development of more comprehensive ethical codes and policies in the field.