Paternalism is not acceptable in dentistry today because it eliminates the patients’ right to choose the treatment they feel is right for them, even if their choice is not what the doctor feels is best. Paternalism violates the patient’s autonomy and self-determination. Dentists accept the ethical principle of non-maleficence and in many countries, are also recognizing the right to informed consent. Most people trust health professionals who serve them. Dentists are among the trusted professionals, and the paper will investigate the (...) attitudes to dentists in several different countries as examples. When patients request inappropriate dental treatment, the dentist must decide how to balance a concern with patients' wellbeing with respect for their choices. It is important for a dentist to keep this in mind and to reflect of its implications, especially when dental practice seems to be changing so much under the influence of the malpractice crises, the changing economic scene, the changing regulatory environment, and so on. A dentist must consider the patient’s values and personal preferences, and must involve the patient in the decision-making process. It is the dentist’s responsibility to determine the decision-making capacity of each patient with the help of appropriate surrogates. For example, patients may be given choices about which type of tooth repair they will choose, given that there are often choices between what an insurance will cover and what an insurance will not cover. Are dental implants only for the rich, and dentures for the poor? Is there a class divide between a silver, gold or white smile? Ethics affect virtually every decision made in a dental office, encompassing activities of both judging and choosing, relationship with patients, the public, office staff, and other professionals. This paper gives an overview of bioethical issues in dental practice and explains the fact that dental ethics cannot support paternalism even in prevention. (shrink)