Restoration and enhancement: is cosmetic dentistry ethical?

The ethical ground for restoration (returning a patient to healthy form and function) differs from enhancement (using medical means to improve appearance). Physicians and dentists who argue that enhancements improve self-esteem must reconcile this claim with the fact that they are not licensed to practice psychology. The extreme views are that doctors either should provide cosmetic services as requested by patients or they should not. The middle position is that doctors must retain their fiduciary position of trust based on professional judgment and advocating for patients' health interests. Patient health always outweighs patients' cosmetic desires.