Chasing Perfection: The Trap of Overtreatment in Aesthetic Dentistry

University of Monastir, Faculty of Dental Medecine of Monastir, Research Laboratory of Occlusodontics and Ceramic Prostheses, Monastir, Tunisia

*Corresponding Author: Dr. Sarra Nasri, Assistant Professor, University of Monastir, Faculty of Dental Medecine of Monastir, Research Laboratory of Occlusodontics and Ceramic Prostheses, LR16ES15, 5000, Skanes, Monastir, 5000 Tunisia, Phone No: +216 95191569, ORCID: 0000-0001-6740-6644, Email: [email protected]

Received Date: August 17, 2025

Published Date: November 10, 2025

Citation: Nasri S, et al. (2025). Chasing Perfection: The Trap of Overtreatment in Aesthetic Dentistry. Mathews J Dentistry. 9(2):60.

Copyrights: Nasri S, et al. © (2025).

ABSTRACT

Overtreatment in aesthetic dentistry is a growing contemporary concern. As a result, healthy teeth are sometimes sacrificed in pursuit of an immediate aesthetic result, which may lack durability and compromise biological integrity. Clinical decision-making is therefore influenced not solely by medical criteria, but also by external factors such as patient's visual expectations or media-fueled promises. In this context, ethical and deontological principles must be reinstated at the forefront of therapeutic reasoning. Faith, ethics, and science collectively emphasise that in dentistry, as in all medical fields, what is technically possible is not always ethically justifiable. Practitioners must act not only as technicians, but also as guardians of their patients’ health, trust, and well-being.

MAIN TEXT

The global demand for aesthetic dental treatments has significantly increased, largely influenced by beauty standards promoted through social media [1].

This aesthetic uniformity, often driven by influencers, celebrities, and marketing from dental clinics, leads to a loss of authenticity and personal expression. Smiles become interchangeable and depersonalized, stripping away the distinctive qualities that make each one unique.

Nowadays, patients are opting for invasive procedures such as veneers or crowns, even when their dental condition does not clinically justify such interventions. Adolescents, in particular, are increasingly exposed to idealised representations promoted via social media. Platforms such as Snapchat, Instagram and Tik Tok are reported to be the main sources of information and advertising related to cosmetic dentistry [2-4].

From an ethical standpoint, this trend raises concerns about the risks of overtreatment and the normalisation of unjustified dental interventions.

The pathological obsession with appearance to the detriment of overall well-being and quality of life is where the real issue lies. This particularly affects individuals who are emotionally vulnerable or lacking a strong sense of identity, leading them to conform to trends or correct perceived flaws.

Practitioners often face difficulties with such patients, where the problem stems more from psychological dissatisfaction and unrealistic expectations than from any tangible physical defect. These individuals may be demanding, or even aggressive, and some may suffer psychological deterioration or depression when outcomes fail to meet their expectations.

Previously, patients frequently brought in pictures of celebrities to replicate specific aesthetic features. Today, a more concerning phenomenon has emerged: "Snapchat dysmorphia", where patients seek to emulate filtered version of themselves as seen on social media. This trend blurs the bounday between fantasy and reality, complicating both diagnosis and treatment [4].

According to various codes of medical ethics, healthcare must not be treated as a commercial product, nor should medical interventions be reduced to mere transactions for profit. The role of healthcare professionals is to provide care and services guided by medical necessity not financial gain. The prohibition of medical advertising in countries like Tunisia aims to prevent commercial exploitation and to ensure that patient care remains the primary concern.

On another hand, informed consent plays a crucial role, ensuring that patients fully understand the implications of proposed treatments before agreeing to them. It rests on two core principles: respect for patient autonomy and the necessity of clear, comprehensive communication.

This requirement is particularly significant in cosmetic procedures, which often lack clear medical justification. Patients must be informed about all available treatment options, associated risks, costs, and alternatives, including the option of no treatment at all.

Communication should be devoid of technical jargon and tailored to the patient’s level of understanding. Practitioners must also verify that the patient has genuinely understood the information, by encouraging questions and conforming comprehension.

This approach reinforces trust, enhances satisfaction, and reduces legal risks. Actively involving the patient in healthcare decisions also improves treatment adherence and fosters a deeper understanding of shared responsibilities.

When a dentist routinely fulfills aesthetic requests without proper clinical discernment, he risks deviating from their primary mission: preserving and restoring oral health. This may lead to overtreatment.

In such cases, the dentist may reduce his role to that of a “smile technician,” applying standardised protocols without considering the patient’s individual needs.

To avoid this, practitioners must prioritise active listening, patient education, and thorough clinical evaluation. Aligning aesthetic goals with medical indications ensures compliance with the principles of beneficence and non-maleficence. Ultimately, treating to beautify should never come at the expense of oral health. It is time to reaffirm that in dentistry, as in all of medicine, what is possible is not always justifiable.

The “Daughter Test”, proposed by Frederick J.T. Burke and Martin G.D. Kelleher, is a powerful ethical tool that encourages dentists to reflect on the appropriateness of their clinical decisions [5].

 It is based on a simple yet profound question: “Knowing what I know about this treatment, would I perform it on my own daughter’s teeth?”

This question urges practitioners to prioritise patient well-being over aesthetic trends or financial incentives. It advocates a conservative and respectful approach to dental tissues, particularly when dealing with elective cosmetic procedures [6-9].

Fortunately, multidisciplinary approaches now exist to help address such deviations. The integration of facial analysis, Digital Smile Design, gingivoplasty, orthodontics, and rigorous planning allows for a balance between aesthetic objectives and conservation of dental tissue.

CONCLUSION

It is essential to reposition aesthetics within a medically sound framework, that respects anatomy, function, and above all, the well-being of the patient. The practitioner’s role is not merely to satisfy a request but to guide it within a responsible therapeutic context.

The future of aesthetic dentistry lies not in the proliferation of procedures, but in the clinician’s ability to harmonise science, aesthetics, and ethics. Enhanced professional awareness, stricter regulation of practices, and better patient education regarding clinical realities are key measures to ensure that aesthetics does not become a vehicle for abuse.

FUNDING

No external funding was received for this study.

CONFLICT OF INTEREST

The authors declare that they have no conflicts of interest related to this work.

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