Ethical considerations of randomized control trials with human participants in dentistry. A reflective analysis.

A potential conflict is built into the roles of dentists and researchers with regard to ethical principles such as beneficence, nonmaleficence, respect for autonomy, and justice. The practitioner has an obligation to do what is believed to be best for the individual patient: the dentist as researcher has an obligation to use rigorous experimental methods, including randomized control trials (RCTs) to discover what is best for patients generally, including the investigation of experimental modalities. This is the equipoise problem-how can a professional be assured of offering the most beneficial treatment available if only using approaches that have worked in the past? This essay explores the ethical foundations for this challenge and proposes a groundwork for balancing ethical obligations to patients and the needs for scientific and public health advances.