BIOETHICS AND INFORMED CONSENT IN ORTHODONTICS: A SYSTEMATIC REVIEW
Keywords:
orthodontics; informed consent; bioethics; autonomy; risk communication; Ecuador; health legislationAbstract
DOI: https://doi.org/10.46296/yc.v10i18.0912
Abstract
Background: In orthodontics, informed consent is not merely a signed form but a bioethical communication process aimed at ensuring autonomy, understanding, voluntariness, risk proportionality, and shared decision-making. This is especially relevant because orthodontic care is frequently elective, long-term, cooperation-dependent, and often provided to adolescents whose parents or caregivers participate in decision-making. Objective: To synthesize evidence on bioethics, informed consent, comprehension, information recall, readability, risk communication, and ethical reporting in orthodontics. Methods: A systematic review was designed according to PRISMA 2020. A PEO framework was used: patients, parents/caregivers, orthodontists, and orthodontic trial reports; exposure to informed consent, bioethical communication, risk communication, or educational materials; and outcomes involving comprehension, recall, readability, knowledge, satisfaction, ethical reporting, or validity of consent. Twenty-five studies were included. Due to heterogeneity, a narrative thematic synthesis was performed. Results: Written consent alone was insufficient. The least remembered domains were specific orthodontic risks such as decalcification/caries, root resorption, relapse, and retention. More favorable strategies included simplified readability, chunked information, audiovisual support, mind maps, active rehearsal, and early presentation of essential risk information. Conclusions: Informed consent in orthodontics should be continuous, staged, and verifiable. Best practice combines clear language, clinical dialogue, readable written materials, visual aids, comprehension checks, child assent where appropriate, and documentation of individualized risks.
Keywords: orthodontics; informed consent; bioethics; autonomy; risk communication; Ecuador; health legislation.
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