Ethics: moral principles that govern a person’s behavior or the conduct of an activity. Regardless of discipline, health-care providers are rooted in foundational ethical principles that prioritize patient well-being, autonomy, and trust. Ethics may be codified within the dental profession, but virtue ethics—the character traits and habits that often guide our decision-making—are cultivated over time, often long before we ever step into the operatory.¹

Who we are before entering the health-care profession influences the ethical lens through which we navigate patient relationships, clinical decision-making, and reflective practice.

Influences on our ethical framework

Yes, dental hygiene education teaches ethical standards and professional responsibilities, but our moral compass is often shaped by personal experiences, cultural influences, family values, and the environments that raised us.

Our ethical framework is inherent and shaped in our nonclinical lives. The values our families model influence how we view compassion, accountability, and responsibility, while cultural norms and faith traditions can shape perspectives on communication, authority, caregiving, and advocacy.² Educational experiences, mentors, and role models then challenge or reinforce the beliefs we carry into adulthood, while personal lived experiences deepen our sense of empathy and resilience. Even socioeconomic background informs us of accessibility to care, trust in health care, and barriers patients face in maintaining health.

Together, these experiences contribute to the ethical lens through which we communicate, make clinical decisions, and ultimately deliver care.

Evolution of ethics in dental hygiene

Dental hygiene ethics is initially focused on patient safety, infection control, and professional conduct—recall the foundational principles of nonmaleficence, beneficence, justice, and autonomy. As the profession has evolved, ethical expectations have expanded beyond technical competence to include cultural awareness, advocacy, and patient-centered care.

Organizations such as the ADHA continue to guide accountability and ethical clinical practice.³ Ethics is no longer viewed as simply a set of rules to follow, but as a reflective lens through which dental hygienists approach everyday care and professional relationships. It is through self-awareness that these professional standards become personally meaningful, bridging who we are with how we practice.

The power of self-awareness

Self-awareness is the ability to recognize one’s own emotions, values, biases, strengths, and limitations, laying the foundation for reflection. Through reflection, you allow yourself to provide enhanced patient-centered care by making deliberate, ethically sound choices that support professional integrity and patient trust. Increased self-awareness allows clinicians to recognize situations where their knowledge may be limited.

The ability to identify underdeveloped gaps in experiential framework allows clinicians to seek guidance, reducing errors and improving outcomes.⁴ Seeking guidance can strengthen communication, teamwork, and interprofessional collaboration, in turn, resulting in a growth of experiential framework and superior patient care.

Reflection as a bridge

As we go through life, we build a scaffolding of experiences that gradually create the framework for our cognitive and behavioral orientation toward certain situations. Every success, mistake, or ethical dilemma adds a new layer of scaffolding. This framework sharpens the lens of how we interpret and respond.⁵

The more we develop this framework in professional experience, the more we increase our confidence, empathy, and situational awareness. Since ethical decision-making is often done unconsciously, we rely on experiential scaffolding to prioritize values and anticipate consequences.

Reflection is a deliberate, thoughtful process of examining one’s experiences, actions, and decisions in order to understand their meaning and improve future practice. It involves looking beyond what happened to consider why it happened, how personal values and assumptions influenced the outcome, and what could be done differently moving forward.

Reflection of these experiences acts as a bridge between who we are personally and how we practice.⁶ Biases or assumptions can alter ethical decision-making when responding to certain situations. Regular reflection can align ethical decision-making with core values such as integrity and accountability rather than habit or situational pressure.

Utilizing reflection as a tool for professional growth intentionally strengthens and calibrates everyday practices. The lack of intentional reflection can leave a framework with underdeveloped gaps, ultimately limiting communication, clinical decision-making, and consistency of patient-centered care.

Take a moment

Think of a patient interaction that may have challenged you emotionally, professionally, or ethically. As you reflect on the encounter, consider the following:

• What emotions did I experience during this interaction?
• Did any personal assumptions, biases, or experiences influence my response?
• Did I approach the patient with curiosity and understanding?
• Were my response and reactions aligned with the type of provider I strive to be?
• If faced with a similar situation again, what might I do differently?

Reflection is not about having the “right” answer in every situation. Rather, reflection allows us to create space to better understand ourselves, recognize our blind spots, and approach future encounters with greater intention. Ethical growth begins with our willingness to pause, reflect, and be open to learning.

Cultivate ethical practice

Ethical decision-making begins with a person’s virtue ethics and what they know before they become a health-care professional. Through formal education, clinical application, and self-reflection, our ability to navigate such situations becomes stronger and more intentional. This reinforces the idea that ethical decision-making is cultivated over time through experience and education—not solely from codified rules.

After a challenging encounter, journal about the experience, seek mentorship when faced with ethical uncertainty to talk it out, and engage in continuing education focused on ethics, cultural awareness, and patient-centered care. Create space for conversations with others that challenge assumptions that encourage growth.

Related:

• Seismic strains: Surveying the ethical fault lines in dentistry
• Beyond fraud: The ethical decisions dental hygienists make every day

Editor’s note: This article first appeared in RDH eVillage newsletter, a publication of the Endeavor Business Media Dental Group. Read more articles and subscribe.

References

1. Leontis A. Exploring virtue ethics: the philosophical theory. Philosophos. December 17, 2025. https://www.philosophos.org/ethical-theories-virtue-ethics
2. Smith CB, Purcell LN, Charles A. Cultural competence, safety, humility, and dexterity in surgery. Curr Surg Rep. 2022;10(1):1-7. doi:10.1007/s40137-021-00306-5
3. Standards for clinical dental hygiene practice. American Dental Hygienists’ Association. 2025. https://www.adha.org/resources/standards/
4. Salem GMM, Hashimi W, El-Ashry AM. Reflective mindfulness and emotional regulation training to enhance nursing students’ self-awareness, understanding, and regulation: a mixed method randomized controlled trial. BMC Nurs. 2025;24(1):478. doi:10.1186/s12912-025-03086-w
5. Holm S. Reasons, respect, and identity in public health decision making. Am J Bioeth. 2021;21(9):43-45. doi:10.1080/15265161.2021.1952345
6. Heydari S, Beigzadeh A. Medical students’ perspectives of reflection for their professional development. BMC Med Educ. 2024;24(1):1399. doi:10.1186/s12909-024-06401-2