A 2025 Ontario Small Claims Court decision, Duchene v. H.S. Bedi Dentistry Professional Corporation, is an important reminder to dentists that excellent clinical work does not protect against liability when informed consent is missing, particularly in cosmetic dentistry.
The case turns not on whether the dentistry was competently performed—it was—but on whether the patient ever agreed to the aesthetic outcome that the dentist deliberately intended to achieve. Ultimately, the dentist did good work but did not obtain the requisite informed consent from the unhappy patient and was ordered to pay $8,802 plus interest as damages.
Background
The 66-year-old plaintiff patient had a lifelong dental history involving peg lateral incisors. Meaning: tooth 1-2 and 2-2 did not develop properly, resulting in teeth that are smaller, pointed, and cone-shaped.
Over many years, the patient’s previous dentists had built up those teeth using resin bonding, resulting in lateral incisors that were equal in length to her central incisors. By the patient’s own account, she was happy with their appearance, notwithstanding the ongoing need for periodic maintenance.
When her longtime dentist retired, the defendant dentist took over the practice. During a series of visits in 2022, the plaintiff underwent cleaning and then resin restoration. The plaintiff’s position was simple and consistent: she believed she was attending for routine treatment to address a recurring dark spot on one lateral incisor—a problem she had dealt with many times before. What she did not expect was a reshaping of both lateral incisors.
On June 7, 2022, the defendant dentist performed resin bonding restorative work and shortened and thinned both lateral incisors by approximately 1–2 millimetres to achieve what he described as the “golden maxillary ratio.” The result was intentional and, according to the defendant and his expert witness, clinically acceptable and aesthetically improved from a professional standpoint. Based on this, the patient should have been happy and the dentist too for a job well done!
The problem, however, was not the result—it was the process.
Immediately after the procedure, the plaintiff was upset. She testified that she was devastated when she saw the change in the mirror and would never have agreed to having her lateral incisors shortened. The defendant dentist offered to place porcelain veneers at no professional charge, though lab costs would still apply. The plaintiff declined further treatment and eventually sued, seeking damages for lack of informed consent.
The Issue
Crucially, the plaintiff did not allege that the dentistry was negligently performed. The case was entirely about consent.
The Decision
The defendant dentist testified that he routinely conducts a “time-out” discussion with patients before aesthetic work and asserted that he would have discussed the golden maxillary ratio and obtained consent. However, he could not recall the specific discussion with this patient and relied heavily on his usual practice.
The court found this insufficient, particularly given the absence of any chart notes documenting a discussion about reshaping or shortening teeth. In retrospect, just a little bit more time charting the usual practice could have prevented this whole lawsuit from going the way it did!
The judge placed significant weight on the documentary record. The dentist’s notes referred repeatedly to “applying” resin restoration, not removing resin or altering tooth length. In the court’s view, this language aligned far more closely with the plaintiff’s understanding of the treatment than with the dentist’s later explanation.
The court accepted that the dentist acted with good intentions and believed he was improving the patient’s smile. However, benevolence does not substitute for consent. The judge concluded that the dentist unilaterally decided to alter the plaintiff’s teeth based on professional aesthetics, without clearly explaining the proposed changes or obtaining informed consent for that specific outcome.
The legal analysis focused on informed consent rather than battery. The court rejected the battery claim, finding that the patient did consent to dental work generally. However, the lack of informed consent amounted to negligence because the dentist failed to disclose a material change in appearance that a reasonable person in the plaintiff’s circumstances would want to know about—and likely refuse.
Importantly, the court emphasized that cosmetic dentistry is fundamentally different from treatment aimed at correcting functional or medical problems. Where treatment is purely aesthetic, the patient’s preferences override the dentist’s professional opinion, a point even the defence expert conceded in cross-examination.
Damages were awarded despite the absence of physical injury. The court awarded $5,000 for pain and suffering, anxiety, and loss of confidence, along with $2,802 in pecuniary damages to cover future restorative work, an admitted overpayment, and the cost of a second opinion. Prejudgment interest was also awarded.
Bottom Line
Informed consent is outcome-specific, not just procedure-specific. A patient consenting to “resin bonding” does not automatically consent to a permanent change in tooth length or shape. Charting matters. Courts will readily infer that “nothing was discussed because nothing was charted,” particularly when the alleged discussion is not routine or obvious. Cosmetic intent heightens the consent obligation. Where treatment is aesthetic only, patients must be told exactly how their appearance will change—and given the opportunity to say no. Good or even great dentistry is not a defence. Courts will impose liability even where the clinical result is excellent, professionally endorsed, and complication-free. Do not rely on habitual practice alone. When things go wrong, courts expect specific recollection or documentation, not general assertions of what you “always do.”
For dentists, this case is a clear warning: when altering a patient’s smile, professional judgment must yield to patient autonomy, and that autonomy must be carefully documented—before the handpiece ever turns on.
