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Communication in dentistry is bilateral process which usually is based on response (understanding) by the person. That’s why the Oral Healthcare Providers (OHP) should be convinced the consent given by the patient is valid. It means that at the beginning of the treatment the orthodontist will ask a lot of questions and have expectations to receive appropriate answers. There is a specific lack of awareness about the first orthodontic consultation at 7y of age, occurrence and prevention of most of the common tooth jaw discrepancies which affect the oral health, self-confidence and overall development of the child. A variety of socio-demographic, educational, personal and other factors mostly divided into objective and subjective factors influences the perception of facial attractiveness. The orthodontic treatment lays down on the personal desire and attitudes, depends from the motivation but is not without a risk for the patient. The aim of the current research is to present the most objective and subjective factors identifying the patient’s refusal.  Material and methods: It’s a case report based on preliminary discussion and orthodontic consultation over the cephalometric analysis and cast models. Orthodontic treatment protocol was followed and given informed consent by the individual was received.  Results and discussions: An electronic search was conducted using the Medline database (PubMed), Science Direct, and Scopus. In this case report were described the treatment options for Class III malocclusion with an emphasis on maxillary protraction and existing impacted canine 13. The decision making capacity was evaluated and also what are the objective and subjective factors and how to proceed with patient refusal.  Conclusions: Despite the orthodontist’s efforts to improve the management of the dental practice and to attract new patients, these challenges should never been from the first importance. Contemporary dentistry requires that the patient’s right to refuse should be respected and this refusal must be accepted. Because orthodontic treatment is expensive, the process of returning money or sharing responsibility for the treatment depend on the socio-cultural characteristics of both the patient and the doctor. The whole situation requires a very delicate approach, as it affects the image of the dental community in society at whole.

Decision Making Capacity or How to Accept Patient’s Refusal for Orthodontic Treatment