It is argued that the state becomes an ethical agent when it requires that candidates for licensure perform dentistry on patients. As an ethical agent, the state is required to give full information, obtain true voluntary cooperation of patients, not expose patients to increased risk, and provide oversight while unlicensed dentists are practicing and follow-up care where untoward outcomes occur. The possibility of unsuccessful outcomes is known in advance, and there is no evidence showing that known exposure of individual patients to risk is compensated by decreased risk to patients generally.