Ethics is the foundation of contemporary dental practice, guiding clinical decision-making, protecting patient welfare, and fostering trust between dentists and patients. In the United States, rapid advancements in digital dentistry, artificial intelligence, teledentistry, and corporate healthcare, coupled with evolving patient expectations and healthcare policies, have introduced complex ethical challenges that extend beyond traditional clinical care. This comprehensive review examines the application of the core ethical principles of autonomy, beneficence, non-maleficence, justice, and professional integrity in contemporary dental practice. It highlights emerging ethical concerns, including informed consent, patient confidentiality and data privacy, overtreatment associated with financial incentives, conflicts of interest, ethical use of artificial intelligence and digital technologies, professionalism, and disparities in access to oral healthcare for vulnerable populations. The review further explores how technological innovation, commercialization, and changing models of healthcare delivery influence ethical decision-making and professional accountability. By synthesizing current evidence, this review emphasizes the need to strengthen ethics education, promote transparent patient communication, establish evidence-based ethical guidelines for emerging technologies, and improve equitable access to quality oral healthcare. Reinforcing ethical principles alongside scientific and technological advancements is essential to preserving patient trust, ensuring professional accountability, and supporting ethical, patient-centered, and equitable dental practice in the United States.