The challenge is defining “required”. A patient may present with gum disease and need treatment for it, but the patient decides the treatment is not “required”…the patient is not in pain, they don’t notice the gum disease, so they elect to do no treatment. In this situation, the patient would definitely benefit from treatment to control or eliminate gum disease. Another patient may have a healthy mouth, but desires a nicer smile. The dentist recommends some procedures to improve the patient’s smile and the patients accepts. The procedures are not necessary or required, but they carry some value for the patient, and the patient sees these elective procedures as a valuable to them, even if the treatment is not required.