Clinical decision making with an emotional bias : Dentistry


Today I had a patient who came in requesting for extraction of 32(lower left lateral incisor)

32 was firm without any sign of disease. I asked her why she wanted it extracted. She wasn’t very sure, she just wanted it out.

Reading through her records, about two weeks ago, an associate of mine had put it in her Tx plan to extract 32 because it was proclined and wouldn’t look good for her dentures. She had consented to the plan.

A week later she was scheduled to extract 32 with another associate of mine. In the records, it was stated that she refused the extraction, so a new plan was made making sure she acknowledged the fact that her dentures might not look good.

Today, she came in wanting it extracted. I asked her if she was sure. I saw her face sorta change. As if she came in wanting to get an extraction and now my question; Are you sure? , had made her doubt everything again.

I hate extracting sound teeth for denture purposes. I truly believe that nothing will ever replace the feeling of a natural tooth and if you are on your way to wearing dentures, might as well save all you got.

I think I did make her change her mind with that question. I only asked her that knowing how a few of my other previous patients had felt after extracting their teeth for the purpose of aesthetics.

Anyways, here’s my question; should i tell my patients to not extract their teeth when they came in wanting exactly that? Is it really my job to change their perception? Is it my job to tell the next patient, no you can RCT that tooth or all that needs is a good cleaning? You can save the tooth.

In regards to this patient, i had asked her to wait and make her decision with in 2 weeks. I ultimately regret my decision because not only did I not give the patient what she wanted, i also made her more confused.

What would you do?


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