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Word Count: 2,017
When a 38 year old male patient requests an extraction of a healthy tooth the dentist must remain open minded assessing the patients perspective in terms of the desired results and knowledge of the procedure Firstly the patient must be well informed about the procedure its consequences costs and alternative options available Secondly the patient must be competent to make a logical treatment decision This decision making process requires the dentist to balance ethics values and principles in determining an appropriate course of action for any given patient while assessing competence to provide informed consent 1 IDENTIFYING ALTERNATIVESIt appears that this patient is unhappy with his previous decision for lower right first molar extraction and the resulting facial asymmetry He likely feels self-conscious expressing wishes to correct the treatment in order to restore his appearanceMultiple courses of action exist Firstly the dentist could refer him letting someone else worry about the patient The patient could go to another dentist to obtain a second opinion leading to a better understanding of the treatment options leading him to change his mind and obtain an implant On the other hand the patient could take drastic actions and seek the help of a plastic surgeon leading to an invasive surgical procedure Alternatively the patient could give up and not follow through on the referral leading to further dental deterioration this is the most likely outcomeSecondly the dentist could extract the tooth this would harm the patient in the long term by causing bone deterioration chewing difficulties and further change in facial appearance As a result the patient could regret the decision at a later date leading to more invasive restorative procedures This could cause him to avoid dentists due to the negative experience in order to avoid further harm As a result he could tell others about his negative experience and discourage many from going to the dentist His views could lead to a poor rapport for the dentist
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