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Inside Dentistry
November 2016
Volume 12, Issue 11
Peer-Reviewed

Helping Patients Choose

The principle of patient autonomy should guide all aspects of dentistry, particularly when helping patients choose whether to save a tooth with root canal therapy and restoration (Figure 6) or to pursue extraction of the tooth with or without replacement (Figure 7). Furthermore, the alternative treatment choices of doing nothing and leaving the diseased tooth in place or extracting the tooth without a fixed replacement—along with the risks and benefits associated with each option—must always be presented to the patient.

As the American Dental Association Code of Ethics1 specifies, all treatment should be done “according to the patient’s desires, within the bounds of accepted treatment.” Thoughtful consideration of all factors germane to treatment course and outcomes, and thorough communication of these factors to patients, allows the team of patient and practitioner to confidently proceed with appropriate dental care.

About the Author

Brooke Blicher, DMD
Assistant Clinical Professor
Department of Endodontics
Tufts University School of Dental Medicine
Boston, Massachusetts

Clinical Instructor, Department of Restorative Dentistry and Biomaterials Science
Harvard School of Dental Medicine
Boston, Massachusetts

Instructor in Surgery
Dartmouth Medical School
Hanover, New Hampshire

Private Practice
White River Junction, Vermont

References

1. American Dental Association. Principles of Ethics and Code of Professional Conduct. With official advisory opinions revised to April 2012. Chicago, IL: https://www.ada.org/~/media/ADA/About%20the%20ADA/Files/code_of_ethics_2012.ashx. Accessed January 24, 2016.

2. American Association of Endodontists. AAE Position Statement 2007. Implants. Chicago, IL: https://www. aae.org/uploadedfiles/publications_and_research/guidelines_and_position_statements/implantsstatement.pdf. Accessed January 24, 2016.

3. Gargiulo A, Krajewski J, Gargiulo M. Defining biologic width in crown lengthening. CDS Rev. 1995;88 (5):20-23.

4. Juloski J, Radovic I, Goracci C, et al. Ferrule effect: a literature review. J Endod. 2012;38(1):11-19.

5. Katz H. Endodontic implications of bisphosphonate-associated osteonecrosis of the jaws: a report of three cases. J Endod. 2005;31(11):831-834.

6. Doyle SL, Hodges JS, Pesun IJ, et al. Factors affecting outcomes for single-tooth implants and endodontic restorations. J Endod. 2007;33(4):399-402.

7. Chugal NM, Clive JM, Spångberg LS. Endodontic treatment outcome: effect of the permanent restoration. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104(4):576-582.

8. Iqbal MK, Kim S. For teeth requiring endodontic treatment, what are the differences in outcomes of restored endodontically treated teeth compared to implant-supported restorations? Int J Oral Maxillofac Implants. 2007;22 suppl:96-116.

9. Pjetursson BE, Tan K, Lang NP, et al. A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. Clin Oral Implants Res. 2004;15 (6):667-676.

10. Gatten DL, Riedy CA, Hong SK, et al. Quality of life of endodontically treated versus implant treated patients: a University-based qualitative research study. J Endod. 2011;37(7):903-909.

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