Surpreet Arora: Response to Case 3- 0.

5mm

In a complex case as this one, an experienced provider such as Dr. Rex could have explained all the possible and reasonable outcomes to the patient. It is very important to ascertain a patients expectations early on and allow them to make an informed decision and cho ose a treatment that is best for them among the various treatments alternatives presented to them. In such a scenario Dr. Rex could have explained the pros and cons of a cantilever lateral incisor which is great for esthetics and has a possibility of a potential diastema between the central and lateral incisor. By doing so he would have mentally prepared the patient to face the challenges with the treatment and compromise a bit on esthetics if necessary. Patient could have been educated on how to maintain adequate oral hygiene in case food trapped in the potential space between these two teeth. In such a situation, Dr. Rex should offer periodic recalls for evaluation of the prostheses to this patient and even offer complimentary hygiene appointments to ensure good periodontal status for this patient. Additionally, he can present this case at his local study club to his colleagues to brainstorm ideas on how to handle this situation. No matter what decision he makes he should always put patient welfare above everything else. The most important aspect of handling this situation is effective patient provider communication. Most lawsuits result due to poor communication between the two. I think most dentists in such a situation would educate patient on maintaining good hygiene in this space and offer periodic recalls and hygiene appointments to ensure patients periodontium is in good health. In my opinion Dr. Rex is obligated to bear the price (entirely or in part) of any corrective fixed prosthodontics treatment ( such as a precision attachment) that he may decide to offer this patient, in case he didnt explain the possible limitations of the original treatment . If I was in this situation I would provide patient with a corrective treatment and bear at least a part of the cost of this treatment. I would do so because this would be the right thing to do. For me relationship and patient satisfaction is more important than the overhead and collections. If Dr. Rex considers himself a Principalist he would do the same. He would take all the correct and morally sound steps to meet this patient needs, as long as those are realistic and possible within the scope of this specialty.