Question

Your dental practice, which is within an urban city, has many long-standing patients. A number of patients within the practice are on public assistance and struggle with money issues. Dr. Gordon is very generous and understanding about her patients’ limitations and

often provides free dental services. Your next patient of the morning is Jason S, a 14-year-old junior high school soccer player. His mother has made an emergency appointment, as he was hit in the mouth during a soccer game yesterday. His mother is concerned that Jason’s front teeth may be loose as a result. His mother reports that Jason had a thorough “cleaning” in another dental office 4 months ago. Clinical examination reveals no trauma but some mobility, so you take radiographs. Clinically, Jason presents with no obvious signs or symptoms of disease, with lack of tissue inflammation and minimal amounts of plaque biofilm. Jason’s radiographs, however, show moderate vertical bone loss around the maxillary central incisors and mandibular central incisors. Bitewing radiographs also indicate moderate bone loss around the maxillary and mandibular first molars. Probe readings on his incisors and molars are in the 4 to 6 mm range.

You present your findings to Dr. Gordon, who asks you to perform thorough periodontal instrumentation on Jason. You remind Dr. Gordon, that Jason had a dental hygiene appointment in another office 4 months ago and that his insurance only allows for periodontal instrumentation every 6 months. Dr. Gordon states that Jason is in dire need of this treatment and asks you to instruct the office manager to hold off on submitting Jason’s insurance claim until it is within the

6-month time frame.

1. How would you classify Jason’s periodontal condition?

2. What ethical principles are in conflict in this dilemma?

3. What is the best way for you to handle this ethical dilemma?

Answer 1

1)  Periodontal disease is broken up intofour separate stages: gingivitis, slight periodontal disease, moderate periodontal disease, and advanced periodontal disease. Gingivitis is the only stage of periodontal disease that is reversible as it has not yet had time to attack the bones. Jason has slight periodontal disease as mild bone involvement is in Jason's case

2) ethical dilemma or ethical paradox is a decision-making problem between two possible moral imperatives, in this case the ethical dilemma . The principles in conflict are autonomy and beneficience because beneficience do good to pt and family told that they had this procedure 4 months ago so here occurs a dilemma

3) Have a conversation: With the exception of extreme ethics violations, confronting the individual directly first is often the best way to manage a situation.