Resumen

SYKES, LM  y  VORSTER, M. The ethical debate between what patien want, need and can afford, and what treatment clinicians think they should receive. S. Afr. dent. j. [online]. 2023, vol.78, n.9, pp.473-475. ISSN 0375-1562.

Endodontic emergencies are common procedures in dental practice, and need to be addressed as soon as possible. The initial treatment is usually extirpation of the pulp -also known as emergency root canal treatment (ERCT), -followed by complete cleaning, shaping and obturation of the root canal system. Root canal therapy (RCT) needs to be completed with a definitive restoration to increase long-term prognosis of the tooth. Both of these carry additional costs. Patients treated in government facilities often have limited access to follow-up care due to long waiting lists, financial constraints or logistical challenges. It is also difficult to determine how many patients return for these procedures as some who remain pain-free and asymptomatic may not see the need for any further treatment. Others may experience complications necessitating extraction of the tooth. The prognosis of unrestored extirpated teeth is unpredictable and literature Is scant, thus dentists often need to make a judgement call when deciding between trying to save a tooth and recommending an extraction. This paper debates the ethical issue of considering patients' wants and needs, versus what clinicians think they should receive, as well as the issue of paternalism, in relation to the informed consent process.

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