For the Good of the Patient

A famous entertainer requires hospitalization to remove a large palatal cyst at the apex of his two central incisors. Surgery is performed by an oral surgeon with mixed results. The surgical area does not heal properly, and the teeth are very mobile. The oral surgeon and the patient's general dentist decide to extract the teeth and make an anterior fixed bridge. Before the extraction appointment, the patient consults with a friend's periodontist (perio 1) who describes another surgical solution that allegedly will keep the patient's teeth.

The patient is confused and consults again with the oral surgeon who says that the periodontal surgery is worth a try but that if he consents to this treatment, it must be done by the periodontist he recommends and works with (perio 2). If not, the oral surgeon refuses to continue to treat the patient. The patient has confidence in both the oral surgeon and perio 1. He wants to undergo the periodontal surgery with perio 1 but wants to continue to be treated by his oral surgeon and general dentist who will work only with perio 2. Perio 1 finds out about the problem and refers his complaint of the oral surgeon and dentist to the local dental society for mediation and/or ethical violations. The patient has a dilemma.