Ethics & Law · single question
A 61-year-old male with stage IV metastatic pancreatic cancer and generalized stage III grade C periodontitis presents with gross caries and a sinus tract on tooth 30, but no pain. Each of the following may be an appropriate treatment EXCEPT one. Which is the EXCEPTION?
Show answer and explanation
Correct answer: C. Implants for missing teeth
For a patient with terminal illness and approximately one year to live, treatment goals shift to comfort and quality of life. Periodontal maintenance, simple restorations, and even root canal therapy to eliminate infection/discomfort are appropriate palliative care. However, implant placement requires significant healing time (3-6+ months) and would not be completed before the patient's expected death — making implants inappropriate and not in the patient's best interest.
- A. INCORRECT (IS appropriate). Periodontal maintenance helps manage infection and preserve quality of life, which is appropriate for palliative dental care.
- B. INCORRECT (IS appropriate). Endodontic treatment of an infected tooth eliminates pain and prevents spread of infection, which is appropriate palliative care.
- C. CORRECT (this is the EXCEPTION — NOT appropriate). Implants require months of healing and osseointegration. For a patient with an estimated one year to live, implants are not realistic, cost-effective, or in the patient's best interest. Simpler prosthetic solutions would be more appropriate.
- D. INCORRECT (IS appropriate). Restoring carious lesions prevents further deterioration and maintains comfort and function.