An elderly patient with poor oral hygiene and multiple untreated carious lesions attends with his daughter, who asks only for a new partial denture and declines everything else 'for now.' What should the dentist do FIRST?

Correct answer: D. Explain that a comprehensive examination and treatment plan must precede any prosthesis

• A. ❌ Impressions taken before disease control produce a prosthesis that will not fit the treated mouth.
• B. ❌ Dismissal is disproportionate. The patient has not refused care; the family simply has not been informed.
• C. ❌ Building a prosthesis on untreated disease accelerates failure of both the abutments and the denture — this is below the standard of care.
• D. ✅ CORRECT — A removable prosthesis placed onto an unstable, carious foundation is doomed. The patient (or his decision-maker) must be told what the full picture is, what the risks of the partial approach are, and what a complete plan would involve. Only then can there be a genuinely informed decision.

Note: Note also: if the patient has capacity, HE — not his daughter — is the decision-maker. Address him directly.