Ethics & Law · patient case question
Each of the following should be included in Patient A’s informed consent for extraction EXCEPT one. Which is the EXCEPTION?
Patient case: Consent Across Three Patients
Patient: 39-year-old male, plus two additional patients seen the same day
Chief Complaint: “My wisdom tooth on the bottom left is broken down and I want it out.”
Background: Patient A: 39-year-old male, healthy, no medications, no anticoagulant or antiplatelet therapy, no allergies. Tooth #17 grossly carious and non-restorable. Risks, benefits, and alternatives to extraction were discussed in full; he asked questions, expressed understanding, verbally agreed, and signed the consent form. Patient B: 5-year-old male attending with his mother for restorative treatment. Patient C: 44-year-old male rendered legally incompetent following a gunshot injury to the head; his wife has been appointed his legal guardian by the court.
Medications: Patient A: none
Vital Signs: Patient A: BP 120/76 mmHg · HR 72 bpm · RR 16 · T 98.6°F
Findings: Patient A: #17 with gross distal caries extending subgingivally, non-restorable. No pericoronitis, no trismus, no lymphadenopathy.
Show answer and explanation
Correct answer: D. Risk of bleeding related to his anticoagulant medication
- A. Incorrect — this should be included. Postoperative infection is a standard disclosable risk of a surgical procedure.
- B. Incorrect — this should be included. Delayed healing and alveolar osteitis are recognized risks of any extraction and must be disclosed.
- C. Incorrect — this should be included, and it is particularly important for #17. The inferior alveolar and lingual nerves lie in close proximity to mandibular third molars, and paresthesia is the most significant specific risk of this procedure.
- D. Correct — this is the exception. He takes no anticoagulant or antiplatelet medication, so a medication-related bleeding risk does not apply to him. Consent must be individualized to the actual patient rather than recited generically.