A patient with restorable teeth demands you extract everything and give them dentures. What do you do?

The classic dental ethics scenario. It sits exactly on the line between autonomy and non-maleficence.

How to structure your answer

1Explore why they want it
2Educate on consequences
3Offer alternatives
4Weigh autonomy against harm
5Know where your own line is
6Refer if you can't proceed

Ask what's driving it: cost, fatigue with dental work, fear, a family member's experience
Be concrete about consequences — bone loss, function, irreversibility
Offer alternatives including phased treatment
Acknowledge autonomy has limits when harm is severe and irreversible
You may decline and refer; that's a legitimate ethical position

A strong answer

What lands

First, I would ask the patient why they want all their teeth extracted. I’d want to understand their concerns, whether they’re experiencing pain, are unhappy with the appearance of their teeth, or are frustrated with ongoing dental problems. I would listen to their concerns and explain that while dentures may seem like a simple solution, they come with their own challenges, including changes in chewing ability, comfort, and fit. I would also explain the benefits of preserving natural teeth whenever possible. Then, I would discuss alternative treatment options tailored to their specific needs and goals, making sure they understand the benefits and limitations of each. Ultimately, I would respect the patient’s autonomy, but I would not perform irreversible treatment that I believe is clinically unnecessary. If the patient wanted a second opinion, I would fully support that decision and let them know they’re always welcome to return to discuss their options.

Finds the reason, explains what dentures really cost, and knows where the line sits.

A weak answer

What most people say

At the end of the day that's the patient's decision. I'd tell him honestly that I don't think it's the right choice and explain what he'd be giving up, but if he's an adult who has heard the risks and still wants it, it's his mouth and his body. I'd rather he have it done by someone who treats him respectfully than go somewhere worse.

Picks autonomy immediately and skips the reasoning the station is actually grading.

The trap

⚠Picking a side immediately. 'It's their body, I'd do it' and 'I'd refuse, that's malpractice' both score poorly. The point of the station is the reasoning between those poles.

Reading it isn't the same as saying it.

Most people can explain a good answer and still fall apart saying one out loud. Admitted asks you all 100 questions in a faculty voice, records you, and scores your pace and filler words.

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