The dentist should be aware that some patients will
opt to have an extraction of a tooth on the grounds of
time involved in treatment, fear of treatment, lack of
confidence that root canal treatment is likely to be
successful or the total cost involved.
Although medical
conditions (e.g., diabetes, or habitual tobacco smoking)
may complicate or delay healing, in general, medical
reasons are not a contra-indication to root canal
therapy. However, conditions which limit a patient’s
ability to lie supine (e.g., spinal arthritis), to open the
mouth wide (e.g., rheumatoid arthritis), or to tolerate
rubber dam (e.g., anxiety disorders), may make
endodontic treatment more difficult but not impossible.
Following appropriate explanation of what is planned,
the dentist should take into consideration the following
questions that may influence the overall treatment plan
and management:
(1) Is endodontic treatment in the
patient’s best interest? (2) What are the patient’s
expectations? (3) Will the patient be able to tolerate the
treatment planned? (4) Will the patient be able to
afford the treatment planned?