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Clin Cosmet Investig Dent
Clin Cosmet Investig Dent
ccide
Clinical, Cosmetic and Investigational Dentistry
1179-1357
Dove

492709
10.2147/CCIDE.S492709
Letter
The Ethical Dilemma of Tooth Extraction on Patient Request [Letter]
Fayaz et al
Fayaz et al
http://orcid.org/0009-0009-8517-4002
Fayaz Yahya 1
Ahmadi Shahab Uddin 1
Miri Said Ahmad Sorosh 2
1 Department of Stomatology, Khatam AL Nabieen University, Kabul, Afghanistan
2 Department of Prosthodontics, Khatam AL Nabieen University, Kabul, Afghanistan
Correspondence: Yahya Fayaz, Department of Stomatology, Khatam AL Nabieen University, Kabul, Afghanistan, Tel +93 (0) 706281798, Email dr.yahyafayaz@gmail.com
29 8 2024
2024
16 283284
23 8 2024
28 8 2024
© 2024 Fayaz et al.
2024
Fayaz et al.
https://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
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pmcDear editor

I am writing to address a critical ethical issue highlighted in my recent article titled “Common Reasons for Permanent Tooth Extraction and Its Correlation with Demographical Factors in Kabul, Afghanistan”, published in Clinical, Cosmetic and Investigational Dentistry (2024). The article observed a concerning increase in tooth extractions based on patient requests, particularly among individuals from lower socioeconomic backgrounds.

Our study, conducted at the National Curative and Specialized Stomatology Hospital, revealed that socioeconomic status and education significantly influence patients’ decisions to request tooth extractions. Patients from disadvantaged backgrounds frequently choose extraction due to limited access to affordable dental care and a lack of awareness about alternative treatments.1 This trend not only perpetuates poor oral health outcomes but also exacerbates existing health disparities.2

The financial burden of tooth extraction, encompassing the direct costs of the procedure and subsequent restorative or orthodontic treatments, is considerable, particularly for those with limited financial resources.3,4 Moreover, the esthetic and functional consequences of unnecessary tooth loss, including impaired chewing function, bone loss, and diminished quality of life, are substantial.5

As dental professionals, we have an ethical responsibility to provide patients with comprehensive information about the implications of tooth extraction and to explore all viable treatment options. Performing extractions solely based on patient requests, without a thorough clinical assessment and discussion of alternatives, undermines our commitment to long-term patient care.

To address these challenges, it is crucial for healthcare systems and policymakers to enhance access to affordable dental services and to implement educational campaigns that emphasize the importance of oral health. Additionally, empowering dentists to engage in open dialogues with patients about the long-term effects of tooth extraction and promoting preventive and restorative treatments are essential steps toward addressing this issue effectively.

In conclusion, the practice of tooth extraction on patient request presents a multifaceted ethical challenge. By tackling underlying socioeconomic factors and emphasizing patient education, we can move towards a more ethical and equitable dental care system that better serves the needs of all patients.

Disclosure

The authors report no conflicts of interest in this communication.
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References

1. Fayaz Y, Ahmadi NA, Ahmadi SU, Atiq MA. Common reasons for permanent tooth extraction and its correlation with demographical factors in kabul, Afghanistan. Clin Cosmetic Invest Dentistry. 2024;25–31. doi:10.2147/CCIDE.S442179
2. Mogîldea DM, Bădărău L, Chilari D, Bicer A, Hîţu D. The impact of socioeconomic status on patients with oral and maxillofacial injuries. In: Cercetarea în biomedicină și sănătate: Calitate, excelență și performanță. 2021:487.
3. Ghonmode S, Shrivastava S, Kadaskar AR, Bapat S. Socioeconomic burden of orthodontic treatment: a systematic review. Med Pharm Rep. 2023;96 (2 ):154. doi:10.15386/mpr-2457 37197274
4. Nguyen PMT, Kenny DJ, Barrett EJ. Socio‐economic burden of permanent incisor replantation on children and parents. Dent Traumatol. 2004;20 (3 ):123–133. doi:10.1111/j.1600-4469.2004.00235.x 15144442
5. Oberoi SS, Sharma G, Oberoi A. A cross-sectional survey to assess the effect of socioeconomic status on the oral hygiene habits. J Indian Soc Periodontol. 2016;20 (5 ):531–542. doi:10.4103/0972-124X.201629 29242690
