(dental dilemma) Can Someone Help me . . .

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Dec 15, 2011
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I have this dental Dilemma and i could not figure an ethical solution

Ms.julia is now patient in your office with a chief complaint that she “hates her partial denture” and she wants a “porcelain bridge”. She is a 39 year old computer analyst working for the same company for the past 15 years, and has had a fee-for service dental insurance contract with her company since she was hired

Ms.julia is in excellent general and dental health, and has had yearly dental examinations for the past 15 years. Twenty years ago, she had a serious auto accident and lost her mandibular central and lateral incisor, mandibular molars on the right side; Along with her maxillary right first and second molars she initially wore a temporary acrylic partial denture for three years that was replaced by her current removable partial denture that she has worn for ten years. The fit and appearance of the partial denture is poor. Her excellent periodontal health, Tooth position, size and occlusion would tolerate either a fixed or removable denture

You have explained to Ms.julia that she will not have occlusion on tooth #16 if a #33-34 porcelain fixed partial denture is made, but she does not care. You agree to submit pre-estimate for a fixed partial denture along with radiograph to her dental insurance company. Her dental insurance has $250 deductible with a co-pay of 50%for prosthodontics, for maximum annual benefit of $1,000

Five week later, you receive a replay and a rejection of the treatment plan with an explanation that a removable partial denture would be allowable. Ms.julia is upset and insists that you complete the fixed partial denture. Submit it as a removable partial denture, and she will pay the balance you explain to her that is illegal, but she again insists that you follow her decision

what would you do?
 

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