Large dental groups can sometimes impose quotas on dentists who work there. Sometimes those quotas include procedures that may be beyond the training and experience of the dentist. In one particular claim, a patient was scheduled for one surface composite restoration. The treatment plan included the extraction of #17, but the patient was supposed to be referred to an OMS for that extraction. The dentist was “pressured” by the employer to extract tooth #17 on the day the patient presented for the surface composite restoration. Concerned that refusing to perform the extraction might have led to consequences in the practice, the dentist extracted the tooth. It was a difficult procedure, and a paresthesia resulted. The dentist was sued, and the lawsuit alleged the dentist performed a procedure beyond his training as well as a lack of communication – the patient thought she was only going to have a restoration.