Author Topic: Kind of weird question about dental work  (Read 801 times)

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Hillia

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Kind of weird question about dental work
« on: July 25, 2014, 09:30:02 PM »
DH's cousin needs a cavity filled.  He says his dentist won't do it because of his 'fat tongue'.  Is this really a thing?  I can see perhaps additional charges because it would take  longer/be more difficult, but surely it's possible.  I mean, people with Down syndrome often have enlarged tongues, and they get dental care.  It just sounds like an excuse on someone's part.

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JoW

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Re: Kind of weird question about dental work
« Reply #1 on: July 25, 2014, 09:31:43 PM »
It sounds to me like the cousin needs a new dentist. 

Jocelyn

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Re: Kind of weird question about dental work
« Reply #2 on: July 25, 2014, 09:57:08 PM »
Perhaps the dentist is saying that he lacks the skill or equipment necessary to do the procedure safely?
I wonder if the patient inquired about having it done under anesthesia, and because of the nature of his tongue, the procedure would be too risky in the doctor's office, and he can't admit patients to the hospital. I would guess that any given dentist might not have all the safeguards needed to resuscitate someone whose airway got blocked.
I would contact the dentist's office and ask for a referral to a dentist who is trained and equipped to perform the work. If the dentist refused, THAT'S when I'd contact the state dental board to ask for a referral, and take my business elsewhere.
Perhaps the dentist thought he'd communicated something like 'If you want a referral, ask' and is thinking the patient isn't wanting more care. People can get confused when a doctor or dentist gives them bad news, and not really hear what else is said.

Julian

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Re: Kind of weird question about dental work
« Reply #3 on: July 25, 2014, 10:12:35 PM »
POD to Jocelyn.

Large tongues are an airway risk, and the dentist may not be qualified to manage a patient with such a risk.  Also, particularly if the filling is towards the back, the tongue may well get in the way and holding it out of the way might be uncomfortable for the patient under a normal local anaesthetic. 

Under a general anaesthetic, airway management is much easier.  And more comfortable for the patient! 

In a former life I was an OR nurse, and regularly did dental / maxillofacial surgery.  We frequently operated on Down Syndrome patients under general anaesthetic for routine dental procedures like this.  It's much less stressful for the patient and carers, and safer from a general management perspective.

Cousin needs to seek a referral to a dentist / OMF surgeon that runs a practice capable of doing GAs.

mandycorn

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Re: Kind of weird question about dental work
« Reply #4 on: July 31, 2014, 05:23:48 PM »
I think he needs a second opinion. My dentist does second opinion visits for free (in the hopes that if you like/trust him, you'll let him do the work).

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Hillia

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Re: Kind of weird question about dental work
« Reply #5 on: July 31, 2014, 05:42:26 PM »
Well, I talked to Cousin, and got additional info:

- The dentist in question does only low income/government benefit work - so his scope is going to be limited to relatively basic procedures. 
- At the time of the remark, the dentist had just spent 3 hours doing one back-of-mouth filling, and said, 'I can't spend any more time with  you'
- Cousin has a self-described 'small mouth, which he can't open very far'.  Slight eyeroll; this is a real issue, but Cousin has a habit of latching on to any tiny issue that would make him 'special'. 

So I mentioned to Cousin that what he needs is to find a dentist who is certified and set up to do work under general anesthesia.  I will take a wild stab in the dark and guess that Original Dentist didn't mention this because many people who have their medical/dental needs taken care of under a government program do not have the cash to seek out another provider for a more expensive service.  Since they are in a very small town, with the closest metro area about 200 miles away, there are likely not any providers on the government network nearby who can do that level of work, so he just didn't mention it.  Sounds like it came down to poor communication by the dentist.

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Jocelyn

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Re: Kind of weird question about dental work
« Reply #6 on: August 02, 2014, 07:51:51 PM »

- Cousin has a self-described 'small mouth, which he can't open very far'.  Slight eyeroll; this is a real issue, but Cousin has a habit of latching on to any tiny issue that would make him 'special'.   

(snip)
 Sounds like it came down to poor communication by the dentist.

Given the first statement, and that upon your questioning he gave a totally different reason why the dentist couldn't work on him (not a fat tongue), I don't think the blame should be placed entirely on the dentist.