Dentists - a nice thread

Mrs_P_Pincher

I have posted before about the problems I was having with my dentist, who had treated me appallingly and finally refused to sign me off as dentally fit at the end of a course of treatment and then had his office staff hassle me to cancel my Denplan agreement.

I had lots of good advice from the chaps on here and this morning went to see another dentist for a check up. She took her time, explained everything, didn't cause me any pain or discomfort at the time, took on board the stuff I'd put on the medical questionnaire without comment, gave me a brushing lesson, which I have never ever had before and has booked me in for a scale and polish first thing on Monday morning.

It's not all good. I have now lost 50% of my bone and I have a decaying wisdom tooth, which will need to come out, and I suspect that this might be why the previous dentist would not sign me off as fit. This will be because I had one before on the other side that he didn't tell me about for two years and by the time he did I had been diagnosed as having had a series of strokes, then diagnosed with TGN and put on anti-convulsants and then investigated for MS.

At that time I lost the feeling in the left hand side of my face and I never got it back. I assumed it was something to do with the extraction, but I am told it cannot be, so I will need to investigate that through my doctor.

The best thing though was that I explained how, without telling me, the previous dentist had doubled the length of my appointments, the better to deal with my phobia. She was incredulous and assured me that I am definitely not phobic!

I now feel empowered. I'm not looking forward to Monday, or the extraction, but I think that's only natural.

I am tempted to complain about the other dentist, to Denplan at least, but I suppose if a complaint was upheld, he would just retire, which is what I suspect he wants to do anyway.

Mrs P P

j.e.j.

Glad you've found a better dentist now It took years for me to find one who I'm reasonably happy with.

I'm not sure if or how private dentists are regulated, tbh, but if you were mis-treated you perhaps ought to look to pursue it. He might be doing the same to other patients.

Magnolia

I have a great dentist - he is young and qualified in the last couple of years. Kind and gentle and considerate.

I want him for my son *love*

brook2jack

Private dentists are, like all dentists , very heavily regulated.
The process for complaining is similar to nhs. First write to the practice, if you are not happy then try the private complaints scheme
http://www.dentalcomplaints.org.uk/. Which is run by the gdc. If you are still not satisfied you can complain to the gdc itself http://www.gdc-uk.org/Pages/default.aspx .

There are a whole lot of other people who also regulate private dentists and to whom complaints can be made eg cqc in England and HIW in Wales but the private dental complaints service should resolve things before they go that far.

People may be interested to know over 50 different bodies have the right to inspect a dental practice,so even private dentists are very heavily regulated.

Denplan excel schemes require a log of complaints to be kept by the practice and regularly inspects practices so contacting the practice itself should bring this to the fore if it is an excel practice. At the most the worst denplan can do is remove the dentists denplan accreditation.

Toothsmith

I wold disagree with that last bit Brook.

Denplan Excel inspections are carried out by fellow dentists. If a dentist found something so bad at a practice that he had severe concerns, then it would be his professional duty to report it to someone like the General Dental Council, and so launch some very serious proceedings indeed.

In reality though, a practice that had entered into the process of gaining Excel accreditation, and keeping up with it would rarely if ever have a serious issue that would need that sort of action. If a practice had been good enough at one point, it would take serious effort to get that bad that quickly!

brook2jack

TS you are right. However it never occurred to me because, as you said , to get accredited in the first place is quite a process and it's difficult to imagine how dractically standards would have to fall to merit a gdc referral
without eg a change of ownership. What I was trying to say is that , other than recinding denplan accreditation, there is little denplan can do itself without reffering to dental complaints process/gdc etc.

Mrs_P_Pincher

A debate has started in my absence. I'm going to leave him. He's not that important in the grand scheme of things.

Well, I've had my scale and polish, twenty minutes, no anaesthetic, mouth feels fine, so I'm really pleased, but it looks as though my underlying adrenal fatigue is causing some problems. I know that this means I shouldn't have an anaesthetic with adrenaline in it - that causes an immediate physical reaction - but I am wondering whether I need some hydrocortisone or something similar to stop me feeling as if I have been run over by a bus after the appointment. Two appointments in five days, even with the weekend to rest in between, has actually made me quite ill.

Do any of the dentists on here have experience of treating patients with adrenal fatigue?

Mrs P P

brook2jack

I doubt that many would say so as adrenal fatigue is not a conventional medical diagnosis. Adrenal insufficiency is a valid diagnosis and people with this should be well versed as to how to deal with this very serious medical problem.
Dentists deal every day with addisons disease , adrenal tumours etc.
There are very few medical indications for not using an adrenaline containing local anaesthetic since the amounts used are far smaller than the amount of adrenaline produced by someone who is eg nervous about treatment, and unless the injection is direct into a vein very little enters systemically. Most people who feel a reaction to an injection are reacting to the massive amounts of adrenaline their own body produces in fight or flight reaction.

In the old days when people were on long term steroids there were protocols for adjusting medications to stop a steriod crisis but this has mostly been discontinued.

If you have been prescribed hydrocortisone for any reason then you know it is not a drug to be messed about with

Hydrocortisone or any medications should never be adjusted without consulting your gp.

Mrs_P_Pincher

Interesting. I was under the impression that it was good practice not to give an LA containing adrenaline to a patient with hypothyroidism or adrenal issues, the two often coming together. Apparently not then?

I was also coming to the conclusion that what my previous dentist had identified as a phobia was actually a major physical reaction.

You seem to be suggesting that the physical symptoms I have experienced after my appointments are a factor of my own adrenaline supply, even though on the last two occasions, with the new dentist, I have had no obvious nerves, my head was clear and I was certainly nowhere near a fight or flight situation.

This just gets more interesting. I need to see my GP about this paraesthesia anyway, so I'll see what he thinks.

Thank you

Mrs P P

brook2jack

Many people feel that they are not "nervous" about dental treatment but feel nauseous/weak/faint after treatment and put it down to a reaction to the anaesthetic etc. However many people dont eat before an appointment and are generally apprehensive. Blood sugar levels drop and adrenaline increases.

Hypothyroidism ,pituitary tumours, addisons disease etc are not contraindications for anaesthetics containing adrenaline because as said before the amount is minuscule compared to what the average person will produce during the journey to the surgery let alone during the visit. Compared to the past there are very few indications for adrenaline free injections.Dentists also use an injection technique to avoid injecting into a vein, but even this causes a very transistory problem. Local anaesthetic with adrenaline is used because the adrenaline causes the local blood supply to constrict to keep it and the anaesthetic local. So if you have "an immediate" reaction to local it is very unlikely to be the tiny amount of adrenaline that is held very close to the injection site that caused it.

The reason why there are very few conditions where you do not give adrenaline containing local anaesthetics these days is adrenaline is a very good vasoconpressor so keeps the la working better and for longer and effective pain relief is far better at keeping adrenaline levels down than not giving an adrenaline containing injection.

Mrs_P_Pincher

Thank you for that. Something I need to think about.

However, I do know the difference between being 'generally apprehensive' and not having any breakfast and what's happening to me now.

Need to talk to my doc I think.

Mrs P P