Can a NHS dentist just remove me from their list!?

JasonBat

Toothsmith wrote: »

It's certainly a possibility.

I'm certainly starting to think that is a possible contributor (the pain seems to be emanating from my UL1 which was previously supporting a bridge and therefore subject to compromise).

Seems my oral surgeon (or past oral surgeon) is trying to explain the swollen muscle as a result of 'clenching' which is what I suspected he would try and do. Funny how that is only effecting the side of my face effected by this issue together with the fact that any grinding etc. was never ever mentioned in the many years I consulted with him.

Toothsmith

JasonBat wrote: »

I'm certainly starting to think that is a possible contributor (the pain seems to be emanating from my UL1 which was previously supporting a bridge and therefore subject to compromise).

Seems my oral surgeon (or past oral surgeon) is trying to explain the swollen muscle as a result of 'clenching' which is what I suspected he would try and do. Funny how that is only effecting the side of my face effected by this issue together with the fact that any grinding etc. was never ever mentioned in the many years I consulted with him.

Well it was your mention of the swollen muscle that made me think of the possibility of grinding several posts ago!

It's certainly a possible explanation for some of your symptoms. The things you find 'funny' above are all possible presentations of the problem, so I really wouldn't dismiss it.

And 'cracked teeth' need a cause! Tooth grinding is often the thing that causes the cracked teeth!

Obviously I can have no idea what is causing your problems. I don't have access to enough information. But tooth grinding (bruxism) is certainly a possibility, and given that this has been going on for so long, I would suggest a little more time to properly investigate this is much better than diving in and digging around in your jawbone for fragments of debris that may or may not be there, and may or may not be the causes of the problems. Especially when such investigations might leave you worse off

Edit - Just reading your post again, cracked tooth syndrome is much more a problem around molars rather than incisors. Molars can have cracks, and yet still have the bulk and strength to stay together. Incisors are more fragile teeth, and would be more likely to just break. Other dentists on here might correct me - but I've not heard of it affecting incisors before.

brook2jack

I would agree with TS but would add one thing.

OP would seem to have a level of mistrust ,suspicion about motives about the professionals who have been dealing with a decades long problem with limited success.

Atypical facial pain is a difficult diagnosis because no reason can be found and treatment is very difficult.

OP seems to have had consultations with many people from ent to oral surgeons to dentists to neurologists. I am not sure from the limited information available that it is right or useful to op to continue trying to second guess a diagnosis as this only seems to increase the level of mistrust op has towards the teams trying to sort out their problem.

I am not sure how it will progress ops case by further discussion of possibilities and blame on the Internet.

Having already made official complaints and made contact with regulators etc op would seem well versed in complaint management and perhaps it would be best if we all left op to find a clinical team they can place trust in.

JasonBat

Toothsmith wrote: »

Well it was your mention of the swollen muscle that made me think of the possibility of grinding several posts ago!

It's certainly a possible explanation for some of your symptoms. The things you find 'funny' above are all possible presentations of the problem, so I really wouldn't dismiss it.

And 'cracked teeth' need a cause! Tooth grinding is often the thing that causes the cracked teeth!

Obviously I can have no idea what is causing your problems. I don't have access to enough information. But tooth grinding (bruxism) is certainly a possibility, and given that this has been going on for so long, I would suggest a little more time to properly investigate this is much better than diving in and digging around in your jawbone for fragments of debris that may or may not be there, and may or may not be the causes of the problems. Especially when such investigations might leave you worse off

Edit - Just reading your post again, cracked tooth syndrome is much more a problem around molars rather than incisors. Molars can have cracks, and yet still have the bulk and strength to stay together. Incisors are more fragile teeth, and would be more likely to just break. Other dentists on here might correct me - but I've not heard of it affecting incisors before.

Thanks Toothsmith.

I think I will leave the investigations to the facial pain clinic in London, at least in terms of my meetings with hospital staff.

Okay, I might give the bruxism thing some more thought and discussion. What worries me though that, as you and both correctly suggested, no clinician including the consultant I met with has ever mentioned this is the many years this problem has presented itself (one would consider this due reason for complaint).

The problem with the incisor is that is has been root filled and subject to apical surgery. I think the oral surgeon in question did indeed suspect this might be playing a role as he noted the root filling was short. It has also been crowned for many years and I am wondering if the area surrounding the crown (around the gum line) has been slightly compromised or subject to a hairline fracture.

JasonBat

brook2jack wrote: »

I would agree with TS but would add one thing.

OP would seem to have a level of mistrust, suspicion about motives about the professionals who have been dealing with a decades long problem with limited success.

Atypical facial pain is a difficult diagnosis because no reason can be found and treatment is very difficult.

OP seems to have had consultations with many people from ent to oral surgeons to dentists to neurologists. I am not sure from the limited information available that it is right or useful to op to continue trying to second guess a diagnosis as this only seems to increase the level of mistrust op has towards the teams trying to sort out their problem.

I am not sure how it will progress ops case by further discussion of possibilities and blame on the Internet.

Having already made official complaints and made contact with regulators etc op would seem well versed in complaint management and perhaps it would be best if we all left op to find a clinical team they can place trust in.

I respectfully disagree. I think this thread has proved most helpful.

I put it to you, in the event you are suggesting my distrust in not justified, that if a consultant made an assertion in unequivocal terms and later denied making that assertion or anything to do with that assertion it would certainly raise concern and subsequent suspicion and distrust.

I think the second guessing is more of a matter of first guessing and these steps appear not to have been taken and based on the fact that you agree with Toothsmith you would agree with that.

Toothsmith

JasonBat wrote: »

The problem with the incisor is that is has been root filled and subject to apical surgery. I think the oral surgeon in question did indeed suspect this might be playing a role as he noted the root filling was short. It has also been crowned for many years and I am wondering if the area surrounding the crown (around the gum line) has been slightly compromised or subject to a hairline fracture.

Such a failure in a tooth like that would be quite obvious. The 'hairline crack' would very soon lead to either the tooth breaking or a very noticable infection setting in.

JasonBat

Toothsmith wrote: »

Such a failure in a tooth like that would be quite obvious. The 'hairline crack' would very soon lead to either the tooth breaking or a very noticable infection setting in.

What do mean by very noticeable because I sure am noticing the pain?

I suppose it depends very much where the crack is and how it is angled.

The other possibility is all the gum scarring in the area is adding to the problem. There is plenty of scarring due to all the surgery I've had.

Toothsmith

Swelling, exuding pus, periodontal pocketing, root resorbing, loose tooth, bad taste and failing very quickly.

A tooth with the history you describe for this tooth wouldn't have enough bulk left to 'hide' a crack for very long!

JasonBat

Toothsmith wrote: »

Swelling, exuding pus, periodontal pocketing, root resorbing, loose tooth, bad taste and failing very quickly.

A tooth with the history you describe for this tooth wouldn't have enough bulk left to 'hide' a crack for very long!

I see.

I've raised a complaint with the practice in question and, after refusing to even discuss this over the telephone, are refusing to see me again in any capacity.

So, I've taken the matter to the GDC and am on the look out for another dentist.

If my new dentist asked what went wrong with my old dentist then any suggestions as to what to say (in the event of history repeating itself)?

Toothsmith

If you want a dentist to be truthful with you, then it's probably only right that you should be truthful with them?