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

JasonBat

Toothsmith wrote: »

You make a few mentions of these 'foreign bodies' Jason.

One or some of which seem to have been removed - some of which you think are still there. What do you think these bodies are? What did the ones removed turn out to be?

If they're bits of root left from previous extractions - they're not exactly 'foreign' - they're still bits of you. If they're old bits of filling material then they are indeed 'foreign'.

Both retained roots and filling debris are usually no trouble - although occasionally they can cause problems.

Okay, fair comment.

Yes, to cut a long story short, UR1 and UR2 were knocked out in a fight with my brother when I was 12. They were placed back but failed to join with the bone and became brittle and cracked after being root filled.

They were then extracted and my dentist couldn't get all of the cracked tooth and root filling out so he just left them suggesting, as you have, that they will do no harm.

So, after some 20 years, my consultant reluctantly agreed to remove them and agreed they were infected and therefore troublesome.

I then later underwent apical surgery on the UL1 as this had been root filled but the consultant appeared to be unclear on the effectiveness of the root treatment.

So, in short, it could be there is still some post extraction or apical surgery fragments in that area or it could be something totally harmless.

If it was harmless then at least they could acknowledge it was there and of no concern.

Just to be clear, I'm not positive there is anything there but I'm also not positive there isn't. However, the actions of those involved and bearing in mind what I have seen and experienced it certainly opens my mind to the possibilities.

Toothsmith

JasonBat wrote: »

Okay, fair comment.

Yes, to cut a long story short, UR1 and UR2 were knocked out in a fight with my brother when I was 12. They were placed back but failed to join with the bone and became brittle and cracked after being root filled.

They were then extracted and my dentist couldn't get all of the cracked tooth and root filling out so he just left them suggesting, as you have, that they will do no harm.

So, after some 20 years, my consultant reluctantly agreed to remove them and agreed they were infected and therefore troublesome.

I then later underwent apical surgery on the UL1 as this had been root filled but the consultant appeared to be unclear on the effectiveness of the root treatment.

So, in short, it could be there is still some post extraction or apical surgery fragments in that area or it could be something totally harmless.

If it was harmless then at least they could acknowledge it was there and of no concern.

Just to be clear, I'm not positive there is anything there but I'm also not positive there isn't. However, the actions of those involved and bearing in mind what I have seen and experienced it certainly opens my mind to the possibilities.

Ok - thanks. It's making a bit more sense now that more info is available.

Re-implanting teeth can cause those teeth to ankylose - that is fuse directly to the bone rather than attach with the usual membrane that gives the tooth it's normal 'shock absorbancy'. This can make a tooth exceptionally difficult to extract if and when necessary - and bits are often left.

Getting rid of everything can be exceptionally difficult, and cause quite a lot of bone loss, making it very difficult for any replacement (Denture, bridge or implant) to get an even half-way decent looking outcome.

One or two root filling materials commonly used in the 70s, 80s and even still today, can be a bit irritant to tissues if they get out of the tooth and into the surrounding tissue - so it isn't beyond the realms of possibility that something like this might be the cause of your problem.

This is a tricky problem - as going in and exploring round the extraction sites would be very damaging to the bone of the jaw, yet leaving things alone in a patient with pain is obviously not ideal either.

I still think the jaw problem is something that should be explored, but what you really need is someone who can explain the pros & cons of all the options available to you and someone you can work constructively with to come up with a plan - bearing in mind that the only 'ideal' plan is inventing a time-machine and going back to a few seconds before the fight and yelling 'duck'

JasonBat

Toothsmith wrote: »

Ok - thanks. It's making a bit more sense now that more info is available.

Re-implanting teeth can cause those teeth to ankylose - that is fuse directly to the bone rather than attach with the usual membrane that gives the tooth it's normal 'shock absorbancy'. This can make a tooth exceptionally difficult to extract if and when necessary - and bits are often left.

Getting rid of everything can be exceptionally difficult, and cause quite a lot of bone loss, making it very difficult for any replacement (Denture, bridge or implant) to get an even half-way decent looking outcome.

One or two root filling materials commonly used in the 70s, 80s and even still today, can be a bit irritant to tissues if they get out of the tooth and into the surrounding tissue - so it isn't beyond the realms of possibility that something like this might be the cause of your problem.

This is a tricky problem - as going in and exploring round the extraction sites would be very damaging to the bone of the jaw, yet leaving things alone in a patient with pain is obviously not ideal either.

I still think the jaw problem is something that should be explored, but what you really need is someone who can explain the pros & cons of all the options available to you and someone you can work constructively with to come up with a plan - bearing in mind that the only 'ideal' plan is inventing a time-machine and going back to a few seconds before the fight and yelling 'duck'

Many thanks Toothsmith.

Yes, appears to be a tricky problem indeed.

I think that is why everyone is a bit reluctant to get fully involved here. My consultant did mention that digging in with more surgery could indeed make matters worse so it seems very much of damned if you do and damned if you don't type thing.

Also, there is quite a bit of scarring in the area in question and I've also had my UR5 and UR6 subject to apical surgery and these may also be playing a part. Nothing appears to be showing up on the x-rays though but the same was the case prior to these teeth undergoing the apical surgery only for signs of infection to appear (another reason I'm not a big believer in x-rays).

If I can get hold of a digital copy of the last x-ray of the UR1 and UR2 area (which has been untouched) I may decide to post a link to it so you can see what I mean.

I imagine after 20 years some of the fragments may be hard to spot hence my concern.

Also, if I want to go for an implant in future the last thing I need is something embedded in my jaw complicating matters. Understandable?

Yeah, was a bit difficult to duck at the time as he took it upon himself to climb on top of me, pin me down and deliver a few blows all over something remarkably trivial at the time.

Toothsmith

Knowing a bit more about it all now - I don't think it's in anyone's interests to be giving you dodgy prints of radiographs or scans. And, like Brook earlier, I'm sure any difference in appearance is simply due to how much toner was in the printer.

It's a good idea to get the digital original though, as then it can be manipulated by the consultant to see if he can find anything by changing contrast/brightness etc. Sometimes though, there can be compatibility issues between the generating software and the viewing system! So it's not always straightforward!

I still don't think leaping in with complaints is the best way to go though - despite your frustration. This is not an easy case, and it's far easier to do the wrong thing than the right thing! I know that doesn't really get you any closer to a solution.

JasonBat

Toothsmith wrote: »

Knowing a bit more about it all now - I don't think it's in anyone's interests to be giving you dodgy prints of radiographs or scans. And, like Brook earlier, I'm sure any difference in appearance is simply due to how much toner was in the printer.

It's a good idea to get the digital original though, as then it can be manipulated by the consultant to see if he can find anything by changing contrast/brightness etc. Sometimes though, there can be compatibility issues between the generating software and the viewing system! So it's not always straightforward!

I still don't think leaping in with complaints is the best way to go though - despite your frustration. This is not an easy case, and it's far easier to do the wrong thing than the right thing! I know that doesn't really get you any closer to a solution.

Many thanks Toothsmith.

Yes, I just had another conversation with the receptionist at the practice and she said that in the many years she has worked there nobody (presumably other clinicians included) has ever requested a digital copy of any x-ray and was quite resistant in acceding to my reasonable and polite request.

So I rang up and got advice from the GDC who confirmed that the practice is legally obliged to provide a digital copy as per the Data Protection Act and so I have put this in writing to them (without raising a complaint you will be pleased to know ).

I know what you mean regarding the complaints but I can assure you if I hadn't raised a complaint regarding the consultant's dismissive behavior I would not have found myself undergoing an MRI which appears to have shed some light albeit only a little.

People on this forum have been a million times more helpful than the consultant in my recent consultations with him and I'm sure he is getting paid a handsome salary whilst I am drugged up to the eyeballs on painkillers.

Errata

Toothsmith wrote: »

It's a good idea to get the digital original though, as then it can be manipulated by the consultant to see if he can find anything by changing contrast/brightness etc. Sometimes though, there can be compatibility issues between the generating software and the viewing system! So it's not always straightforward!

Would an external image such as that ^^^ get past an NHS Hospital Trust firewall?

Toothsmith

Errata wrote: »

Would an external image such as that ^^^ get past an NHS Hospital Trust firewall?

Good question, and I don't know!

I imagine it would have a better chance if it came from another NHS address, so maybe make a copy and post it, or take it with you on a flash drive when you go?

I understand what you're saying about consultants. They are not always the best with the people skills! As for the receptionist at the practice, it wouldn't surprise me if you're their most complex patient!

It is wrong, but I'm also not surprised they're trying to get rid of you! Your problems are way beyond what the NHS dental system is currently set up for! Short in-and-out visits are what keeps it going! Not complicated things requiring thought and planning!

JasonBat

Toothsmith wrote: »

It is wrong, but I'm also not surprised they're trying to get rid of you! Your problems are way beyond what the NHS dental system is currently set up for! Short in-and-out visits are what keeps it going! Not complicated things requiring thought and planning!

Tell me about it! I'm sure he wants to free himself of a headache.

Presumably I can just see another dentist at the same practice?

Toothsmith

JasonBat wrote: »

Tell me about it! I'm sure he wants to free himself of a headache.

Presumably I can just see another dentist at the same practice?

I don't know - that would be down to them.

JasonBat

Okay, I'm getting more and more irked and offended by this dentist.

On Monday I dropped in a letter asking him to clarify why he felt there was a 'irrevocable breakdown' after asking him why there appeared to be a discrepancy in x-ray print-outs (which I initially thought was a harmless question).

In my letter I informed him that I meet the legal definition of disabled as set out in the Equality Act due to the cumulative effects of the condition in question (chronic atypical facial pain) when considered with other health conditions I suffer from.

At the same time, I politely asked the receptionist if I could get a digital copy of the x-ray (singular) in question. The receptionist said she didn't know so she would get the practice manager to call me.

Needless to say I heard nothing and phoned back a day or so later only to be handed more print-outs which were sitting at reception.

So I contacted the GDC and asked for advice and they informed me that I was entitled to a digital copy as suggested by those posting in this thread. I then put this request in writing as suggested by the GDC.

I then get a letter back today saying that I am to be charged an absurd fee of £50 and I need to supply the USB memory stick. Also, I would need to wait 40 days (working days I suspect) for this after payment!

I'm also accused of 'harassing the practice staff' and making them feel 'uncomfortable'. Clearly this dentist is up to no good.

How does one go about bringing an NHS complaint?

I'm no doubt going to be raising the issue with the GDC.