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Archives for January 2021

Pediatric Dentist Left Bruises on Son- Normal or Not?

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boy injured pediatric dentist

My six-year-old had to see the pediatric dentist to have two teeth removed yesterday. He was incredibly sore after and overnight. We tried icing it and giving him ibuprofen, but it didn’t really help. By this morning, it looked like he’d been in a boxing ring. I phoned the dentist to find out what happened and they told me there was nothing out of the ordinary about the treatment—just that sometimes this happens. I want to believe them. We have a good relationship with the doctor and all my kids have seen him, so we’ve been patients for probably a decade by now. But, I’ve never seen or heard of anything like this and it’s quite alarming. My son doesn’t remember anything about the treatment. They sedated him during the visit. So, I really don’t have anything but the word of the dental office to go on. Is this normal? Or should I have my son seen somewhere?

Thank you,

Ann

 

Dear Ann,

As scary as it may look right now, your son is probably experiencing a side-effect of receiving anesthetic and will be just fine in time. However, you should get him checked out by the pediatric dentist or a physician just to be sure.

Hematomas May Occur by Receiving Anesthetic

As Jacqueline J. Freudenthal, RDH, MHE, associate professor and chair of the Department of Dental Hygiene at Idaho State University explains, “A hematoma develops when a blood vessel (artery or vein) is inadvertently injured by the needle. If the injury is minor or the tissue is dense, a hematoma is unlikely to be noticeable extraorally.” She notes that the care team can help diminish the impact by stopping treatment and applying pressure and ice right away and continuing with ice off and on for the next six hours. So, you did the right thing by applying ice at home. However, she also notes that, “ If an artery or vessel is injured in a vascular area, such as the pterygopalatine or infratemporal fossa, a more dramatic response of swelling and bruising may occur.”

Most hematomas heal on their own with no further care needed. However, more serious cases do require additional treatment and follow-up care with the dentist or a physician. This has been observed and studied in children.

Sometimes Bumps Happen During Extractions

It’s also possible your son is more susceptible to bruising or was bumped during the extractions. This doesn’t happen much with baby teeth because they have shorter roots and tend to come out easier than adult teeth, but it’s possible trauma occurred during the extraction too.

Take Him to the Pediatric Dentist or His Pediatrician

It sounds like your instincts are spot-on here. Your son is in pain and has obvious signs of injury. Whether they happened during the course of normal treatment or not, he should be seen right away. Chances are, he’ll be sore for a bit and the marks will dissipate over the next couple weeks. However, if he is experiencing one of the rarer complications, medical intervention could be necessary. Give the pediatric dentist a call back and let them know you’d feel better if the doctor took another look at your son. If they can’t get him seen right away or you have concerns about what may have happened in the treatment room, have him visit his pediatrician or another doctor instead.

 

This blog is sponsored by Dr. Raymond Bolt, a provider of general and pediatric dental services in Auburn, AL.

Can My Auburn Dentist Dismiss Me if I Get Implants in Mexico?

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mexico map with thumbtack

I have a good relationship with my dentist here in Auburn, but I need to get implants done and they’re way out of my price range. I initially tried saving up to have them done here but something always came up and I never got anywhere close to having my portion after nearly two years of trying. I have a sister who lives in Texas near the border and she’s gone a couple times and says most there are accredited by the American Dental Association and that it’s the same as having it done here because of it.

I tried to approach the subject gently with my dentist the last time I was in and he told me that he wouldn’t continue to treat me if I went. He said that it’s not safe and, if he continues to treat me and there’s an issue, he could be held liable for the Mexican dentist’s shoddy work. I’m heartbroken. I understand what he’s saying and respect his concerns. At the same time, I would have loved for him to do the work. I really would have. I just can’t afford to have him do it. And, I would never in a million years go after him if something didn’t go right in Mexico. In a way, I feel betrayed. He’s making me choose between having a full set of teeth and staying with him as a patient. Can he even do that?

Thanks,

Sharon

 

Dear Sharon,

So sorry to hear you’re dealing with all this. The short answer is, “maybe.” The full answer is complicated. Let’s take a look.

Exercise Caution if You Seek Treatment Outside the United States

There is nothing that’s “the same” as visiting a dentist in Mexico versus one in the United States other than both are dentists and both will provide similar types of treatment. When you talk about the licensing, the continuing education requirements, and the recourse if something goes wrong, it’s night and day. That’s not to say there aren’t good dentists in Mexico, but they simply do not have the same requirements as they do here. And, if you do wind up with a dental emergency, you’re a day’s drive away from your provider and have little recourse if he or she doesn’t do right by you.

Dentists Can Dismiss Anyone from Their Practices

A dentist doesn’t really have an obligation to keep you as a patient in the long run. You can be dismissed from a practice for virtually any reason. The only general caveat to this is that there are generally guidelines about the dismissal process that involve providing care for a period of time while you become established with a new dentist.

It May Be “Unethical” for Him to Dismiss You for This

Dismissing a patient for seeking treatment in Mexico is a bit different, though. The ADA addresses it in terms of a patient’s freedom of choice.

“The ethical dentist will treat the patient who has received dental treatment outside the United States in the same manner as he/she would treat a patient who has transferred their care from any other practice, irrespective of the fact that the treatment performed outside of the United States might or might not be substandard and, in some instances, a possible detriment to the patient’s health. A dentist should consult applicable state law to determine the definition of “patient of record.” Failure to treat such a patient may raise ethical concerns under ADA Code Section 2.F, Patient Abandonment.”

So, what we can ascertain is that your dentist could find himself in hot water with the local dental board if he dismisses you, even though his concerns about you receiving poor quality treatment are valid. In the same narrative, the ADA reminds dentists to keep good records, so it’s easier to identify the root cause of any issues if multiple providers are involved.

The Final Decision is Yours Alone

At the end of the day, you’d have to report the dentist to the board and they’d ultimately decide whether he behaved unethically or not. They may indeed agree he’s out of line in this case. But, whatever the board might decide, you feel betrayed by your dentist and seem to have lost faith in him. For that reason alone, it sounds like your needs are better served by a dentist who will honor your wishes. As an aside to this, it might be worth checking out other local dentists to see if someone here can still help you. True, you won’t get the same prices as you would in Mexico, but you can be assured the dentist treating you will be held to a higher standard of care. You may be able to find an affordable dentist who offers payment plans or similar as well. Best of luck to you.

 

This blog is sponsored by Dr. Raymond Bolt, an Auburn, Alabama dentist who provides affordable and comprehensive care.