American Dental Association Archives - Dental Care at Flint's Crossing

Can My Dentist Dismiss Me for Refusing to Vaccinate?

Posted on August 15, 2021 by Athena Smiles.

I’ve been seeing the same family dentist for nearly 20 years. I genuinely respect and trust him, but I recently received an email from his practice that has me quite upset. The notice indicated that, going forward, he was requiring all staff and patients to have the COVID vaccine. The letter indicated that, if I chose not to comply, he would continue treating me on an emergency basis for the next month and then I needed to find a new provider. The letter made no allowances for age or medical reasons, let alone philosophical ones.

The problem is, my primary care physician has told me that I should not vaccinate due to a pre-existing health condition. And, the real kicker is, I’ve already had COVID. I am, for all intents and purposes, immune.

I phoned the office thinking they’d make an exception. Nope. They promised to send my records to my new dentist when I found one and wished me well. After 20 years. I’m heartbroken and, honestly, a little dumbfounded. Can they really do this?

Thanks,

No Vax in Alabama

Dear No Vax,

So sorry to hear this! These are definitely challenging times and everyone is trying to navigate a new normal. Unfortunately, the news here is not positive for you.

Vaccinations are a Great Ethical Debate

The American Dental Association (ADA) recently released a detailed report called “Ethics of Vaccination.” Throughout the 16-page document, experts weigh in on various aspects of the debate. On one hand, it notes that refusing to treat an unvaccinated patient could indeed violate ethical standards.

“The dentist has a legal and ethical obligation to treat patients who may have a disability, which may include those unable to be vaccinated,” the report reads. It goes so far as to say the dentist may need to communicate with a patient’s physician if the patient cannot vaccinate due to disability and suggests a variety of ways practices can help reduce risk.

With that said, if your vaccination status hinges on a disability or because you belong to a protected class, it could potentially be considered unethical to dismiss you. The ADA nudged doctors in the direction of lawyers if they’re making decisions such as this.

The California Dental Association published similar remarks, saying “Dental practitioners are obligated to protect their patients’ health, but that obligation extends to those who may be exposed to a communicable disease — and unvaccinated patients are the most at risk.”

But, Yes, Your Dentist Can Dismiss You for Not Being Vaccinated

In the end, though, the ADA gave tips for dentists on how to address this concern with patients if they decided not to see unvaccinated patients. There is no official ruling on this, and so dentists have to do what they feel is right.

Request to Speak Directly with Your Dentist

Your dentist may have reasons he didn’t list for his new policy. For example, if he’s unable to be vaccinated and is afraid of catching and spreading COVID, his response would be understandable.

Equally, he may not know your situation and he may be able to make an exception for you given the circumstances. Give the practice a call back and ask to speak directly to the doctor when he has time. You may still not get the answer you want, but perhaps you’ll get some closure. Best of luck to you.

This blog is sponsored by Auburn, AL dentist Dr. Raymond Bolt.

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

Posted on January 10, 2021 by Athena Smiles.

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.

Will Removing My Metal Fillings Help Prevent COVID?

Posted on November 10, 2020 by Athena Smiles.

I have some health conditions and am really worried that I’ll catch COVID-19. If I do, there’s a good chance I won’t survive it. I’ve been taking as many precautions as possible, but one avenue I haven’t looked at is my oral health. I recently came across an article that said there are links between mercury-containing fillings and weak immune systems. I have a few metal fillings that I’ve probably had for going on 20 years now. I’ve never given them much thought, but if there’s any chance they could be putting me at risk, I’d like to have my mercury fillings removed. Is this something dentists are doing now?

Thanks,

Janet

Dear Janet,

You pose an interesting question. Yes, there are some links between your oral health and immune system, but they’re probably not what you think.

No Links Between Amalgam Fillings and Immune Health Have Been Proven

Rather than expecting you to take them at their word, the American Dental Association (ADA) draws on research from:

The Alzheimer’s Association
The International Journal of Dentistry
The Mayo Clinic
The National Multiple Sclerosis Society
The National Council Against Health Fraud
The National Institute of Dental and Craniofacial Research (NIDCR – one of the National Institutes of Health in the U.S. Dept. of Health and Human Services)
The New England Journal of Medicine
The U.S. Food and Drug Administration (FDA)

All of these organizations stand by the belief that amalgam fillings (the metal ones which contain mercury) are safe. They further contend that there is no scientific evidence to prove otherwise.

There Are Links Between Periodontal Disease and Immune System Issues

In the early stages of gingivitis, people experience symptoms like bleeding gums and inflammation. As it progresses, the gums start to separate from the teeth, creating tiny pockets bacteria thrive in. Ultimately, the localized infections cause bone loss and eventually the loss of teeth too.

It’s this—periodontal disease—that researchers have a keen eye on these days. They initially noticed people with periodontal disease were more likely to suffer from a wide range of conditions such as diabetes and cardiovascular disease. The inverse is true as well. In more recent years, they’ve discovered the link is probably inflammation.

“It is very important to consider the inflammatory / immune response as a whole, rather than many different modules working separately,” researchers say. They don’t think the inflammation is localized. They believe that, when one area of the body is impacted, others are reactive too. They believe the immune system is tied into this—that inflammation and immune disorder are linked. To that end, a healthy immune system relies on the treatment of inflammation. You must take care of your whole body and that includes good care of your teeth and gums.

You Can Still Have Your Fillings Replaced

At the end of the day, if having those amalgam fillings replaced makes you feel better, go ahead and have it done. It’ll be treated like a cosmetic treatment versus a medically necessary treatment by your insurance, but it’s a common procedure your dentist won’t bat an eye at. But, if you do go in for it, make sure you’re getting your teeth cleaned too!

This blog is sponsored by Dr. Raymond Bolt, an Auburn, Alabama mercury-free dentist.