dental explorerA young woman needed a dental exam before starting a new job. She chose a dentist online. She went to her exam.

She complained of no dental problems. None of her 32 teeth had ever been restored. Her x-rays showed no signs of decay. The bone supporting her teeth looked healthy.

On clinical examination, visual findings were of a mouth with good oral hygiene and no staining on the teeth. [But] when the dentist did his clinical check for caries, he found that the explorer “stuck” on all 20 of the posterior teeth occlusal [biting] surfaces and also some buccal [cheekside] pits.

Some would take a “wait-and-see” approach here, perhaps counseling on diet and other factors that could hasten or stop the development of decay. Some might treat with ozone or turn to micro air abrasion just to be safe. You probably wouldn’t start drilling away at the teeth.

Or would you?

Several months later, she visited her parents while on vacation, and they noticed the many silver fillings in her mouth; she explained to them what happened. The patient’s father was very upset, so he took her to see her childhood dentist, who had seen her last about two years earlier.

This dentist examined the patient and, with her permission, asked the treating dentist to immediately forward to him his dental chart and digital radiographs for the patient. When they arrived by email, he made note that not a single one of the filled teeth had even a hint of pretreatment radiographic decay, and he did not see any clinical sign that there were likely any decayed teeth to have been diagnosed as carious by an explorer.

And now she has a mouth full of one of the most toxic substances on earth.

That makes for a doubly horrible horror story.

We believe that the best dentistry is the least dentistry. We feel that restorations should only be done after other, less invasive treatments have failed or the decay or damage to the tooth is so great as less invasive procedures are no longer an option. And we believe that patients deserve to know all their options up front and should play an active role in the decision-making process – not be told like a child to do this or that, regardless of their desires, beliefs, or values.

As for the young woman, she sued on the grounds of negligence and “egregious, malicious, and outrageous acts.” Amazingly, the jury found for the defendant, whose experts had testified that he was only doing what he’d been taught in dental school.

Yet it was a different story with the state dental board. They fined and suspended the dentist.


Image via Wikimedia Commons

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