Dental Articles

A Deep, Dark, Mysterious Hole


By Dr. Deborah Marynak

I’m always looking for stories in dentistry that bring a smile to our face, make us think about the relationships we have with our patients and/or are just plain ridiculous! Today I bring you all three in a story shared by a friend and colleague that he just couldn’t resist sharing with me.

Apparently with an eye on Risk Management, this doctor made a habit of sending a medical release when a patient presents pregnant and in any stage of the pregnancy. This medical release helps him decide what he can and cannot do for this patient, based on the upcoming exam.

The patient in question was coming in with a toothache, but the medical release was leaving him scratching his head, unsure of how he was to treat this toothache. The physician stated “no x-rays, no anesthesia and no antibiotics without a firm conversation with the MD.” He was thinking this must be a high-risk pregnancy with medical complications.

The patient presented and following a clinical exam, the doctor discovered that if this were a high-risk pregnancy, certainly the patient would know it. However, the patient was unaware of any problems with the pregnancy. Clinically this tooth appeared normal, but the symptoms verbalized by the patient indicated the tooth was in the process of dying. Feeling a need for a documented release, the doctor felt his hands were tied. The office manager telephoned the MD’s office and expressed the confusion, explaining the need for a radiograph and an antibiotic was probably indicated based on the verbalized symptoms. Would they please fill out the newly faxed release, indicating which antibiotics we couldn’t prescribe?

When the release came back, the MD had indicated an “ok” for Penicillin; he further indicated in order to take a radiograph, the patient “should be in a full body lead apron!” OMG...we laughed so hard. In our combined years of clinical dentistry (87 years) we’d never heard anything like this!

This story topped a former medical release indicating a need for a “high risk dental specialist.” The dental office indicated there was no such specialty in dentistry. It simply reinforces my belief that the medical profession should know more about dentistry and its numerous links to medical issues. A former supervisor (a medical doctor) of mine told me: “We know nothing about the mouth. It’s like looking into a deep, dark, mysterious hole.”

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