AIBU to be pissed off with my inappropriate dentist.

[MurkyMo]

I asked my private dentist for a referral letter to a specialist as I have longstanding pain from a tooth that's had a lot of work done. I think the filling is bad or the tooth has a micro fracture, pain started the day after it was done. Decay was left inside and then I ended up with root canal treatment. Then a second RCT. My new dentist thinks there's nothing wrong with the tooth hence my move to an endodontist. But that's not the problem, the problem is the referral letter he wrote.

I gave him a document with a diary of my symptoms and treatments thinking it might help him find the problem and he says about it "tellingly, she references her own autism in it." Tellingly???? wtf?!

He says "I am not convinced that this is a dental problem, but appreciate that her dental fixation might be provoking a response in an already sensitised area"

Fixation??? WTF???? He's not a psychologist, why is he putting that in a referral letter to an endodontist. Surely it should be a clinical letter simply pointing out my symptoms and his clinical findings, not some amateur psychological assessment of me that dismisses my symptoms and alludes to my autism being part of the problem.

Any dental or medical professionals think this is off??

And what will the endodontist make of it?

I'm raging!

That would also enrage me.
Not sure what you can do about it, though.

Well, why did you reference your autism in a diary of your dental symptoms?
If you did that, then I’d mention it as well. As it could be your fixation rather than a dental issue.

Well I just got it a few hours ago and i'm so tense about it. I just don't want the endo to have a preconceived idea of me. Surely they'll assess the tooth independent of that sloppy and unnecessary psychological analysis of me

He has to let the other dentist know the full picture, so YABU.

Possible disability discrimination? As you say he’s not qualified to comment on your autism at all.
Sorry I’m not medical but it doesn’t sound right.
Hopefully as you say the specialist will just look at the facts and listen to you.
Hope you can get it sorted soon.

The autism is relevant to any medical assessments or treatments so that's whey I referenced it.

It's not for him to say if he thinks its a fixation or not. His job is to submit his clinical findings, not a dodgy psychological assessment. He's not a psychologist.

I think you are unreasonable for saying that “decay was left inside the tooth”. A filling or restoration can fail and a tooth can die because it is too damaged to survive. Nothing to do with “decay being left inside”!

I have x-rays that show the decay a few weeks after it was filled. I have a letter from a specialist to the original dentist saying there is decay under the filling and it needs to be removed ASAP

Why is it relevant to a dental issue

His clinical findings are that there is nothing wrong with your tooth. He has submitted that. But you’ve given him a diary of your tooth symptoms and mentioned your own autism in that - which really isn’t applicable but you’ve made it so. Of course he has to pass it on as it does look like you’ve got a fixation on this, as he cannot find anything wrong with your tooth.

They will look at your tooth, if there is something then they will find it. But they also do need the full medical picture. And you’ve just said that you believe your autism is applicable to any and all medical issues you have, so… why are you mad he mentioned?

The referral letter is about you, not for you. You shouldn't really have read it (although most of us would). There's nothing unprofessional or inappropriate in his letter. If the specialist sees something, he will disregard the dentist's preliminary opinion and proceed with appropriate treatment. HCPs are encouraged to review the patient holistically, so yes it's okay to consider OP's autism.

Why shouldn't I have read it?

Why? How can you expect people to understand. Autism does not cause rotten teeth or bad filling so why is it relevant?

My dental practice and GP surgery send me copies of all letter, why wouldn't I read them?
My dentist is aware that micro fractures can show only when you bite down, and wouldn't be so dismissive.

Because presumably it's not addressed to you? It may be about you, but you're not entitled to view even your own medical records without submitting a formal request under GDPR.

Which is it? Either it’s relevant so he should mention it in his letter, in which case, why are you angry? Or it’s not relevant and he shouldn’t have, in which case, why did you and why do you keep saying it’s relevant?

1. It quite clearly can affect the patient's ability to maintain good oral hygiene, can affect their ability to tolerate toothpaste etc, and can affect what you eat.
2. It may mean that the patient requires additional support for their dental treatment.

The cult-like worship of doctors and dentists allows them to do that. I would go back and demand the letter is re-written and also say 'you are not QUALIFIED to opine on my mental health'. Stand up for yourself, for goodness sake!

It is addressed to me, well via email. You can ask for your referral letters, they are legally obliged to give them to you.

That’s a very old fashioned opinion. Most doctors these days, thankfully, are more enlightened about health as a partnership, and about co-ownership of your data.

@MurkyMo not the same story as you and I don't have autism. But I had some quite complicated dental work done a few years ago. After that I had pain and swelling in my jaw. No one took it seriously, then my dentist referred me to a specialist and he referred me to facial pain clinic in London and I thought finally! I went thinking I was having scans done and to look into it further. When I got there I was directed into the room that said 'psychology' on the front. My heart sank. I travelled and spent money to get to this appointment. I remember how gutting it was.

But in that case why is she worried about the dentist passing on the information

Well in that case, fine, but the rest of my post still stands.

It's relevant in many ways as at least one poster has said above.

The OP is, rightly, taking issue with the word 'tellingly' which, together with a reference to her 'dental fixation' reads a lot like he thinks it's all in her head.

Poor show OP. I'd be furious too but really it all depends on the attitude of the letter's recipient as to whether it affects your further care.