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!

I absolutely understand why you’re furious when there’s evidence of a physical problem and have/am going through this exact issue with something else (and have suspected autism which my specialist has latched onto and blames my physical symptoms on it, even when there’s evidence of physical problems). He will do scans and tests which show the problems in black and white and he’ll acknowledge the issues and then goes straight back to the autism. It drives me absolutely potty every time I have a consultation or receive a letter. So I’m really really sorry.

How do you know that a dentist is highly qualified? 😂

British dentists are known to people who had experience of living in some other countries as generally not very good. There are some good ones but they require careful research. They tend to use outdated techniques and yes, pretty well known for bad quality root canal work and do find it easier to take a tooth out indeed (because there are not good with root canals and not good with modern techniques of saving teeth). There are specialist microscopes now, low dose x rays and electronic locators and success rates in RTC are 90-95%.
in many countries the dentists are now highly trained in using newer equipment and are able to provide higher quality outcomes

Because a dentist is a highly qualified profession? He didnt just waltz off the street into the practice? A dental degree is 5 years plus a foundation year

Agree with all of this. Look up “Stepwise Technique”. I also agree it is common for a tooth to discolour after root canal treatment. And dentists are highly qualified.

so? Some are better than others. Just because someone has a degree doesn’t mean they are GOOD. All doctors and dentists have a range of how good they are. Not all lawyers are good. Not all accountants are good. Someone who graduated bottom of the class will not be as good as his peer who is top of the class.

i also updated my post so perhaps you haven’t seen this paragraph so I’m copy pasting it here:

British dentists are known to people who had experience of living in some other countries as generally not very good. There are some good ones but they require careful research. They tend to use outdated techniques and yes, pretty well known for bad quality root canal work and do find it easier to take a tooth out indeed (because there are not good with root canals and not good with modern techniques of saving teeth). There are specialist microscopes now, low dose x rays and electronic locators and success rates in RTC are 90-95%.
in many countries the dentists are now highly trained in using newer equipment and are able to provide higher quality outcomes

Because in order to be a dentist you have to have a bachelor’s degree in dentistry which takes 5 years followed by at least one year of foundation training. That’s highly trained. (Unless the dentist trained abroad but even then their qualification must be approved before registering with the GDC. You can’t just say you’re a dentist and get registered).

Sometimes dentists just can’t win in the UK. We are damned if we do and damned if we don’t.
if we opt to do root canal on the NHS we try our best but with limited funding we aren’t able to use all the fancy stuff you’ve mentioned above.
If we dare to opt to do a root canal procedure privately or refer to a specialist you can be sure that a post will crop up on Mumsnet slating us for charging too much.

British dentists are highly qualified. Five years study as an undergraduate, which includes working throughout the summer holidays. Followed by at least one foundation year. Thereafter we must complete continued professional development regularly, as well as work towards professional post grad exams ( such is the competition in the sector. )

In the UK general dentist and endodontist are not the same thing. You can be a qualified dentist but not be able to perform more complex root canal work. In other countries it’s often part of general dentistry and expectation

what is this blind faith that just because someone studied for several years and passed an exam they are automatically HIGHLY qualified? They are JUST qualified

I’m saying this as a solicitor. Just because someone is qualified as a solicitor doesn’t mean they are good or highly qualified.

You can get high marks in written exams and so get a higher grade. Doesn’t mean practically you’re any better than someone who got lower marks in written exams. This is true for many professions. Also someone may be much better at all fillings but dreadful at extractions. Are they better or worse than someone who is excellent at extractions and poor at complex fillings?

Microscopes for endo have been around and used by specialists in the UK for years (At least 27 years that I can remember). Yes not all general practices will have one because the cost is high. A general dentist who feels they cannot do a good job for a RCT will refer to a specialist who will have the appropriate equipment. The same way a GP will refer a patient for something that is beyond their scope as well. Just because a dentist is trained in everything doesn’t mean they can do everything 100%. This is exactly why specialists exist. You wouldn’t expect a GP to be a specialist in every single aspect of medicine. Would you want a brain surgeon to do a heart transplant? Referring out for more complex cases isn’t a bad thing.

There also isn’t any evidence is there of where the dentists in question trained? How do we know they are all British trained? I recently worked with an overseas dentist locum who didn’t know what a BPE was. Obviously not that highly trained in their country right? Because they aren’t an expert in one thing.

Yes sure grades alone are not a predictor of how good a specialist is. Glad we have established though that qualified professionals can vary in quality of their work and just because someone passed an exam doesn’t mean they are a highly qualified specialist. Just because someone is a doctor, a dentist, a lawyer or an accountant they can still be rubbish

In many other countries this equipment is much more available and dentists overall are expected to do high quality root canal work. It is not a specialty. British dentists are known for huge variability in quality and stubborn refusal to
adopt more modern equipment and techniques even in composite work. Sorry that’s how it is.

If it was the case that the dentist left decay in the tooth on purpose as a particular technique, then why did the endodontist on discovering it on an x-ray refer me straight back to the first dentist with the instruction to them to address the caries as a matter of urgency???

Your talking bullshit, "known to some people living abroad in some other countries as not being very good" 😂 Dentistry is highly regulated in the UK, and we have very good standards of care compared to the majority of the rest of the world

I think most UK dentists would use apex locators 🤣 and we all know about microscopes, a lot of patients in the UK aren't prepared to pay for the equupement/materials it takes to provide a successful RCT. The RCT failure rates in the UK aren't any worse than across the world and any dentist practicing in the UK is highly qualified

The dentist could easily take out the tooth, OP would be happy and they would get paid. The fact they aren't doing a treatment they dont deem necessary points to them being a half decent.

I don’t know, and I’ve not seen your notes, radiographs or sequence of events. If I were you I would see the recommended specialist for a second opinion and try not to stress or become “fixated” 🫣🫣🫣😉😉😉

You know or you actually use them? 😂
the question of cost is a different matter. But just because you are restricted in what you can use due to costs doesn’t allow you to say you are highly qualified in modern technology- if you don’t use it due to cost you are not well versed in it, end of story

Thank you and I'm sorry too that you're in the same boat. I think I'll stop telling medical professionals that I'm autistic. I had thought that maybe they would understand why I might be a bit odd during consultations, rabbit on about whatever was ailing me or be pretty silent about it . But all it seems to do is make matters worse. Better they think I'm just weird than end up with some half baked psychological opinion on my mental health!

😅

Right so all British dentists are all rubbish but can vary in abilities (mainly poor apparently) but all foreign dentists are all much more highly trained and specialised and up to date on equipment and don’t vary in abilities at all? Good to know.
As I said before, we don’t actually know the nationality and training country of any of the dentists being discussed. They may not be UK trained.

I didn’t say “all” in either scenario, don’t twist my words into something else please

I have not copied and pasted anything. I replied to a comment by quoting the comment I was replying to. This is for ease of following the thread. I replied to the OP and addressed a question to her which she has now answered. At no point did I give any kind of a description of a dental procedure by copying and pasting or anything else. My question did not require that.

From my experience, I've been treated a lot better by medical professionals when they just think I am weird/odd (ie when they don't know I am autistic) vs actually telling them I am autistic, in my experience, they then get laser focused on that and then don't really consider other things beyond, you are autistic, therefore this must be in your head. It's a shame and it shouldnt be like that, but essentially that has been my experience.

What is it with dentists?! I was flustered at appointment with a new dentist, I had my toddler with me in the buggy and I was keeping him amused with Peppa on his tablet and a stick of cheese… in the appointment I was my usual conversational self but was a bit flustered keeping an eye on my child. I made a joke that the dentist didn’t seem to get but I thought nothing of it. It was otherwise a very normal dental experience bar the dentist not seeming to be much of a “people person” and barely speaking two words to me. Anyway, she rang my bloomin GP and told her she thought I was “manic” - cue the GP being bewildered as I have absolutely no history of any mental health issues or anything atall on my medical record (aside from the usual colds and pregnancy related things like c section). GP rang me and I was mortified - I explained I was just chatting away but keeping an eye on my toddler, and I felt like a joke I made didn’t land. Apparently the Dentist thought there was something wrong with me because I “didn’t seem nervous about being there”… um no, I have never had a bad experience in a dentist (until this point)… I was miffed, embarrassed and blooming Angry! She “diagnosed” a mental health issue where there wasn’t one, and had the audacity to say that she didn’t think it was normal to be relaxed and happy to be at the dentist… that says a lot about how she views patients I guess! If the dentist thinks you might not be “ok” why not just ask “ Are you feeling ok?” I’d have said “yes I feel fine, busy running around after my toddler but thank you for asking”. Bonkers…. ! I changed dentists!!

You've bruised the dentists ego by questioning them and they're lashing out. They're unprofessional imo. Shame if it biases the specialist.

@PaddlerRock I had a similar issues a number of years ago. Out of curiosity, what was the issue/diagnosis in the end up? For me it was myofascial TMJD, however I also had a dodgy tooth extracted, which no one believed was cracked.

My autism is relevant to any medical issue I have as it impacts how I act and react in a clinical setting. Many autistics are the same. Autism just just impact one area of life....