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!

@PaddlerRock what happened in the end? Did your tooth get fixed?

18 months in and out of hospital and 5 operations later I’m fine! Well, functioning. I hope you get somewhere with sorting your tooth! X

You obviously missed the exclamation mark 🙄

You’re right, he’s not a psychologist as much as you don’t hold a dental degree.
the endodontist will read, and appoint as normal.

Having attended something similar there were people in there who had zero teeth left for all sorts of reasons, one had gone through a windscreen in a car accident.
And an OT (bless her she was doing her best) and did a session. At one point she talked about finding joy in doing the dishes and one fearsome lady asks…
Have you ever gone through a windscreen? And when the OT said she hadn’t the lady added…
Will you kindly fuck off and go on your tea break then.
I actually made a few friends there. The one I am still in touch with had a tumour - not dental.
I have never ever known gallows humour like it. And at the end a specialist gave me pregabelin. Which helped the pain but caused me other issues.
There was a pain group next door to us and they used to get given toast and they’d pass some in and fearsome lady asked could they cut the crusts off as we spent so long having to suck them to get them gone, the toast was stone cold.
This lady actually nicknamed herself Jackboot. They threatened us with gentle exercise in a new gym and told us to bring trainers so she came in these huge industrial boots so she didn’t have to join in.
Honestly, you’re not on your own.

I love "Jackboot" ! 😆

Meanwhile in the endodontists office.

If you give yourself license to mention your autism where you believe it to be applicable then you have to accept that others will a cept that as permission to do the same.
Instead of raging about it you ought to be querying it directly.
It seems as though the major issue you have is professionals misconstruing the impact of your autism.
Out of all people involved, you are the only one in a position to put it right.

I'd suggest seeking advocacy for this if you feel you need it.

Raging about it is not healthy for you, and not productive in fixing what you feel is wrong.

Maybe time out from the whole thing, do something you enjoy, then return to it tomorrow with fresh eyes. No rage required.

She was absolutely ruthless. She’d had a terrible facial injury I felt for her, with a huge scar down her face.
The weeks she wore the jackboots she wore a floral dress to ‘lady’ them up a bit.
The only time we behaved ourselves was
’medication’ week and we got told to reduce it, it’s bad for you.
It became like a play in the end, I could have written one with all of our back stories and experiences.
But Jackboot was Queen. ‘If he thinks I’m getting on those exercise bikes he will get this toe cap up his arse!’

NHS patients legally have rights to access to their records and OP has the right to read anything written about her.
I'd have been annoyed about the dentist's comment as well, but mostly because of the way it was written. It would have been better to say something like 'It is possible for dental pain to follow a painful procedure for no clinical cause'. No need to mention autism.

It's not a stupid question. I'd like to know too please because I'm also struggling to understand how having autism (unless it's so severe you have a carer/don't speak etc) has any influence on your dental health.

Yes, exactly. And this is a private dentist, not NHS

All patients, I should have said.

Decent dentists know that even a healed tooth can be very painful for some people. People often adjust their bite because of it, or clench their jaw, or grind their teeth in the night.

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.

He has done- he doesn't think there's anything wrong with your tooth and he wants the specialist to know that too...

He thinks you have facial pain / trigeminal neuralgia and might need some pain modifying drugs instead of more dental treatment. Regardless of the method of communication if you have had multiple investigations and nothing has shown up then this is an appropriate thing to consider. It would not be right for you to seek multiple treatments from multiple different practitioners if the problem is sensitised neural pain rather than odontogenic pain - even if the original trigger was teeth it may not be dental now. The implication is NOT that it is not real. The implication is that it would be irresponsible to continue having multiple expensive treatments if that isn't going to 'fix' the problem.

@BerryTwister Tooth is as it was (currently on second root with crown), the pain is still there. I just get on with it for now. That side is still swollen!

Perhaps you could explain to those of us who aren't familiar with autism and in the dental setting in particular. You're assuming that everybody knows.

I don't think someone who has chosen to look at teeth every day for their whole life, and has undergone years of dental training in order to be able to do this, can accuse anyone else of a "dental fixation"

It is not nerve pain, it is inflammatory. All the symptoms point to that. There are things that could be causing the problems that would not show up on an x-ray that's why I'm going to an endo. The dentist barely looked at the tooth, he did not perform a proper examination. Probably because he's so sure that I'm creating the symptoms myself through some psychosomatic fixation problem.

It was definitely inappropriate for the dentist to include that in your referral. I'm not sure who you'd complain to, but at the very least I'd be looking for a new dentist.

In my experience, dentists can really struggle to admit when they've made a mistake. I once had a filling done, and afterwards I said, "I think you've accidentally stuck my teeth together because I can feel pressure." They didn't even look and just told me it was "absolutely impossible". I refused to leave the chair until they checked, and they ended up having to use a drill to separate the teeth because they had actually bonded them together. I switched dentists immediately afterwards.

This ^ 😆😆😆

If the OP thought her autism was sufficiently relevant and significant to record in her diary of dental symptoms, why would it be irrelevant or inappropriate for her dentist to reference it in the referral letter to a specialist?

Even more so if her dentist is confident that here is no clinical evidence of a dental problem, so there must be something else at play.

Of course, her dentist might be clinically incompetent if he (or she) has missed clear evidence of a dental problem, but that would be a completely different (and legitimate) complaint...

Kindly, if your dentist has assessed you and found nothing physically wrong, but is still referring you to a specialist, then what explanation should your dentist use on the letter for why he is referring you? It would look odd and unnecessary otherwise?

https://www.gdc-uk.org/raising-concerns/how-to-get-a-refund-or-make-a-complaint

A dentist will not necessarily know anything more about autism than the average person. They might do, but they might well not.

There's a chance they might have had some kind of training on disability or autism awareness, but even if they have, it would not be particularly complex or specialist unless it's a particular interest of theirs. It might have been an afternoon or a day.

They might have met autistic patients, friends or family members, taken an interest and had some experience with it, but they might not.

Just because someone is a medical professional doesn't mean they know all about autism.