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!

The letter was unprofessional in my opinion and says a lot about his lack of understanding of neurodivergence.
Autism absolutely can be relevant to dental procedures and I have no idea how people on this thread can read that the dentist wrote “tellingly she referenced her autism” or whatever without seeing the judgement and implication behind the word “tellingly”. What exactly is it supposed to be telling them?
I would either juicy find another dentist and never go back - or make a complain to the practice

If you've already seen an endodontist and have already had 2x endo treatment on the tooth, what is it you're hoping for from another endodontist? If the endo has failed twice, extract and have an implant.

I think don't mention it unless you have to. Some medical professionals will use any excuse to psychologise your symptoms. It's best not to give them any ammunition as if they put that stuff on records it can follow you round and then you can't get anyone to take you seriously. You could end up with seriously problems like that. Has happened to someone I know

My son is autistic and I'd be raging about this too! I'm not sure if it is disability discrimination, maybe given he has taken your disability and made a judgement on the situation (which he has shared with another professional) because of the disability (which he isn't medically qualified to do, as he isn't a psychiatrist).
However, I think it probably depends on whether it actually impacts your treatment which hopefully it won't. If it does impact the referral then I'd definitely take it further.
I'd be tempted to put a complaint into the dental surgery anyway and ask that if possible you see a different dentist in future and request he does some autism/nd training/cpd. Of course it's possible to get fixations but (for example) my son does not fixate on things but is autistic and his dentist only knows because we want them to know in advance that he communicates differently to the average ten year old (which can be jarring if you don't expect it or know about it!) I'd be really annoyed if they assumed he did certain things based on a general, lay persons understanding of his diagnosis. He, for example, is great at tooth brushing (loves a routine) whereas lots of autistic kids find it very difficult- not everyone is the same just because they are autistic!

If you have previously told them you do fixate on things then I have much more sympathy with the dentist, but it sounds like they just know your diagnosis for general info, and have presumed this, which is really inappropriate.

He has trained for years and years to do his job id assume he knows more about teeth than you do , you being autistic isn't relevant at all , was it mentioned once or several times throughout?

It's the dentists job to pass on any information he deems relative. If he thinks it's all in your head he has an obligation to tell the next person you are seeing.

Fellow healthcare professional here. Refer him to the general dental council for unprofessional conduct and impressions outside his expertise. What a cock!

How come you accepted this as a possibility from the first person who said this, who claimed to be a doctor, but are now certain this is not what was meant? What changed your mind? Not saying you are wrong, just wondering what information you used to decide this?

But the comments comments come from the op having mentioned autism in a diary about teeth...where does autism impact on teeth...hence the understandable comments about autism..
For which we only have the ops word on

Why op did you see it necessary to mention autism when its a dental diary. I have a major health issue but if I was recording my teeth I wouldn't mention it

But why even mention autism re teeth...I think there is a lot more to it than the op has said

Please don’t follow this advice. GDC referrals are extremely stressful, potentially career ending, drag out for several years and are a huge financial drain.
if you want to make a complaint please contact the practice in the first place. Local resolution is always the first thing to try.

I agree with those who say the dentist is right. You yourself referenced your autism in your diary you submitted to the dentist, and so you must feel it’s relevant. He is not doing a psychological assessment, but informing the specialist as part of holistic clinical information. Your autism might affect how you communicate your symptoms, how when and what you choose to eat, and how you perform oral hygiene. I think the word “tellingly” means that the way you worded your diary meant it was important to you.
Fixation is an unfortunate choice of word, unless it refers to a dental procedure (eg the fixation of an orthodontic brace or post for a crown for example.) Either way I don’t see it as derogatory. Perhaps an alternative such as “ troubled by” the tooth might have been better.

To be fair it does sound like you have a fixation on the tooth? Doing hours of research, going off on a tangent talking about it, not accepting anything other than your own assessment being proved correct. It’s reasonable the dentist points that out to other dentists. By all means find a new dentist, from the sounds of it they’ll probably consider it a favour.

You know facial pain is actually a thing though right? I’ve seen people who insist they have toothache and have the tooth removed but it doesn’t help. So they decide it’s the next tooth along and have that tooth out. Then the next one. Until they have had every single tooth removed on that side of their face. And still the pain remains. It’s awful. And I’m sure the person then wouldn’t be happy with a dentist for removing healthy teeth when they are still left in pain. So it’s very hard to get it right! When nothing can be seen on a tooth it is always worth considering facial pain as a reason.

Trust me people with this type of pain often INSIST it is tooth related. They will swear blind they know what tooth it is and that it is definitely toothache.

People who have had limbs amputated often still feel pain in that limb. It’s due to the nerves not the limb. You wouldn’t say it’s “a fucking foot issue” to someone without a foot. You’d accept that it’s either nerve related or psychological. So this is why dentists will consider other reasons for “toothache”. They don’t want to risk being sued when they extract a tooth/teeth that wasn’t the cause of the problem.

Because I am open minded and considered the information because if correct, that "her dental fixation" meant the tooth restoration then it lightened my load of feeling so badly misinterpreted. However I double checked and it seems that dental fixation does not mean a tooth with a filling and RCT. Hope that helps you understand🙃

Should I call him a cock in my report?!!

I might save the GDC for the first dentist who missed the decay in this tooth in the first place. Then when I pointed it out to her she filled it but left decay behind under the filling which lead to the tooth dying and the whole thing has left me with two and a half years of pain from a tooth which none of the local dentists seems to want to diagnose properly because they are all in a referral loop with each other and so don't want to identify a cock up by a dentist who gives them business.

The most recent dentist did not examine the tooth itself, just looked at an x-ray and said it is fine. No effort to look more closely, to examine the discolouration around the filling or to give me any credit for my detailed observations over that time period that distinctly point to an inflammatory issue. There are many things that an x-ray does not show. And instead of doing a proper job he labelled it as a dental fixation because I'm "tellingly" autistic.

Actually I meant to say at the end, because he thinks my reporting is tellingly autistic. Which he must think is a way of discrediting it. Well that just shows how much he knows about autism!!

Because root canal is clearly not the process you describe

I haven't described any dental process. I read through the thread, saw the answer from a doctor saying they would take it to mean fixation of the tooth, which the OP responded to considering it, then lots of other people saying fixation meant what the doctor had said, and the OP responded quite firmly that it didn't mean that. So I asked what I asked. That was all I posted.

Please allow the first dentist and the practice to do their own investigation first. Give the dentist a chance to defend themselves. GDC process is particularly harsh ( much more so than GMC or other similar regulatory bodies). Dentists also have the highest work related suicide rates of any profession. It can be extremely stressful and there are other ways to deal with it in the first instance.

You just copy pasted a description of a process which is not what root canal treatment is. Anyone who had root canal treatment and had a treatment of fixing the tooth per description knows they are two different things. If you are not a doctor maybe you yourself shouldn’t argue and copy paste definitions that you don’t understand. And a person CLAIMED to be a doctor which doesn’t mean they are or that they are a dentist

Yes I most likely will approach the practice manager once I get this tooth problem resolved. I'll do that first anyway.

This dentist is dismissing your pain because you’re autistic and ignoring medical evidence?
I think you need a second opinion from another dentist.

The first dentist didn't miss decay. Leaving decay under a filling is normal practice in certain circumstances, if removing the decay is going to expose the pulp then there's techniques whereby you leave it to try and prevent root canal. If you had pain almost immediately then it was clearly already into pulp, the dentist

Discoloration around a filling means nothing, the xray presumably showed no pathology around the root or around the filling. And why on earth would the dentist praise you for your detailed observations? A folder of detailed observations does point to a fixation on the tooth

The dentist is highly qualified, they will know what pattern fits best with pain from a failed RCT or inflammation from a tooth. There maybe something wrong with your tooth, I dont know but it sounds like the dentist has done enough within the scope of a general dentist to diagnose a failed RCT. And as I said previously the easiest thing for them to do would be just to take it out