I’m upset about my last appointment. Let me preface this by saying I am a sedation veteran. If it is anything except a cleaning, I use sedation. Because of that, I usually don’t need a lot of serious care and I’ve never had a problem in the past, so this took me by surprise. I’d had some recent illnesses and missed a couple of cleanings, which is how I eneded up needing a crown to begin with. I went into the procedure expecting to have a tooth prepped for a dental crown. It wasn’t until I was home and becoming more lucid that I realized the tooth was gone. How could this have happened? I couldn’t give consent for this while under sedation. How did he have the right to take the tooth? I’m a little shocked because I’ve been going to this dentist for years. I’ve never had a problem like this before.
Callie
Dear Callie,
I can tell you are upset and that this was a bit of a shock to you. I can understand that. Before we get into how this can happen, I just want to say how great it is that you’ve been using dental sedation to deal with your anxiety. Because you’ve had a good relationship with him, I’d start by calling and ask what happened. It would be highly unusual for a dentist to do a treatment without consent. In fact, it’s unethical. My guess would be that in your original agreement of signed consent there was something in there about the possibilities.
Let’s look at why this change in procedure could have been necessary. Two things come to mind right away. First, is the x-ray. Your dentist is using a 2-Dimensional readout to diagnose and plan treatment for a 3-Dimensional area. It’s possible it was hard to read the extent of decay. Once he got in there he realized the tooth wasn’t salvageable.
A second possibility is the decay just blew up between the time he did the x-rays and your appointment. These type of things can take off quickly. You can be fine one day and battling a serious infection the next. Before you know it you have a dental emergency on your hands.
If your dentist noticed things had gotten bad, he would have been negligent to leave it there. Even in the 21st century, people still die from tooth infections. By removing the tooth, he prevented that.
If you talk to him and it turns out you didn’t agree to him doing any necessary work, then yes, he has a problem. It is a big tenant of dental care that you always give informed consent. You can’t give that under sedation. Dentists know that. However, check your agreement first. There may be something in there about important treatment which comes up during the procedure.
Dealing with Your Missing Tooth
It is important you replace your missing tooth. The ideal tooth replacement is a dental implant. Another option is a dental bridge. This makes more sense if one of the adjacent teeth needs to be crowned anyway. Without that, you ‘ll be removing healthy tooth structure.
There is also a removable partial denture. All of these options have pros and cons you can discuss with your dentist. You won’t have to make a permanent decision right away, but you will need to at least get a temporary replacement in so the teeth don’t shift into the open space. A common and inexpensive temporary replacement is a dental flipper. This will allow you to protect the area while you research your options.
This blog is brought to you by Baton Rouge Dentist Dr. Steven Collins.