Am I justified in making a complaint over treatment?

Stheno

I have a phobia of dentists, and until recently had not seen one for about four years.

I made the decision recently to make an effort taking care of my teeth, and to deal with two which were cracked, and as I travel a lot, made an appointment with a dentist which opens on saturdays in my locality.

On my first visit I had a check up and a small treatment plan to deal with the two bad teeth, and a proper clean/scale/polish.

On my second visit, I had one of the bad teeth extracted, and as I smoke, I knew there could be some complications.

After the extraction (on a Saturday) the dentist put a stitch in, and advised it would dissolve in a couple of days. From the day of the extraction onwards, my gum/jaw was very sore, and it didn't stop.

The following Wednesday, my gum where the tooth had been extracted became very painful, and felt like it was cut. The day after on Thursday evening, I checked it in the mirror and discovered that the stitch was loose and rubbing against my gum continuously, so I removed it by snipping it with a scissors, and the pain lessened.

The pain continued and at a follow up appointment two weeks later I advised of this. The dentist pretty much said, it's healing slowly as you are a smoker, and any further work will be complicated by that, then he applied a dressing, which relieved the pain I was in.

That was all well and good until last night when I felt a very sharp edge rubbing against my gum, and then this evening what appears to be a piece of the tooth that was extracted, finally came to the surface of my gum and came out.

I'm considering making a complaint on the basis of the dentist not noticing this last week on the follow up examination, and not taking the possibility into account and doing an xray, as I've had another two days of pain due to imo his lack of attention

Am I overreacting? I have to wonder if that piece of tooth (pic attached) being left behind delayed the recovery and do consider the dentist last week should have taken an xray.

davo10

That is not part of the tooth, it is part of the surrounding bone. Teeth are not designed to come out easily, the dentist has to move the tooth from side to side to widen the socket and allow for the bone to be lifted out ( think of trying to lift a deeply buried stake from the ground by trying to pull it straight up, it won't budge but if you push it from side to side it pushes the surrounding earth outward and lowers the resistance to movement). Sometimes a little of the very thin jaw bone up near the top of the tooth gives way during the extraction. As the site heals this bone fragment gets pushed up to the surface and comes out. It's uncomfortable/ painful but it is part of the extraction process. Smoking hinders healing by reducing the tissues ability to recover, it also causes weakening of the bone by reducing blood flow. You can make a complaint but it won't go anywhere, the fact that you allowed the tooth to deteriorate to the point where extraction was necessary and left yourself open to post op complications by smoking means that even if the tooth was extracted by the most skilled operator, this would have been the likely outcome.

The fragment is usually not visible as the soft tissues close until it pops up to the surface as the swelling goes down. Put it this way, if the dentist said at the follow up visit "I'm concerned about this so I'm going to remove the bone in the area where you had a tooth extracted" what would you have said? " ya go for it, drill away the bone"?

Stheno

davo10 wrote: »

That is not part of the tooth, it is part of the surrounding bone. Teeth are not designed to come out easily, the dentist has to move the tooth from side to side to widen the socket and allow for the bone to be lifted out ( think of trying to lift a deeply buried stake from the ground by trying to pull it straight up, it won't budge but if you push it from side to side it pushes the surrounding earth outward and lowers the resistance to movement). Sometimes a little of the very thin jaw bone up near the top of the tooth gives way during the extraction. As the site heals this bone fragment gets pushed up to the surface and comes out. It's uncomfortable/ painful but it is part of the extraction process. Smoking hinders healing by reducing the tissues ability to recover, it also causes weakening of the bone by reducing blood flow. You can make a complaint but it won't go anywhere, the fact that you allowed the tooth to deteriorate to the point where extraction was necessary and left yourself open to post op complications by smoking means that even if the tooth was extracted by the most skilled operator, this would have been the likely outcome.

Thank you, that explanation makes sense.

I think for me, I'll be going back to my old dentist who is difficult to get an appointment with as they work limited hours, but I am much more comfortable with them Lesson learned to make an effort to stay with a practitioner you are happy with!

Oral Surgeon

It doesn't sound ideal but it doesn't sound like your dentist did anything wrong or negligent. The healing after the extraction was not ideal, sounds like you got a dry socket (a common complication and more common in smokers)...
Stitches become can become loose just before they fall out, they can be annoying...
Dry socket is self limiting but the dressing placed can ease the pain in the interim...
The piece of "tooth" you have is more likely to be a piece of bone. Dry socket is alveolar osteitis- inflammation of the bone. This in addition to the trauma to the bone during an extraction can cause a sequestra of bone to loosen and be externalised a few weeks later, it's a know complication and even happens to me on occasion.

I honestly don't think that there is much to complain about op. The reality is that if you were a non smoker , this would be much less likely to happen!! So there is a certain shared blame....

Stheno wrote: »

I have a phobia of dentists, and until recently had not seen one for about four years.

I made the decision recently to make an effort taking care of my teeth, and to deal with two which were cracked, and as I travel a lot, made an appointment with a dentist which opens on saturdays in my locality.

On my first visit I had a check up and a small treatment plan to deal with the two bad teeth, and a proper clean/scale/polish.

On my second visit, I had one of the bad teeth extracted, and as I smoke, I knew there could be some complications.

After the extraction (on a Saturday) the dentist put a stitch in, and advised it would dissolve in a couple of days. From the day of the extraction onwards, my gum/jaw was very sore, and it didn't stop.

The following Wednesday, my gum where the tooth had been extracted became very painful, and felt like it was cut. The day after on Thursday evening, I checked it in the mirror and discovered that the stitch was loose and rubbing against my gum continuously, so I removed it by snipping it with a scissors, and the pain lessened.

The pain continued and at a follow up appointment two weeks later I advised of this. The dentist pretty much said, it's healing slowly as you are a smoker, and any further work will be complicated by that, then he applied a dressing, which relieved the pain I was in.

That was all well and good until last night when I felt a very sharp edge rubbing against my gum, and then this evening what appears to be a piece of the tooth that was extracted, finally came to the surface of my gum and came out.

I'm considering making a complaint on the basis of the dentist not noticing this last week on the follow up examination, and not taking the possibility into account and doing an xray, as I've had another two days of pain due to imo his lack of attention

Am I overreacting? I have to wonder if that piece of tooth (pic attached) being left behind delayed the recovery and do consider the dentist last week should have taken an xray.

Stheno

Oral Surgeon wrote: »

It doesn't sound ideal but it doesn't sound like your dentist did anything wrong or negligent. The healing after the extraction was not ideal, sounds like you got a dry socket (a common complication and more common in smokers)...
Stitches become can become loose just before they fall out, they can be annoying...
Dry socket is self limiting but the dressing placed can ease the pain in the interim...
The piece of "tooth" you have is more likely to be a piece of bone. Dry socket is alveolar osteitis- inflammation of the bone. This in addition to the trauma to the bone during an extraction can cause a sequestra of bone to loosen and be externalised a few weeks later, it's a know complication and even happens to me on occasion.

I honestly don't think that there is much to complain about op. The reality is that if you were a non smoker , this would be much less likely to happen!! So there is a certain shared blame....

No that's fine as I posted above

Dianthus

Stheno wrote: »

Thank you, that explanation makes sense.

I think for me, I'll be going back to my old dentist who is difficult to get an appointment with as they work limited hours, but I am much more comfortable with them Lesson learned to make an effort to stay with a practitioner you are happy with!

If it's any consolation, likely the exact on same post-extraction scenario (dry socket, followed by a loose splinter of bone) is a very common occurrence in general dental practice, & your healing response would have been no different no matter what dentist you saw.
A dentist you've seen for years has the advantage of having built up rapport & trust with you as a patient (checkups & cleanings & fillings ect), a relationship a "new" dentist doesn't have the advantage of, that's all.
Fair dues on making inroads on restoring your dental health, keep the faith!

Stheno

Dianthus wrote: »

If it's any consolation, likely the exact on same post-extraction scenario (dry socket, followed by a loose splinter of bone) is a very common occurrence in general dental practice, & your healing response would have been no different no matter what dentist you saw.
A dentist you've seen for years has the advantage of having built up rapport & trust with you as a patient (checkups & cleanings & fillings ect), a relationship a "new" dentist doesn't have the advantage of, that's all.
Fair dues on making inroads on restoring your dental health, keep the faith!

That's a very true point that you've made, I think the one main difference with this dentist was that from day one, he went on and on and on and on about my being a smoker, while with my previous dentist it wasn't an issue, and tbh I didn't like the new dentist. Personality wise, I found him dismissive even though I explained that I wanted to draw up a long term plan to restore my teeth, and then improve them, including getting braces. He mentioned good practice at home, and when I asked what he meant, just said, well just brush and floss. As well with my old dentist I've have rung in to check if I was having problems a few days later, but was put off doing so by this new guy.

My old dentist was the first I saw for many years after I developed my phobia, so he does have a big advantage over any other. He's difficult to get to given my work schedule as I travel a lot, but I'll just have to plan.

All in a good lesson in not sacrificing a good dentist for convenience

Stheno

I now have a second piece of bone making it's way through, it's pierced my gum tonight.

It's like I've a new tooth breaking through.

Oral Surgeon

Stheno wrote: »

I now have a second piece of bone making it's way through, it's pierced my gum tonight.

It's like I've a new tooth breaking through.

Have you seen anyone else about it at this stage…??

Stheno

Oral Surgeon wrote: »

Have you seen anyone else about it at this stage…??

No it just broke through today, am going back to my old dentist hopefully in the next week. I know he'll scoff at me going to another dentist, but he'll know why I did, and I trust him. I'm not expecting him to make it all right, I think at this point, I just want a bit of reassurance that it's ok. I know I smoke, but generally I take care of my health, I'd to have a Dexa scan earlier this year to check my bone health and it was fine, and this is the first time this has happened to me with an extraction, having had two before.

I know I sound like a right whinger, but this has to be on the far scale of what can go wrong getting a tooth out!

Oral Surgeon

Stheno wrote: »

No it just broke through today, am going back to my old dentist hopefully in the next week. I know he'll scoff at me going to another dentist, but he'll know why I did, and I trust him. I'm not expecting him to make it all right, I think at this point, I just want a bit of reassurance that it's ok. I know I smoke, but generally I take care of my health, I'd to have a Dexa scan earlier this year to check my bone health and it was fine, and this is the first time this has happened to me with an extraction, having had two before.

I know I sound like a right whinger, but this has to be on the far scale of what can go wrong getting a tooth out!

You mention a dexa scan, have you ever had bisphosphonate medications (or similar) to "strengthen" the bones?? Feel free to pm me if you like (not that there is anything embarrassing about taking them..!)

FYI, extraction complications can get far worse than this, nerve damage, holes into the maxillary sinus, broken jaw, severe sepsis…..

Stheno

I've pmed you