Friday, December 7, 2012

my family dentist left me with a lose tooth after beating on it?

Q. My family dentist didin't finish my tooth extraction, and referred me to an oral surgeon. Is this common? I was left with painful mouth, antibiotics and pain medication while trying to make an appointment with an oral surgeon. It was a horrible experience! Why did he try to pull it to begin with?

A. Sometimes a dentist will think that he has the abilities to do something that he doesn't. It could have looked like a normal extraction but when he started working on it he found out that the root was curved around the bone or it was anchored in there better than he thought it was. Or he could just be a crappy dentist. A good dentist would have looked at the x-rays and referred you to the oral surgeon before this painful process began. And if he was a half decent dentist he would have immediately called an oral surgeon's office and had an appointment made for you to get the job finished. Not made you wait in pain while trying to schedule your own. Not all extractions are created equal but it does sound like this guy doesn't have the professional courtesy to take care of his patient. Sorry. And I certainly hope there was no charge for that office visit.


How much does a Cosmetic Dentist make a year?
Q. My little brother wants to be a dentist and so far teachers tell him to be a cosmetic dentist who requires a little more study and skill but pays off eventually. About how much does a normal family dentist make and how much does a cosmetic dentis make a year?

Thank you!

A. It depends on location, patient base, how big your practice is, your expenses etc, it varies to widely to give estimates


What should one expect from shadowing a dentist?
Q. Eventually I'd like to get into dental school. However, I'm a bit intimidated by the shadowing process. It's not that I'm afriad of the actual clinical stuff... it's just that shadowing seems so awkward. I shadowed my family dentist and they just had me walk around, form appointment to appointment, observing. That was fine, but I can't imagine getting hundreds of hours this way... The hygenists seemed annoyed, and the dentists weren't exactly used to me being there. Was I doing something wrong? What SHOULD shadowing regularly be like?

A. I think that finding a good dentist to shadow is key. I didn't do it, but some of my classmates did. I found it difficult to find someone (since I don't have any connections through relatives), since the laws where I live pretty much prohibit anyone without a license (ie, dentist, hygienist or licensed assistant) touching the patient and confidentiality really limits who is present.

If you find someone who would let you assist, that's fantastic! When you talk to the dentists, ask them how involved they will allow you to be. You will also want to find someone who will explain what they are doing, otherwise it will be very boring to watch. Ask them in advance if they would be okay with you asking questions as they go. Most probably would be, but it will be good for you to know this so you don't feel awkward asking. If you are really ambitious, you might even be able to call in the day before to find out what's on the program, and then read up a bit on some of the procedures you might be watching. (Although this isn't expected by any means.) Also be sure to ask about safety measures and infection control so that you can know this beforehand instead of finding out by doing the wrong thing.

If they aren't used to having you there, I can see how you might feel ignored or in the way. I wouldn't take it personally, you probably didn't do anything wrong. The best thing to do would be to find someone who doesn't look too busy, and ask them to fill you in on who is doing what that day. Pick something that interests you, and then approach the person beforehand (if you can) and ask if they would mind if you tag along with them. As people get to know you, they will probably become more comfortable with you and may involve you more.

If you feel like you are seeing the same things over and over with your family dentist, you could ask him if he knows any specialists you could shadow. He probably has dental school buddies he still talks to in the area who might be doing some interesting things you could watch, even if they only bring you in for one or two specific procedures. (Sometimes they have to ask the patients in advance if they would mind having a student present.)

Oh yes...and be sure to send a thank-you note afterwards!

Good luck!


Is it really better to have your wisdom teeth removed by a surgeon, or can your dentist do it?
Q. Oral surgeon or family dentist? Which is better when you have your wisdom teeth removed? Does anyone have experience with having their wisdom teeth removed while sedated and under local anasthetic instead of while completely knocked out by a general anasthetic?

A. I'm a dentist.

Unbelievable. Six wrong answers in a row. I'm sad to say that even the hygienist (RDH) doesn't know what she's talking about. Her comment about "general anesthesia" was wrong. Oral surgeons do use general anesthesia in their offices--that's what IV sedation is, however it is not to the point where you need a ventilator.

Most general dentists do not remove impacted wisdom teeth and thus refer such cases to oral surgeons. Some general dentists, however, are perfectly comfortable removing impacted wisdom teeth, and rarely refer such procedures to oral surgeons.

Some general dentists are also licensed to administe IV sedation. Most are not. (All oral surgeons are).

I extract impacted wisdom teeth regularly, and refer to oral surgeons only those patients who wish to be sedated. For the patients I treat, I often prescribe for them an anxiolytic medication (e.g. Valium or Xanax) to be taken prior to the surgery and use nitrous oxide during the procedure. Generally these patients are very comfortable.

If your general dentist is comfotable performing the procedure, then you have to ask yourself the following: do you want to be awake and aware of what's going on? Or do you want to be unaware of what's going on? If it's the latter, then you should ask to be sedated intravenously. If your general dentist does not offer IV sedation, then you'll be referred to an oral surgeon.

That's all there is to it. The rest of the answers posted above this one range from inaccurate to just plain clueless, and you should ignore them completely.





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