[porieux]

Mod please delete this thread as well as my account.

I'm not hanging around here at the idiot convention any longer.

[ghporter]

I can understand being upset; this is truly a tragedy. But why say "dentistry is backward" in the U.S.? One dentist overestimates his abilities in sedation and that makes dentistry backward? Thousands of physicians overestimate their abilities with sedation every day-and the basic general practice MD gets far less practice with even minor anesthesia-but does that make medicine backward? I think not. I do think that anesthesia needs to be stressed as a SEPARATE SPECIALTY that anesthesiologists need to take back from everyone with a needle and some xylocaine.

[Millennium]

Originally Posted by porieux

Dentistry in general is pretty damn backward in the US...

Interesting; I've never heard this before. How exactly is it backward?

...but who the hell ever heard of sedating someone to fill a couple of cavities, never mind 3 forms and without any proper monitoring.

'Sedation dentistry,' as the practice is called, is actually relatively new in the US, and not all that popular yet. The benefits are more psychological than anything else, and nobody pretends otherwise. However, this dentist seems to have severely crossed several important lines: he doesn't seem to have had proper training or monitoring, and three forms of sedative are definitely overkill.

I would not call this murder, as I very much doubt the dentist had any intent to kill and this certainly wasn't premeditated, but it definitely looks like involuntary manslaughter due to criminal negligence.

[Big Mac]

Horrible story

[BRussell]

Why is a 5-year-old getting cavities filled? How many adult teeth does a 5-year-old even have? For that matter, how is a 5-year-old even getting cavities in the first place?

[Millennium]

Originally Posted by BRussell

Why is a 5-year-old getting cavities filled? How many adult teeth does a 5-year-old even have? For that matter, how is a 5-year-old even getting cavities in the first place?

I had cavities at age five. My first visit to the dentist that I can remember turned up four of them. At the time, I didn't have any adult teeth yet.

As for why I had cavities in the first place, no one ever figured out exactly why: I wasn't overweight, I didn't eat or drink many sweets, and although I probably didn't get as much exercise as I should have (I was a bookworm even at that age) I got a decent amount. I think they eventually settled on some kind of body chemistry thing: my sisters suffered similar problems.

And no, I wasn't sedated, though the dentists probably wished that I were. I was a horrible dentistry patient as a child.

[andi*pandi]

they fill the cavities now even in baby teeth. Maybe it's to prevent gum disease and damage to the underlying adult teeth? dunno.

this is very sad stuff. My son's been to the dentist once, sat still for 15 minutes and barely let the dentist brush his teeth with special stuff and do a fluoride treatment, I can't picture him getting a cavity!

[turtle777]

Well, unlike in Europe, the oarents could extort, uhm I mean sue the dentist for Eleventy Billion dollars.

-t

[- - e r i k - -]

Cody? Is that you?

[turtle777]

Originally Posted by - - e r i k - -

Cody? Is that you?

Yes, it's me.

How may I direct that call ?

-t

[Chuckit]

Dentistry in the U.S. is not "backward" (in the sense of being worse than most places in the world), but that guy is apparently an idiot.

[goMac]

Originally Posted by - - e r i k - -

Cody? Is that you?

I thought the exact same thing.

[starman]

People LOVE taking pot shots at the U.S.

[KeriVit]

Originally Posted by BRussell

Why is a 5-year-old getting cavities filled? How many adult teeth does a 5-year-old even have? For that matter, how is a 5-year-old even getting cavities in the first place?

My thoughts exactly. If they are gonna fall out in the next couple of years, why?

[KeriVit]

Oh and I don't see dentistry as backwards, I'm just terrified of the dentist. Had a bad experience once and... well, regardless I'm going to the Oral Surgeon tomorrow for a wisdom tooth consult.

The girl incident is horrible, but, I'm not making judgements yet.

[olePigeon]

Dentist != Anesthesiologist

[torsoboy]

Originally Posted by - - e r i k - -

Cody? Is that you?

hahaha... that is the very first thing I though when I read the thread title!




I think the OP was a little overly dramatic; it doesn't seem like murder to me. Maybe the girl just had a reaction to something. Waitint untill the investigation is even started before making death threats is probably a good policy.

[legacyb4]

Cavities are caused by a number of factors that all come together, but bacteria is the primary reason. I would imagine leaving your rotting baby teeth in while your new adult teeth are starting to come in would present a hostile environment and put your adult teeth at risk...

http://www.merck.com/mmhe/sec08/ch114/ch114b.html

Originally Posted by KeriVit

My thoughts exactly. If they are gonna fall out in the next couple of years, why?

[ghporter]

I have seen PRESCHOOLERS with CAPPED INSCISORS!!!! Parents who prop bottles of sweet stuff in baby's mouth so they can do other things instead of attending to baby cause these cavities, as do parents who do not insist on good oral hygene for their kids. Dental problems with the primary teeth can cause HORRIBLE problems with secondary teeth, and the sooner baby cavities are corrected the better the overall outcome. But when parents CAUSE those cavities, I think they need to be kicked in the head.

Strong feelings about this? ME? Naaahh. Why do you ask?

[ambush]

This happens all the time...

We've had a similar case.

[davesimondotcom]

It was a dentist that invented the electric chair. 'Nuff said.

[Zeeb]

Originally Posted by ghporter

I can understand being upset; this is truly a tragedy. But why say "dentistry is backward" in the U.S.? One dentist overestimates his abilities in sedation and that makes dentistry backward? Thousands of physicians overestimate their abilities with sedation every day-and the basic general practice MD gets far less practice with even minor anesthesia-but does that make medicine backward? I think not. I do think that anesthesia needs to be stressed as a SEPARATE SPECIALTY that anesthesiologists need to take back from everyone with a needle and some xylocaine.

I've had one good dentist in 9 years and I had to leave him because I got different insurance, though I'm considering returning to him and just paying out of my own pocket. One loser dentist I had said that my entire mouth was filled with cavities and that he had to fill them all. He filled half before I went to someone else who said I had NO cavities. That same dentist tried to give me VALIUM while giving me the filling.

At a second Russian dentist I went to I was just getting my teeth cleaned--that's all. They were a bit rough with the intruments they were using and caused lacerations on my gum which resulted in an infection.

Therefore, reading this tragic story doesn't surprise me one bit. I would have to say that based on my own experiences, dentistry is pretty backward in my area at least.

[CleoW]

Hey, everyone, cavities don't necessarily develop because of sweets. Some people are born with the holes in their teeth; they expand in the first years of life, necessitating a filling.

[MindFad]

Originally Posted by - - e r i k - -

Cody? Is that you?

Bah, beat me to it. 5-year-old with cavities? She obviously had it coming.

[RAILhead]

You're a rabid anti-dentite.

[kmkkid]

Originally Posted by RAILhead

You're a rabid anti-dentite.

!

[PER3]

Personally I think this 'dentist' should be killed...

From the OP.

This kind of response is pretty disturbing given that we don't have much information about what actually occurred.

[starman]

I think the word "murdered" is a little harsh here.

[porieux]

...

[ghporter]

Originally Posted by CleoW

Hey, everyone, cavities don't necessarily develop because of sweets. Some people are born with the holes in their teeth; they expand in the first years of life, necessitating a filling.

That doesn't excuse the horrible habit of shutting up the baby by stuffing orange juice or Kool-Aid in his mouth. It happens a lot more often than congenital tooth deformities do.

[ghporter]

Originally Posted by porieux

He should be killed just for giving three forms of anaesthesia to a 5 year old.

And dentistry is very backwards, and this is not the reason. I could go on and on and on. Maybe later.

While your rant about why dentistry is "backward" should indeed wait for another time and its own thread, I really have to ask why you feel qualified to state categorically that no 5 year old should receive "three forms of anaesthesia". Got a degree in the subject? Because that dentist WAS certified:

The girl's dentist, Hicham Riba, was certified to administer anesthesia to patients and his state license was current, said Susan Hofer, a spokeswoman for the Illinois Department of Financial and Professional Regulation.

Reports from the family say that there were three types of anaesthetic administered: an oral agent, an IV agent, and nitrous oxide. From what the Cook County ME said about it,

Lack of oxygen to the brain caused by anesthesia caused the death of a 5-year-old girl who never awoke from sedation during a visit to the dentist, the Cook County, Ill., medical examiner's office said Thursday.

...so maybe it could have been the nitrous alone that caused the problem, but I doubt it. Typically, nitrous oxide is administered to calm and relax the patient, NOT to sedate the patient. And the "mask" for nitrous administration in dentistry looks like this:

How could THAT keep her from getting oxygen? Probably not the nitrous on its own.

While I can think of a lot of ways for something like this to happen, I certainly do not think I'm qualified to judge, ESPECIALLY on the basis of news reports that are almost certainly lacking in important information. I'd suggest that EVERYONE follow my lead and withold judgement until the facts are out.

The news reports I have read also point out that the dentist has received death threats. While I can understand being upset about the situation, how can murdering someone help anything? There could have been some situation like the girl having a very odd congenital problem, or a reaction to the medications that would have been outside of the dentist's ability to note or intervene in. And the dentist reports being "devastated" for the girl's family-who wouldn't be? Maybe this WAS just a tragic error.

As for using "three anaesthetic agents", typically sedation (as opposed to a local anaesthetic) is a combination of agents. When I had my wisdom teeth out, I had valium and demerol/fentanyl. The valuim was to relax me, and the combination of demerol and fentanyl were for pain relief and amnesia. They worked fine. While most valium is administered orally, mine was IV simply because they had the capability and it was faster in my case.

Here's a link to the American Academy of Pediatric Dentistry's site on sedation.

[mmontgom]

I happened upon this forum while trying to find more information about this case. I was shocked to read the first post in this thread, which offers little to the discussion other than the topic itself. As a dentist, I would like to know why "dentistry is backwards" because I certainly don't know.

To allay other concerns, "three forms of anesthesia" is not nearly the big deal you guys are making it out to be. Valium is BY FAR one of the safest sedating drugs on earth. Check the literature, almost NO ONE has died from a valium (diazepam) overdose alone. They've taken up to 2000mg of it! Second, an "oral anesthetic" was more than likely just a local anesthetic like lidocaine, articaine, bupivacaine, etc with a vasoconstrictor like epinephrine. Lastly, nitrous oxide is also one of the safest anesthetics in the world. It merits a quick recovery, has few side effects, and is very easily administered.

You need to use all of these drugs in a screaming kid getting her teeth drilled. If you try to do dental work without them, bad things can happen like her knocking the drill or chomping down on it. You need to address pediatric dental problems for numerous reasons the most easily identified one being that you need those primary teeth to hold the space for the permanent teeth. Without them your adult teeth will come in terribly and can affect the way your entire mid and lower face looks. Other reasons include eliminating infection and relieff of pain.

We are all taught that you need to monitor the patient with pulse oximetry (that red light that goes on your finger), their temperature before and after, blood pressure every five minutes, their heart rate (EKG possibly) and MOST IMPORANTLY, their breathing. 90% of anesthesia deaths are human error. Almost all of these are because the patient is not intubated and their respiration stops due to CNS depression in the medullary breathing center.

Anyways, this dentist sucks but I don't think dentistry as a whole is backwards. If you have a way to make me a better dentist, I'm happy to hear it. No one likes hurting people.

[porieux]

...

[porieux]

...

[chris v]

Originally Posted by MindFad

Bah, beat me to it. 5-year-old with cavities? She obviously had it coming.

Is it safe?... IS. IT. SAFE??

[mmontgom]

Originally Posted by porieux

Let's see what other frivolous reasons we can list for this tragedy shall we?

- nobody needs sedation to have cavities filled...ever.

This is false and goes against a lot of credible research. If this were the case no dentist would offer anesthesia like nitrous oxide. "Sedation" is not the same as "general anesthesia". Also she was having crowns put on as well. Imagine a 5 year old kid at the dentist, probably pretty unhappy. Sedation allows you to do your work with minimal side effects to the patient. This child died, but people also die of aspirin. It's no where near the majority of what usually happens.

Originally Posted by porieux

- 5 year olds don't need cavities filled. yeah i understand they make money from doing it, sorry that's not a good enough reason.

Did you read my previous post? That is not the reason that children have their teeth filled. I won't even go into it, if you can google, you'll find it.

Originally Posted by porieux

- no monitoring of the patient. gonna argue with this one?!

I agree that if there was no monitoring that was a serious mistake and goes against US training and certification standards. No excuses.

Originally Posted by porieux

- forcing the mother to leave the room when there was no one to monitor the child

This is also justified. Sometimes the parents are worse than their children. If it was the policy to always remove parents then that is one thing which I disagree with. However, if the mom is in there screaming and interfering with your necessary work in a stressful situation, you may ask her to leave and would be entirely justified in doing so. If he asked her to leave to cover his arse, that is totally different and wrong.

Originally Posted by porieux

There is no ambiguity here over what happened.

Really? What drugs were given to her and in what doses? What monitoring was in place? Where did this dentist get certified and what are his credentials? Did this girl have any genetic predisposition to anesthesia that could have been triggered like in malignant hyperthermia?

Originally Posted by porieux

I rest my case.

If you were an attorney and rested your case after an opening argument with no justification, you would lose and would be disbarred.

The meat of this problem is the monitoring. Going against the idea of sedating a 5 year old and doing restorative procedures is a silly argument. Dentists are highly trained in anatomy and facial development (beyond just the dentition). You're trying to say that the entire profession of pedodontists should be swept away because their work is not needed. That is ridiculous. I would guess that you have zero training in dentistry or even medicine for that matter because you have not said anything worthwhile. If you look at the literature (Entrez PubMed) you will see that these procedures, including sedation, are routine and go off without a hitch most of the time. Sometimes someone screws up and people die. It is a tragedy and he will lose his license and possibly go to prison.

I think I've made my point as well as it can be on here. Good luck with your crusade against dentists. If you ever have any advice as to how I can personally correct dentistry from being "backwards" in this country or how I can be a better dentist, I'm all ears.

[Kevin]

Originally Posted by porieux

- nobody needs sedation to have cavities filled...ever.

There are people with phobias of being awake while getting worked on. They need sedated or they can't handle it.

[porieux]

...

[Kevin]

Originally Posted by porieux

Wow, the rationalization for a dead 5 year old is getting pretty thick in here.

Wow what a knee-jerk. Most of us are just disagreeing on your harsh criticism of American dentistry in general.

Most here are agreeing this was a HORRIBLE incident.

[Spliffdaddy]

Originally Posted by mmontgom

This is false and goes against a lot of credible research. If this were the case no dentist would offer anesthesia like nitrous oxide. "Sedation" is not the same as "general anesthesia". Also she was having crowns put on as well. Imagine a 5 year old kid at the dentist, probably pretty unhappy. Sedation allows you to do your work with minimal side effects to the patient. This child died, but people also die of aspirin. It's no where near the majority of what usually happens.


Did you read my previous post? That is not the reason that children have their teeth filled. I won't even go into it, if you can google, you'll find it.

I agree that if there was no monitoring that was a serious mistake and goes against US training and certification standards. No excuses.

This is also justified. Sometimes the parents are worse than their children. If it was the policy to always remove parents then that is one thing which I disagree with. However, if the mom is in there screaming and interfering with your necessary work in a stressful situation, you may ask her to leave and would be entirely justified in doing so. If he asked her to leave to cover his arse, that is totally different and wrong.

Really? What drugs were given to her and in what doses? What monitoring was in place? Where did this dentist get certified and what are his credentials? Did this girl have any genetic predisposition to anesthesia that could have been triggered like in malignant hyperthermia?



If you were an attorney and rested your case after an opening argument with no justification, you would lose and would be disbarred.

The meat of this problem is the monitoring. Going against the idea of sedating a 5 year old and doing restorative procedures is a silly argument. Dentists are highly trained in anatomy and facial development (beyond just the dentition). You're trying to say that the entire profession of pedodontists should be swept away because their work is not needed. That is ridiculous. I would guess that you have zero training in dentistry or even medicine for that matter because you have not said anything worthwhile. If you look at the literature (Entrez PubMed) you will see that these procedures, including sedation, are routine and go off without a hitch most of the time. Sometimes someone screws up and people die. It is a tragedy and he will lose his license and possibly go to prison.

I think I've made my point as well as it can be on here. Good luck with your crusade against dentists. If you ever have any advice as to how I can personally correct dentistry from being "backwards" in this country or how I can be a better dentist, I'm all ears.

*SMACKDOWN*

[porieux]

...

[starman]

Originally Posted by porieux

This is getting stupid and disrespectful to the actual situation at hand.

Maybe some of us are sick and f'n tired of people taking pot shots at America when it's CLEAR that things like this happen all over the world.

So, basically, you asked for it.

[Kevin]

Originally Posted by porieux

I haven't even made my criticism of dentistry yet, that's the subject
people are trying to bait me with who have no other argument.

Do you not even read what you write?

Originally Posted by porieux

Dentistry in general is pretty damn backward in the US

[JoshuaZ]

Dentistry is backwards? Hmm... well clearly you need to see how its handled in the rest of the world. I long for a good dentist around my parts.

[tboparis]

Dentistry in general is pretty damn backward in the US

I heard it was more advanced in Europe... Not sure though....

[chrisford]

I don't think this is anything to do with anti-American bias (or at least, not as I'm reading it). I do think, however, that porieux is either very young, or not the sharpest tool in the box. This is of course a sad story (not a tragedy, but that's the pedant in me talking) but you can't possibly extrapolate from one sad story (regardless of whether there is any personal culpability) to the state of dentistry in America. Which I have no evidence for. Nor, I doubt, does porieux.

[smacintush]

My dentist is fabulous.

[ghporter]

Originally Posted by mmontgom

We are all taught that you need to monitor the patient with pulse oximetry (that red light that goes on your finger), their temperature before and after, blood pressure every five minutes, their heart rate (EKG possibly) and MOST IMPORANTLY, their breathing. 90% of anesthesia deaths are human error. Almost all of these are because the patient is not intubated and their respiration stops due to CNS depression in the medullary breathing center.

Anyways, this dentist sucks but I don't think dentistry as a whole is backwards. If you have a way to make me a better dentist, I'm happy to hear it. No one likes hurting people.

Welcome to the forums! Can you fill us in on your background? You first sentence quoted above sounds like a close paraphrase of the ADA and APDA's sedation guidelines. Dentist? Dental student?

[Gossamer]

Originally Posted by porieux

This is getting stupid and disrespectful to the actual situation at hand.

You are a terrible person. You're making unsupported claims without any knowledge of the subject, basing your entire opinion on one or two internet articles, and you're calling for the death of someone when you have no idea of the situation.

[Amorya]

Originally Posted by tboparis

I heard it was more advanced in Europe... Not sure though....

I actually heard it was more advanced in America. Especially for cosmetic procedures.

Maybe it's a grass is always greener thing