Difficulties at the Dentist

stuffedToothbrushI waited two months to get my children an appointment with a new dentist. She is one of two who takes the Oregon Health Plan, a state-funded insurance program for kids who qualify.

We’ve really been feeling the pinch of the recession and our family, unfortunately, more than qualifies.

I was so glad that OHP includes dental coverage. It’s been a year since the kids have seen a dentist.

The appointment was for 2:20 p.m and I called around 1:00 p.m. to confirm. We arrived early. The receptionist handed me some paperwork. Included in the paperwork was a consent form. You’re supposed to put your initials by the various treatments, including “any necessary radiation” and “fluoride treatments.”

Unless there’s a problem, I don’t believe in X-raying a child’s mouth. We know that the negative affects of X-rays accumulate in a child’s body. Though the dentist (or doctor) will insist that the amount of radiation a child is exposed to in an X-ray is harmless, every time a child is exposed to X-rays you are damaging more cells and doing more harm. The effects are cumulative. So I think it’s a good policy to avoid X-rays. I skirted the issue on the forms, though, by writing I would bring them the X-rays done by their previous dentist.

I also suspect fluoride treatments are unnecessary. None of my children has ever had a cavity. Our water is not fluoridated. And they have not had any fluoride treatments, except once when James took them to the dentist and forgot to ask the hygienist not to do it.

So in the box where it asks to initial your consent, I wrote a note that I did not want fluoride treatments.

A hygienist came out to talk to me. She said fluoride was perfectly safe. She said the dentist recommended fluoride. I said I had concerns about it and asked to speak to the dentist.

Forty minutes went by. The receptionist called me over.

“The dentist insists on fluoride,” she said quietly. “She thinks you should take your children to another practice that’s more in keeping with your philosophy.”

“We’ve been waiting for a long time,” I said. I wasn’t angry but I was baffled and frustrated. “I waited two months to get this appointment. Could you see the girls today and then we’ll find a new dentist?”

The receptionist looked pained.

“I’ll try,” she said.

An hour and twenty minutes after we arrived, the hygienist and dentist looked at the girls’ teeth. The hygienist called me over to show me a better way to brush Athena’s gums. The dentist, who was examining Hesperus, did not look up.

“Could you take five minutes to talk to me about fluoride?” I asked the dentist.

She did not take her face mask off.

She did not agree to sit down with me somewhere private.

Instead, she spoke in front of her staff and in front of my kids, who were both lying on their backs with their mouths uncomfortably open.

“Fluoride does no damage whatsoever to the human body,” the dentist said. “It doesn’t cause cancer.” Here the hygienists giggled, as if the idea that fluoride might be carcinogenic was actually funny, it was so preposterous. “I believe in prevention: good diet, good hygiene, and fluoride. I will treat problems if I have to but that should be a last resort.”

“It sounds like we do agree,” I said, relieved. “I believe in prevention too. My kids eat well. They don’t drink soda and rarely have candy. And we are trying to improve our oral hygiene. Other than my concerns about fluoride, we’re on the same page.”

“We can’t see you here,” the dentist said. “I am leading the campaign to fluoridate the water. If you won’t do fluoride, I won’t treat you. Besides, the insurance you have requires it.”

I honestly don’t know as much about fluoride as I should. But does it matter whether the dentist is right that fluoride is an absolute necessity (which, since my children have no cavities, it obviously is not) or whether my cautious, I’d-prefer-not-to stance is correct? Should a dentist have the right to kick your child (or you) out of their practice because you refuse an optional treatment?

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19 thoughts on “Difficulties at the Dentist”

  1. i think doctors always get offended when u refuse the treatments they propose. i’m lucky so far in that i’m able to find doctors who will let me negotiate w/them.

  2. I think it sensible to be cautious, especially when children are involved. Unfortunately, so many past theories have proved false. I’m glad I had my children in the 1970s when there were not so many dangers lurking everywhere, even at the dentist’s office! I have a new fabulous dentist. I will ask what he thinks next week when I see him and report back.
    .-= Alexandra´s last blog ..Wellfleet Guidebook Becomes Available =-.

  3. This makes me furious. I’ve dealt for years with dentists, doctors and other professionals who refuse to acknowledge that they might not know it all. You have a right to choose what is best for your family and I don’t see how your insurance could possibly REQUIRE that you use fluoride. Furious!

    I wrote a post last week on making your own toothpaste and some of the perils of chemicals that are used in commercial toothpaste. A reader left a link about fluoride that you might find interesting that is written by an MD. Don’t buy the whole fluoride line without looking into it yourself! http://healthjournalclub.blogspot.com/2009/11/water-fluoridation-part-i.html
    .-= Melanie´s last blog ..DIY Clean Green Deodorant =-.

  4. Wow! What a terrible experience. I’m so sorry you went through that. It can be so exhausting to fight for what we believe in on behalf of our children, who are so vulnerable. Kudos to you for doing that! It hardly sounds right, that this dentist could refuse to see you for this reason. That said, I hope you can manage to find a dentist who is more compatible with your views, because the more you see eye-to-eye with your practitioner, the less stressful things will be.
    .-= Christine at Origami Mommy´s last blog ..Close Enough to Kiss =-.

  5. This is so outrageous I don’t even know what to say. To say they won’t treat you because you disagree about one thing seems to me the height of egotism. And if this dentist is so adamant about it, you would think he would want your family there so he could try to convince you every six months – show what the lack of fluoride is doing in your kids’ mouths (assuming he can prove that!) and use that as evidence to convince you – put his money where his mouth is (so to speak!).

    I am SOOOOO sick of health care professionals who think they can dictate what you should or should not do with your body or your children’s bodies. They are there to offer advice and to provide treatment that you CONSENT to. It should be your decision what treatment you want. It’s not his call. This makes me so angry.

    You’re not alone by the way. I got kicked out of a primary care practice because my pharmacy called their office by mistake instead of my endocrinologist for a refill. They called me and were nasty about how I hadn’t been in to have that condition checked by them – even though I was having it treated by the endocrinologist. They wouldn’t listen to me and sent me a letter giving me the boot.

  6. I’m very surprised the dentist was so inflexible. Sorry you had to go through all that stress and time just to be treated with contempt.

    I have no idea what the laws are, but my sil was turned down by her pediatrician since they disagreed on vaccinations. While it’s hard at the time, I think in the long run you’d probably be happy somewhere where everyone isn’t so hostile. Hope you have better luck at the next dr.
    .-= Almost Slowfood´s last blog ..Tasty Treat: Best Chewy Chocolate Chip Cookies =-.

  7. That’s a new one. I’ve never heard of being “dismissed” over fluoride. I don’t get x-rayed every year (which my new dentist, who bought my childhood dentist’s practice a fear years ago, recommends). I’ll do it every other year, but not every year … because I’ve never had a cavity between my teeth, and I work VERY hard at at-home dental care.

    After a couple times of me saying “no,” they just had me initial my chart, saying I’d refused the x-ray every year, and now, it’s no problem. We do it odd years only.
    .-= Roxanne @ Champion of My Heart´s last blog ..Dog Athleticism on Display =-.

  8. That seems over the top. Our dentist always asks before doing a flouride treatment, and is very responsive to whatever concerns we have. And he’s as conventional as they come. That said, I’m not sure I’d go so far as to say the dentist’s actions were unethical or illegal. Not sure what the law is on something like this, but I’d imagine that health care providers can refuse to treat someone with whom they disagree philosophically. It certainly works the other way around. (I once left an ob/gyn after she co-authored an anti-choice editorial in our local paper.) Clearly this dentist’s politics were in play (since she mentioned the campaign to flouridate water). But I also wonder whether your health plan — being state-funded — does indeed require flouride treatments. That doesn’t excuse her cool behavior, but it might be something to consider.

  9. That is absolutely preposterous, being kicked out of a practice. Never heard of anything like this happening! This dentist seems very unreasonable, not only in her attitude about the fluoride, but in the general way she runs her practice. You have every right to be livid, and hopefully you will be able to find another dentist who is much more accommodating and not so rigid.
    .-= Sheryl´s last blog ..Health Non-Negotiables =-.

  10. Wow. I always refused the extras but I don’t have insurance so I can just say “sorry, money is tight” and no one questions me. I’ve never understood the zeal to x ray a person every single visit. I’ve asked about it and I’ve never gotten a good reason to do it. One dentist told me it was to ensure I didn’t have jaw cancer…. which is so rare. And doctors don’t routinely do x rays and other diagnostics to rule out cancer in other parts of the body. Another dentist told me that the x rays could find cavities more easily. That just does not seem to justify the excess radiation in my mind.

    These flouride treatments seem to be a new thing. My dentist was even giving them to adults for free. I think a flouride company is funding all of that.
    .-= Alisa Bowman´s last blog ..I Had a Dream =-.

  11. I guess that tells you which treatments that dentist makes the most money from: the flouride and the x-rays.

  12. So I looked into this further, and it’s indeed the case that health care providers can refuse to treat patients on moral/ethical/religious grounds. Most of the legislation and lawsuits I came across involved abortion, contraceptives and vaccinations, but apparently these laws are so broad that providers can refuse for just about anything. So while your situation stinks, it appears the dentist was within her rights.
    .-= Christina @ Spoonfed´s last blog ..

  13. I have to wonder if the dentist had ulterior motives. Maybe she doesn’t get paid as much for patients under the Oregon Health Plan so she’d rather not see them and the flouride disagreement was just a means to an end? Since you had to wait so long for an appointment, she must have a lot of patients. Perhaps she’d rather your slots be taken by cash pay or commercial insurance patients.

    Either way, patients should always be treated with dignity and respect and she didn’t. Shame on her.

  14. Unfortunately, I think Tracy’s point is probably valid.

    I’d suggest looking into seeing a dentist at a local dental school (I pay $20/visit at my local dental school since I don’t have dental insurance), but they tend to go overboard on the extras, since they’re training their students to do all these procedures. In fact, my appointments usually last at least two hours and I’m in the chair getting poked the entire time! Still, I appreciate that this service is available in my community for those who’d rather not pay out of pocket (or can’t).
    .-= Susan Johnston´s last blog ..Open Thread: The Long and Short of It =-.

  15. Sorry, that sounds like a very irritating experience! It does sound like you’d be better off finding someone else though — if it isn’t this, it would have been something else, it sounds like the dentist is very rigid. One thing that has come up with our dentist is sealants — he puts them on all “adult” molars as a matter of course, with all of his patients. I had to specifically tell him I did not want the kids to have sealants — and then every time we see him he keeps saying its time to do sealants and I keep saying no. They are plastics, my kids have no cavities, the sealants have to be maintained (redone every few years), they sometimes can get a hole in them that actually traps bacteria under the sealant where a toothbrush can’t get to… who needs it? But pediatric dentists make it sound like you’d be crazy not to get these sealants for your kids and take advantage of these innovations in dentistry. Ugh. Healthy eating and good hygiene should be emphasized — not adding plastics and chemicals to little children’s bodies!

  16. That’s really unbelievable and infuriating Brette. It’s a sad indication of how inflexible, irrational, and irresponsible so many people in the health care profession are. Doctors have to sign an oath to do no harm but kicking a client out of a practice for not following protocol is obviously harmful (to say nothing of utterly ridiculous.)

  17. As Jasper pointed out, Mary, your dentist probably makes A LOT more money if he puts sealants on every child’s teeth. I’m so saddened that our health care professionals seem to be motivated more by profit than anything else. We are really living in a dark time when it comes to the way medicine and dentistry are practiced in this country.

  18. I took my daughters to this dentist at an early age and strongly feel that this woman should not be in the practice of working on children.

    I wish I had done something years ago, but I wasn’t sure what to do. I would never recommend her for any dental care especially for young children and I told everyone I knew back then that I would never recommend her. In fact, when people ask for recommendations, I’ve always made sure to mention her as someone to stay away from.

    It was recommended to me by our non-pediatric dentist that I see her for my daughter’s needs. Even though she was listed as a Pediatric Dentist – which at that time – I was excited that OHP would allow us to see someone that specialized in children’s dentistry, I would never recommend her to any one else. Don’t let the waiting room fool you.

    I went to her because she was the only dentist in the area that could fix my daughter’s teeth – so I was told – 7 years ago. I agreed to have her perform the procedure which I believed was required for Savannah, my 18 month old (at the time) receiving a cap on a back tooth and having her front teeth ground down. (Luckily they didn’t have to be pulled as originally thought.)

    I was forced to hold my daughter’s head with force so she would stay still for X-rays. I remember her getting irritated with me because I felt I was pushing too hard on Savannah’s head and she couldn’t get a good X-Ray. She wanted to get X-rays because she thought other teeth may be deteriorated due to “bottle mouth” from nursing through the night. At that time, I was unaware of concerns regarding X-rays.

    Later she practically yelled at me when I told her weaning was out of the question for my 18 month old for we were no where near weaning. Majority of her nutrition was still coming from nursing and she wasn’t eating alot of food with sugar. I accepted the prescription for flouride, just to get out of there before I’d break down crying.

    To add insult to injury, She also wanted me to force my almost 3 year old to stop sucking her thumb even when she stated that up to age 5 or so, her jaw could reposition by itself.

    After this ordeal, I never went back to her. And other dentists have commented on what great teeth my daughters have, even though Savannah had a root canal by age 6. (Bad teeth just run in our family.) When anyone asks for a recommendation, I make sure to tell them to never even consider her.

    No family should be subject to that kind of scrutiny. I was doing what I thought was right for my daughter at the time, and I had no idea that she would approach the procedures with little care for my young daughter who could only stare at me through a drunken daze and with such fright ,not having a clue as to why her mother and these strangers were being so firm and forceful. After the procedure, I sat in my car and cried as Savannah slept, completely exhausted from this horrific experience. It makes my cry as I relive it in this writing. It took about 3 years for both of us to recover. I strongly believe it could have been done with more care and understanding for both my concerns as a parent and how this could affect my 18 month old daughter.

    Luckily, by the time she needed a root canal at age six (as I mentioned, bad teeth run in our family), we found a great dentist. She was scared of the dentist, as you could guess, but they were extremely friendly and asked her what kind of music she would like to listen to during the procedure as we all walked into a colorful room made just for kids. I wasn’t allowed to stay in the room for the procedure, but I knew this would be a whole new experience. She has not been afraid of the dentist since, even though we have switched offices.

    Long story short, I support you in filing a complaint and I would help anyway I can. I’m really sorry she’s still in practice and that this is still going on.

  19. I think scenarios like the one you experienced are why more offices are taking an active role in educating staff on how to communicate. But it sounds like in this case the “role model” was setting a nonnegotiable tone and has taken a stance that she will not budge on. On top of all that you had to wait all this time to learn of this stance! It might have been helpful if, when a new patient books an appointment, the receptionist discusses the dentist’s policy, etc.
    .-= Meredith´s last blog ..On Film, In Life–Transcending Adoption? =-.

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