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The Thinking Parent's Dilemma; or, Another Dentist Refuses to Treat my Children


The 20-something dental hygienist, wearing dark purple scrubs, smiled at my children and me as she motioned for us to follow her to the examining room.


“Okay,” she chirped at my 10-year-old daughter, “Mom will wait outside while we take a quick picture of your teeth.”


I could feel my face stiffen.


“We aren’t going to do X-rays this time,” I said, keeping my voice as casual as possible. “I mentioned that we didn’t want X-rays when I called for an appointment, and I also wrote it in on the consent form.”


The young hygienist furrowed her brow. “Ah, okay,” she said, her eyes darting awkwardly away from my face. “Just wait in here while I, uh, go check on that.”


She came back a few minutes later.


“Dr. Y says that you have to have X-rays,” she said, still unable to look at my face. “She says she can’t treat your children without them.”


This was in May, 2010, just a few weeks after the President’s Cancer Report, “Reducing Environmental Cancer Risk: What We Can Do Now,” was released. On page 7 of the report, in large font, is a section entitled, “Children Are at Special Risk for Cancer Due to Environmental Contaminants and Should be Protected.”


That 240-page report states definitively that cancer among children (and adults) is on the rise in the United States. Out of 50 countries, the United States has the dubious distinction of rating #9 in the number of deaths from cancer. According to the American Cancer Society, an estimated 10,700 children ages 0 –14 will be diagnosed with cancer in 2010, a rise of more than 10 percent from just five years ago. While childhood cancer is considered “rare,” it is the second most common cause of death among children (after accidents). It is predicted that 1,340 American children this year will die from cancer.


The numbers sadly confirm the anecdotal evidence among our friends and family. As I’ve mentioned previously on this blog, our 14-year-old neighbor Michael is battling leukemia. My daughter’s friend Isaac’s older sister Whitney was 18 when she died of non-Hodgkin’s lymphoma after fighting it for four years, and more than twelve of our adult friends (including my 62-year-old father-in-law who has throat cancer, my 29-year-old friend Faigy who has five children and Stage IV melanoma, and my daughter’s first grade teacher who died at age 59 from breast cancer) have been afflicted by cancer.


The President’s Cancer Report is very clear that radiation (that is, exposure to X-rays) is a known carcinogen and that the more you are exposed to radiation the more likely you are to get cancer. We have all heard that X-rays are harmful. That’s why you and the hygienist leave the room when your child’s teeth are being X-rayed. That’s why your child wears a lead bib to protect the rest of her body from the harmful X-rays. But what I didn’t understand until I started learning more about it, and what most of us don’t think about, is that the harmful effects of X-rays are cumulative. That means that every time you get exposed to X-ray particles, even if the exposure itself is very small, you increase your risk (or your child’s risk) of getting cancer.


According to the report, “…[I]f patients were more aware of radiation exposure due to specific tests and the cancer risk that can accrue with cumulative medical radiation exposure, they might be more likely to raise this issue with their physicians” [my emphasis.] It seems like a simple thing to say, “No thank you. I don’t want my daughter’s teeth X-rayed this time,” but I was worried about bucking the system and a little unsure about how the dentist would react. That’s why I called the practice ahead of time and why I also put the request to not do the X-rays in writing. When Dr. Y came to talk to me about it, I explained that I was requesting we forego using X-rays as a diagnostic tool and only use them if she found something in my daughter’s mouth that was cause for concern.


If you’ve never questioned medical or dental authority before, the idea that the dentist dismissed my family from her practice might surprise you. But if you’ve been gently asking the doctors and dentists and other health care providers who care for your children to intervene as little as possible, chances are this story is maddeningly familiar to you. To Dr Y’s credit, she came to talk to me about her decision not to treat us. She argued, quite reasonably, that the miniscule risk of harm from the X-rays far outweighed the good they would do as a diagnostic tool in looking at my daughter’s mouth.


“They get more exposure to radiation by traveling on an airplane,” she said.


“I know!” I said, hoping to have found a way for us to agree. “I’m worried about that too. Since we travel by plane sometimes and since the effects are cumulative, I’d like to limit radiation exposure wherever I can.”


Dr. Y shook her head and sighed. Our conversation was going in circles. She insisted she did not feel she could provide us the high standard of care that she had been taught in her eight years of schooling without doing X-rays. I explained again that I wasn’t against doing X-rays per se but that I saw no reason to do them unless she saw something to suggest they might be necessary. I said I would of course agree to X-rays if anything in my daughter’s mouth gave her cause for concern.


I also asked her if she read the President’s Cancer Report.


She had not.


“If I’m your dentist, I’m responsible for your daughter’s teeth and I cannot effectively evaluate them without X-rays,” Dr. Y said.


“But as my daughter’s mother, I’m responsible for her health from now until she’s 18 years old and beyond. If she gets cancer at 14 and I come back to you and say, ‘I think the X-rays were one reason why she has cancer now,’ you’ll laugh me out of your office.”


This is the thinking parent’s dilemma. As parents, we are responsible for every aspect of our child’s health, not just today, but for the rest of our child’s life (or at least until they turn 18). While any given health care practitioner has our baby or child’s best interests in mind as it relates to his or her area of expertise, that health care provider is only responsible for a very small part of our child’s heath.


Dr. Y very rightly cares about her patients’ teeth. That is her only concern.


But as my daughter’s mother, I care about her overall health—not just her teeth. Since she has mostly baby teeth anyway, I care much less about whether she might have a cavity than about how her cumulative exposure to radiation might harm her later in life.


This is the second time in three months that a dentist has refused to treat my children.


The first, which I wrote about in this post called “Difficulties at the Dentist,” was because we refused the fluoride treatments. While I appreciate the time Dr. Y spent talking to me about our difference of opinion (unlike Dr. A), I’m greatly saddened by the outcome. I still don’t understand how it is in any way beneficial to the health of a child’s teeth for a dentist to refuse to examine them because of a disagreement with a parent’s request to intervene only when necessary.


This story has a happy ending of sorts. A colleague of Dr. Y’s, who is a fantastic dentist with a great bedside manner and a hilarious sense of humor, overheard the conversation and took pity on us.


Though he thinks I am wrong about X-rays and fluoride, he agreed to put the children on his client list.


It’s official: we now have a family dentist.




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Tags: being rejected by a dentist, cancer, cancer and X-rays, childhood cancer, children's teeth, death rates from cancer among children in America, dentist, difficulties at the dentist, healthy teeth, refusing treatment, teeth, the President's Cancer Report, X-rays



 

Comments (58)

I have been "fired" by doctors who treated (or who I considered have treat) my kids since my eldest was still in the hospital after his birth sixteen years ago. I interviewed pediatricians prior to the birth of my third child hoping to avoid repeats of negative experiences I had had in the past when I questioned or sought to discuss treatment options. In the course of those interviews, two of the pediatricians asked me to leave the office as soon as I said that I was not willing to use the CDC vaccination schedule. The first was polite, saying her practice did not accept patients who varied from the CDC schedule in any way. The second accused me of child abuse. Understanding, questioning and participating in your child's healthcare is both a parental right and responsibility, I think. I have found most doctors disagree with me. .-= Jake Aryeh Marcus´s last blog ..US Department of Labor Issues Fact Sheet on New Workplace Pumping Law =-.
Good for you! Excellent reminder that toxin exposure is cumulative. Every little bit you can avoid counts toward your overall toxic load and we now know that babies are born already contaminated with chemicals. As for dentists, I took my 5yo to a small local practice for the first time before she started kindergarten to see if everything was ok. I nervously said "no x-rays please" and she said "Sure, we don't need those unless there is a problem". She looked at my daughter's teeth, said they were fine and didn't even need a cleaning. I was so so happy with her. Sadly, our insurance doesn't cover her anymore and I guess I'll have to pay extra if my daughter needs to go back. We have also been very happy with our naturopath, unfortunately not covered by insurance either. I don't want to use the providers my insurance covers because they are so mainstream. I am sorry you had to stand up to the dentists and but glad you did, and found someone to work with your family.
I'm glad you have found a dentist! I have many friends who have faced similar issues with dentists over their decision to breastfeed at night. Thankfully, so far my kids haven't had any dental issues so my own night-nursing hasn't been called into question. But again, it's a battle between a parent's concern for the overall child, and a dentist's concern for teeth. Which may, based on research on breastfeeding and dental caries, be misplaced. I will admit, I am afraid to have similar discussions. Although I feel a little sheepish saying that. I really wish that it was easier to question medical authority, and that practitioners were more open to considering a parent's viewpoint. .-= Amber´s last blog ..The Womanly Art of Breastfeeding =-.
Hurray for the new family dentist! How upsetting this experience must have been! I tried to refuse an x-ray the other day at the dentist, to put back a crown that had come off. They would not re-glue the crown unless I consented to the x-ray. I caved. Had to have that crown back. Ugh! .-= Alexandra´s last blog ..An Evening on the Town =-.
My husband and I are slightly afraid of our pediatrician, although she's never really been confrontational with us. Our daughter is fully vaccinated, although we do have concerns about vaccines. We just don't feel like anyone really wants to have a conversation with us about a modified schedule, or forgoing certain vaccines. Sometimes we fib to our pediatrician too. We bought vitamin D drops when our daughter was a newborn, but we only gave them to her about two times. We also let the pediatrician write a prescription for fluoride, but didn't fill it. Our daughter will turn three in March, and we'll visit the dentist. We've pretty much decided that we'll allow fluoride on her teeth, but we don't want her ingesting it. You're post today gives us something else to think about. Ultimately, we're experiencing the same frustration that you are. There's an attitude coming from the medical establishment that treats questions as accusations of some kind, and an arrogance that's really hard to believe. All doctors need to do is examine the history of their own profession to see how many times they've been wrong. Why would they think that they've finally figured it ALL out? Thanks for being a role model. Maybe we'll start trying harder to have awkward conversations.
Jennifer, You certainly were able to make a convincing argument. Good for you! And I'm glad that you were able to find a dentist to agree to treat your kids w/out the xrays. It's so hard to stand up to your convictions sometimes... .-= sheryl´s last blog ..Five Secrets to Losing Weight Without Feeling Hungry- Deprived- Grumpy and Cranky =-.
I have to say that I kept refusing X-rays for this reason and I regret it! I let a couple of years go by (my dentist put up no fight at all) and my son had five cavities...one molar having to be replaced by a stainless steel crown. It was NOT fun and I felt responsible. The issue was that the cavities were between a few of his molars (he needed three painful appointments and now has a thing about both the dentist and needles, poor kid). There was no way the dentist could see the problem without X-rays. I'm all for limiting exposure, but don't make the mistake of NO X-rays or your kids' teeth (and your bankbook!) will suffer.
Jennifer, wow I wish I would have read this last week before my 6 yo dd's appnt. She did get x-rays but I didnt' really think anything of it. Everything went fine but unfortunetly she has a few cavitities :( despite the fact that we brush daily/nightly w/o fluoride and no pop ever and hardly juice. so the dentist wants to fill her baby teeth and will numb her mouth to do it and the fillings do have silver/mercury. I don't know what to do about it yet. Any advise on that? E .-= Erika Marie´s last blog ..Real Men NFP =-.
I am not an expert on teeth, Erika, but I have trouble understanding why dentists fill baby teeth. They are temporary teeth, they are going to fall out anyway, and I wonder why it is necessary to subject a child to the fillings? I know there are justifications (maybe a dentist wants to weigh in here?) but I really question the necessity of this procedure. I think I would get a second (and maybe a third or even fourth opinion) before deciding to do the operation. Our dentist told me last year that my daughter needed a tooth pulled. He said there wasn't room in her mouth for the tooth coming in. I asked another dentist to look at my daughter's mouth. He's a friend and he gave me off-the-record advice. But he looked at her mouth and said, "If it were my kid, I'd wait three months and see. I wouldn't pull the tooth because I bet it'll fall out naturally." I called the dentist back and told him we were going to wait for a few months and then reevaluate. Sure enough, as soon as the grown-up tooth pushed up a bit more the baby tooth fell out. No unnecessary novocaine, no dental bills. I was very glad I decided to wait. .-= Jennifer Margulis´s last blog ..BlogHer Yes! Conference Swag I’m Just Saying No Thank You… =-.
Youch Kimberly. I'm sorry that your son had to go through that. I had some bad dental work done as a teenager and the tooth that the dentist actually destroyed has since been crowned. The dentist ran a fly-by-night operation and filled the cavity so badly that my parents' dentist who later re-did the work said I was lucky I didn't lose the entire tooth. To add insult to injury, she sent my father an outrageously high bill. But I know firsthand--unfortunately--just how painful and uncomfortable getting a crown can be. No wonder your son is afraid of the dentist! .-= Jennifer Margulis´s last blog ..BlogHer Yes! Conference Swag I’m Just Saying No Thank You… =-.
My big problem here is that you told them when you called that you didn't want xrays. They should have told you then that the dentist would not treat your children.
Wow, another frustrating trip. At least this one has a happy ending. I know that these docs want to provide a high standard of care, but your opinion DOES count. Makes me want to toss the lot of them into one of those reality shows that simulate living in 1850 or whenever. How well would they do without all their modern toys? Maybe they don't trust their own judgment without Xray backup. .-= Frugal Kiwi´s last blog ..Field Trip- Felting =-.
Yeah--I haven't gotten x rays in years. My daughter had one when she was a baby. That hurt, but they thought her toe was broken (it wasn't). I don't really understand why dentists and chiropractors are so keen on having them done. The chiropractors bother me more than the dentists because the chiros are claiming to help you be healthy and here they are asking you to step inside an x ray machine. I'm not against these tests when they are seriously needed, but I think there are less risky ways to figure out of a kid has a cavity. .-= Alisa Bowman´s last blog ..40 Things I’ve Learned in 40 Years- Part 3 =-.
Oh, and I wanted to add: the reason my dentist doesn't give me lip about the x rays is because we don't have dental insurance. I just say that I don't have the money to pay for them and that is that. .-= Alisa Bowman´s last blog ..40 Things I’ve Learned in 40 Years- Part 3 =-.
Wow, Jennifer, you are Super Mom. I'll bet 99% of parents are not only unaware of all of this research, but probably wouldn't pay it any mind if they were. Good on you for standing up for what you think is safer. And for me, I think it's almost a bigger deal that you're instilling in your kids the value of questioning the status quo, even when you come up again opposition. Bravo! .-= Stephanie - Wasabimon´s last blog ..Strawberry Pecan Pastries with Cardamom =-.
What a frustrating experience! You are setting such a fantastic example for your kids. They are going to grow up knowing that it's okay to question a medical professional and make sure they get the kind of treatment they need--and want. And you are so right about you having to be the one to focus on your the overall health of your children. Until we have more integrative doctors (and dentists), we're not going to have the holistic approach(es) we need to prevent life-threatening diseases like cancer. Thank you so much for sharing your experience! .-= Jesaka´s last blog ..Cognitive Connection- July 30- Writing It- Querying It and Rejecting It =-.
I'm beginning to think you need to take a online course in dental hygiene so that you can take care of your kids' teeth at home. :o) .-= Roxanne´s last blog ..Pounce! =-.
I'm no dentist, but when my daughter had to have cavities filled I asked about the reasoning. According to him, if we didn't have them filled the cavity could infect her adult teeth and lead to more serious problems. We went ahead and did it but my daughter hated, hated it. .-= MyKidsEatSquid´s last blog ..Adventurous Eating- Food Markets &amp Street Fairs =-.
I had SO MANY xrays as a child (for abdominal tumor) that I literally have a sticker on my chart that says that I should be limited to necessary only. I feel the same way about xrays on my children--particularly when they won't even bother to just look in the mouth first. I mean, please, can't they just LOOK first? We also refuse fluoride. My poor son had that once and came home throwing up violently (and he NEVER has stomach issues--it's made of steel). Dentist said, "Oh.. sometimes that happens.. it's still good to fluoride." I said, "no, we're not doing that anymore." and she backed off. .-= Claudine´s last blog ..Learning To Fly =-.
Anybody else here old enough to remember the 50's when the Buster Brown shoe company had x-ray machines that looked at kid's feet? As kids, we loved to stick our feet in there and see the bones. OH MY GOD!! .-= Vera Marie Badertscher´s last blog ..Road Trip Book- Oprah Favorite in Illinois =-.
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