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Timing is everything in case with two dentists

11 July 2014
As this case illustrates, keeping on top of what’s happening, where and when is vital to minimising problems...

A patient attended two different dentists over a short period of time for the relief of pain in the lower right premolar region. The first dentist saw the patient as an emergency out-of-hours. At that time, a badly broken down tooth (second premolar) was found. It was very carious but not painful.

The dentist felt that an extraction was in order, but having discussed the case with the patient he elected to fill the tooth. Only bitewing x-rays were taken.

The following day the patient had severe pain in the premolar and attended a second dentist who advised extraction. During the process, he extracted the adjacent tooth (first premolar) as well. No x-rays were taken. The following day the patient attended the first dentist with continued pain. He re-examined her and advised that the socket was fine but pain was to be expected.

The patient had kept her extracted teeth and these were presented as evidence some time later. They demonstrated that the tooth had a large piece of bone attached to it.

Learning point:
Treatment involves a number of steps, including investigations, diagnosis, treatment planning, consent and follow-ups. The timing of these issues and of the treatment itself can have a profound effect on the outcome of any problems that subsequently arise.
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