Years of Malpractice – How Is It Possible?

dental-revelations-blog

Where there is smoke, there is fire. Dentists negligent behaviour should be act upon.

Ever wondered how it is possible that the dentists who are not practicing dentistry up to the standards get caught only after years of practicing the profession? Well you have come to the right place to find out.

Is It the Patients’ Fault?

Nope. Absolutely not.

The patients cannot tell the difference between a good and bad dentist when it comes to the skills of a dentist. Or if the procedures have been done as they should and if they are necessary in the first place. Or if the instruments entering their mouth have been properly cleaned (take a look at my previous post about this).

An average patient can only judge the dentist by the looks of him and the practice, and by the dentist’s chair-side manners. The rest is build on a trust of receiving good and adequate care. But every once in a while this trust is broken and the dentist ends up in the headlines.

But please remember that not all the dentists ending up to the headlines are rogue dentists as I have written previously.

Collegiality Gone Bad

Collegiality between the dentists means respect to one another’s abilities to work towards the same purpose. Helping patients. But collegiality has an ugly side as well. It is an unwritten code between the dentists which means one should not interfere or especially under any circumstances criticise a fellow dentist’s work. It is a code one should not break. The hygienists are expected to play by the same rules.

Now, this creates a problem. When a dentist is underperforming, the colleagues hear this from the hygienists and nurses. They see see it from the teeth of the patients who come too see them instead of their regular dentist (e.g. for emergency visit or whilst the regular dentist is on a holiday). They know there is a problem but very rarely they raise questions.

Instead the patient is kept under an illusion that the regular dentist has made the right decisions by distorting the truth.

Distorted truth:

“This decay is in such a difficult area to notice.”

The truth:

“This massive decay is so big that even my half-blind grandmother would find it.”

Distorted truth:

“Your dentist has marked it as an early decay, something to be kept an eye on… it has now grown bigger and needs a filling.”

The truth:

“Your dentist needs to have his eyes checked. This decay should have been filled ages ago. If you are lucky enough, you avoid the root canal treatment.”

Conclusion

It should be every dentist’s duty to report problems in colleague’s way of practicing dentistry. The Code of Ethics by ADA state the following:

Dentists should be aware that jurisdictional laws vary in their definitions of abuse and neglect, in their reporting requirements and the extent to which immunity is granted to good faith reporters. The variances may raise potential legal and other risks that should be considered, while keeping in mind the duty to put the welfare of the patient first. Therefore a dentist’s ethical obligation to identify and report suspected cases of abuse and neglect can vary from one jurisdiction to another

In my opinion, you don’t pull out the biggest guns if you suspect negligent behaviour from your colleague. The dentist in question should be given adequate time to correct the problem e.g. by revising.

The privilege of dentists to be accorded professional status rests primarily in the knowledge, skill and experience with which they serve their patients and society. All dentists, therefore, have the obligation of keeping their knowledge and skill current.

If nothing changes, more severe means should take place. This includes giving warnings and as a last resort filing a complaint to the relevant authorities.

Naturally, if the negligence is severe, one should not hesitate to contact authorities urgently.

The bible of dentistry aka ADA’s Code of Ethics 2018 in full.

 

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Morals in Dentistry

Where It All Started

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Morals in Dentistry

blog

It’s time to get serious again. In this post I will get to the bottom problem of the dental industry. The lack of morals and the urge to maximise profit at the cost of the individuals is like a plaque that sticks around before the cure is found. For about half of the dentists I have met fall into that category and that’s a lot considering that we – the health care workers – should be the ones having the highest integrity of all.

What I will do next is give examples of the lack of morals amongst dental professionals. It will be just a (thin) slice of a (big) cake but you will get the idea no doubt. For clarification, all the examples are from real life and witnessed by yours truly.

NHS Dentists

For those who are not familiar with the NHS, it is the UK’s National Health Service. The NHS dentists work under a contract and receive payments for the treatments done.

Before the year 2006 (when the contract was replaced with a new one) the misuse of the system was widespread. The dentists were laughing at the system that was like a gold mine to them. They could easily make an outstanding pay by doing certain treatments that would not raise questions. It did anything but raise questions. The treatments made them look like they were concentrating on preventive care and looking out the patient’s best interest.

A revelation:

The truth is that they did not care about patients. Patient was merely a tool for money making. An example: The dentists made fissure sealants for every patient who did not have them and they made them from first premolar to the last molar. There was no evaluation if the fissure sealant was needed and it was an easy treatment to justify to the patient as it was preventive treatment.

“It prevents you getting a decay…”

Who would say no to that?

Fissure sealant was very quick treatment to do as it could be done in batches (all the premolars and molars from the left side in one go and next the right side) guaranteeing a very productive day moneywise for the dentist. There are probably millions of people in the UK whose teeth are coated with fissure sealants.

Eventough the NHS contract was renewed in 2006, the dentists found new ways of misusing the system.

Root Canal Treatment on Wisdom Tooth… What The?

The most immoral dentists have found a way to make the most out of every tooth – moneywise. Normally the decision to remove a fully erupted wisdom tooth is made lightly if there are any problems like decaying, periodontal problem, malocclusion with the tooth. But more than once I have seen wisdom teeth that have been heavily filled, root canal treated and even have had crowns on them (on top of the root canal treatment).

There is no other explanation to this than a dentist who is practicing dentistry only to gain wealth.

Performing Treatments Without Having the Skills

Some dentists suggest treatments they have no skills to perform and charge the patient as if they were specialists. An example: A dentist recommends periodontal treatment to the patient. The course of treatment consists four 30 minute visits to remove calculus one quadrant per visit and the cost is the same as if a periodontist would perform the treatment. Once the course of treatment is done by this wannabe specialist, the patient goes to see a hygienist for oral hygiene instructions. The hygienist soon realises that there is still lots of subgingival calculus left and therefore the gum disease is still active.

The hygienist does her best to remove the calculus (which she has skills for) and the patient is left under an illusion that nothing is wrong.

It is called collegiality what just happened. Dental professionals covering for each other’s mistakes and malpractice.

Root Canal File in the Root Canal

In our business the equipment can malfunction and instruments can break in use. In these cases it is good practice to tell the patient what happened. For example a curette’s tip can break inside the pocket of the tooth. It can be found from there but the patient needs to know what happened. Some dentist cover these kinds of incidents or mistakes they have made by simply not informing the patient. Now THAT if anything is malpractice.

An example. A root canal file broke inside the patient’s tooth whilst the dentist was performing a root canal treatment. The nurse did not notice the incident until a control x-ray was taken and the file was clearly visible. The dentist did not inform the patient about the broken file or attempt to remove the file.

Conclusion

The dental industry draws in immoral individuals because it has been allowed to happen. It wasn’t until the 21st century when the dental schools started to interview the applicants for the undergraduate programmes of dentistry. Before this the suitability of the applicant’s personality was not measured by any tests. This means there are dentists in the field that should not be dentists.

In my opinion all the dentists who have not gone through the MMI should be asked to have one. If they fail, they should be struck off their profession.

But no test is a fool proof way of finding the bad seeds. The most rotten souls can often talk their way through any obstacles. And the reason why these individuals are drawn to the dentist’s profession is the well known fact that they make rather nice pay (here’s one article about it).