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    Posted January 7, 2014 by
    qotp1129
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    Illinois

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    The Truth about Pediatric Root Canals

     
    A friend forwarded me the NBC News online tragic story of 3-year-old Ashley Boyle (Hawaii girl, 3, dies after dental procedure). This is the second story I have read regarding dental surgery gone horribly wrong. In a similar outcome, teenager, Jahi McMath, was rendered brain-dead after a routine procedure. This is every parent’s worst nightmare. Many of us have taken our children to visit the family dentist on a regular basis without fear of something going horribly wrong. Unfortunately, the sad cases of Ashley Boyle and Jahi McMath should put every parent on notice when it comes to their child’s dental health.

    I reached out to Tennessee pediatric dentist, Dr. Misee Harris after reading NBC News online article on Ashley Boyle. The following is my interview with Dr. Harris. I wanted her opinion because so often such stories demonize an entire industry without providing adequate background information to help the public better understand the whole story.

    Dr. Harris, I was horrified after reading the article about the death of 3-year old Ashley Boyle. Like any issue, if one party messes up, and I'm not suggesting Dr. Geyer messed up, a story is written that makes it appear that ALL in a particular industry, dentists in this case, will cause grave harm. You are a board-certified, pediatric dentist. From your professional perspective, I would like clarification on several questions regarding children’s dental care.

    Why would a 3-year-old need extensive dental care that included root canals?

    Tooth decay is the single most prevalent chronic childhood disease. In the U.S., over 30% of all children's health expenditures are devoted to dental care. Low-income children visit the dentist less frequently and thus are among the children who are most commonly afflicted with dental disease. Children from families with low incomes have nearly 12 times the restricted activity days (e.g. days for missed school) because of dental problems, as children from families with higher incomes. As a pediatric dentist, I see 3-year-old patients daily who suffer from rampant dental decay and need full mouth dental rehabilitation.

    Why would a dentist suggest having all four root canals done in a day along with other major dental services?

    As for the “root canals” on a 3 year old . . . that never happened. The media is simply uneducated in dentistry, which has resulted in the wrong use of dental terminology. The procedure on primary “baby teeth” is actually called a ‘pulpotomy’. By definition, a pulpotomy is the surgical removal of an inflamed pulp chamber due to the invasion of bacteria. It is a complicated word for a very common procedure in pediatric dentistry. Children who have excessive dental decay often need to have 10+ teeth treated which would amount to approximately 4-5 dental visits. Furthermore, many young children are unable to cooperate in a normal dental setting and thus have to be sedated in the office or receive general anesthesia at a major hospital in order to receive comprehensive dental care.

    What is the average age that an individual would require such a procedure?

    I have seen children as young as 6 months old with dental decay. It’s sad but it’s true. There is a dental crisis in America.

    Why do you think Dr. Geyer's practice close permanently immediately after this tragic incident? Do you think this practice has had similar, less deadly, incidents?

    I don’t personally know Dr. Geyer, however, in order to become a pediatric dentist, he went through 10 years of extensive training which included obtaining a bachelor’s degree, a Doctorate of Dental Medicine/Doctorate of Dental Surgery degree, and 2 years of residency in pediatric dentistry. Such extensive training still does not promise that every procedure will go as planned.

    Pediatric patients are often sedated with medications that can cause respiratory depression as well as CNS depression. Pediatric dentist are all trained to handle medical emergencies that may arise during sedation. All pediatric dentists in the U.S. are required to hold a certification in CPR and PALS (Pediatric Advanced Life Support. After receiving such heat from the media and the devastation of losing a patient, I can only imagine that Dr. Geyer decided that it would be best to take a leave of absence. There isn’t a doctor in the world that would want something like this to happen.

    What types of documents are provided to parents to ensure they understand the risks of such procedures? What safeguards would you recommend for parents who are facing their child having such extensive procedures done?

    Pediatric dentists and dental staff should always inform parents of the extent of their child’s dental decay and thoroughly discuss the risks and benefits of in-office oral sedation. Proper informed consent should always be given and parents should be given the opportunity to ask any questions prior to the scheduling of their child’s dental surgery.

    What safeguards should dentists have in place to ensure they are prepared for emergencies such as this one?

    All pediatric dentists in the U.S. are required to hold a certification in CPR and PALS (Pediatric Advanced Life Support. After receiving such heat from the media and the devastation of losing a patient, I can only imagine that Dr. Geyer decided that it would be best to take a leave of absence. There isn’t a doctor in the world that would want something like this to happen.

    As a dentist, how would you approach a family whose 3-year-old has major dental issues?

    I always like to explain to the parents the cause of their child’s dental decay and discuss preventative and proper home oral hygiene techniques. Most parents have no idea that their child should not be going to bed with a bottle and/or sippy cup. Additionally, many parents do not assist their child with brushing at least twice daily as recommended by the ADA. I sincerely believe that the majority of parents have no idea that they are neglecting their children and causing them to suffer from dental disease. Most parents don’t realize it until their child is in extreme pain. At that point, tooth decay has gone too far.

    As a mother of three and grandmother of six, I could not imagine the heartache Ashley and Jahi’s families are experiencing. Dr. Harris and I extend our deepest condolences to these families during their time of sorrow.

    Sources:

    US News on NBCNews.com, http://www.nbcnews.com/id/53982293/ns/us_news/t/hawaii-girl-dies-after-dental-procedure/?lite=obinsite#.UsssErTp3Z6

    Dr. Misee Harris, http://www.miseeharris.com
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