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  1. #1

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    Three year old dies after dental procedure

    Been following this story all weekend. A three year old in Hawaii went to the dentist in early December to undergo 4 root canals, apparently at the same time. The dentist gave the little girl three different sedatives and left her alone for almost a half hour. The girl went into cardiac arrest, suffering severe brain damage as no one in dentist's office knew CPR. After being in a coma for several weeks, the poor child passed away Friday night.

    Questions that come to mind are why all the root canals were being done at the same time and was the mother aware of exactly how her daughter would be sedated during the procedure?

    The family had announced a lawsuit and are asking for unspecified damages, the dentist's office was closed and an investigation is ongoing.

    RIP little Finley.

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    Three-year-olds get root canals? The whole thing screams gross negligence at best, and maybe even scam. The local prosecutor should be looking into possibly pressing criminal charges.
    "Marge, if you're going to get mad at me every time I do something stupid, then I guess I'm just going to have to stop doing stupid things!" - Homer Simpson in the Mr. Plow episode

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    Very sad.

    The part that surprises me the most is that no one in the office knew CPR. It's one of the most basic life-saving techniques out there. You'd think at least one of them, especially the dentist with 8+ years of schooling, would know CPR.

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    There's no reason a three-year-old should be having root canals. Maybe if all of their teeth were rotting out of their heads with serious dental infections. Maybe. I highly doubt that was the case.

    Not to mention that general anesthesia should not be used in a mere dentist's office. Even if they know how to do it, if something goes wrong, they'll need more resources than a normal dentist's office has. I was sedated for my wisdom tooth removal, and my dentist sent me to an oral surgeon.

    I think dentist scams are pretty common, but multiple root canals on a child with primary teeth is insane. I once had a dentist tell me I needed 5 crowns, and soon. I was suspicious and got second and third opinions, confirmed I did not need any crowns, then I changed dentists ASAP. This was 8 years ago, and I still have no crowns.

    I hope they sue that dentist into the ground. Not that it will bring them their child back, but we've got to send the message that preying on the less informed won't be tolerated. It is disgusting.

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    As a pre-k teacher, I have seen plenty of kids that age get root canals, the thought being pulling teeth prematurely will cause more problems later on for the child. Of course the children who I know who underwent this procedure only had one done at a time and local anesthesia was used.

    It's a tragedy the mother did not do a google search in the dentist, she has a lot of negative comments saying she did unnecessary procedures using too much sedatives. Lesson to be learned is to investigate anyone who will be treating your child and run from anyone advocating so many procedures at one time.

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    Many years ago, my 3-year old cousin died after a dental procedure. They gave him more nitrous oxide after, rather than oxygen, and it killed him. I'm very hesitant to do anything extrordinary for my kid's baby teeth.
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    Quote Originally Posted by judiz View Post
    As a pre-k teacher, I have seen plenty of kids that age get root canals, the thought being pulling teeth prematurely will cause more problems later on for the child. Of course the children who I know who underwent this procedure only had one done at a time and local anesthesia was used.
    Maybe it's just me, but that's scary. I have bad teeth and it's genetic - my parents have dozens of fillings too with root canals, my sister who brushed 3x/day and flossed 2x/day has had a root canal and crown too, and my dental x-rays are perfectly symmetrical on both sides. I still can't imagine having to have root canals for teeth that have only been in existence for 1-2 years. Thought I guess the teeth are smaller so less decay is required to reach the root? Still.

    But you're right that in any case if she required them, having them done all at once and under general anesthesia in a non-oral-surgeon's office is beyond the pale. It should not be the patient's burden to find out if a doctor/dentist is a ticking time bomb.

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    Quote Originally Posted by Badams View Post
    Many years ago, my 3-year old cousin died after a dental procedure. They gave him more nitrous oxide after, rather than oxygen, and it killed him. I'm very hesitant to do anything extrordinary for my kid's baby teeth.
    I'm so sorry

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    Why on earth would deciduous teeth need root canals? Pull them, if they're THAT bad...and I was going to the dentist very young (okay, it was my mother, but still we went to the office) and there were no sedatives involved. And an ordinary DDS is not an anesthesiologist...everyone involved sounds like a negligent idiot.

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    Quote Originally Posted by danceronice View Post
    Why on earth would deciduous teeth need root canals? Pull them, if they're THAT bad...and I was going to the dentist very young (okay, it was my mother, but still we went to the office) and there were no sedatives involved. And an ordinary DDS is not an anesthesiologist...everyone involved sounds like a negligent idiot.
    From comments on AOL from dentists, they said they try to avoid removing baby teeth that normally wouldn't fall out for three or more years. Something to do with the jaw still growing and preventing teeth from shifting causing problems later on. Child root canal is slightly different than root canal in adult and is normally done using only novacaine.

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    How awful! I have had 3 or 4 root canals as an adult (all in the last few years) and they weren't completely unpleasant but I wouldn't want them done on a 3 year old. In fact I had 2 needed on opposite sides of my mouth and I asked the dentist to do at the same time ans she refused saying that it was too much to do more than one at one time. She refused to deaden both sides of my mouth at the same time, which I now appreciate. I hope they do a full investigation.

    I wonder if the child had a heart condition. I have heard of people having tooth problems that lead to infection and heart problems. But I admit that I haven't heard of that happening to small children.
    The privilege of a lifetime is being who you are--Joseph Campbell

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    Quote Originally Posted by Anita18 View Post
    There's no reason a three-year-old should be having root canals. Maybe if all of their teeth were rotting out of their heads with serious dental infections. Maybe. I highly doubt that was the case.

    Not to mention that general anesthesia should not be used in a mere dentist's office. Even if they know how to do it, if something goes wrong, they'll need more resources than a normal dentist's office has. I was sedated for my wisdom tooth removal, and my dentist sent me to an oral surgeon.

    I think dentist scams are pretty common, but multiple root canals on a child with primary teeth is insane. I once had a dentist tell me I needed 5 crowns, and soon. I was suspicious and got second and third opinions, confirmed I did not need any crowns, then I changed dentists ASAP. This was 8 years ago, and I still have no crowns.

    I hope they sue that dentist into the ground. Not that it will bring them their child back, but we've got to send the message that preying on the less informed won't be tolerated. It is disgusting.
    This. My friend convinced me to see her dentist who was supposedly so good. She did an x-ray and informed me I need all my fillings redone, a root canal and a gum graft. No so fast, said I. My dental exams are usually perfect. I am lucky to have dentists in the family who in turn, have colleagues. I emailed my xray to one who then forwarded them to a root canal specialist. The root canal specialist said she couldn't figure out which tooth needed a root canal. Oh and that the xray were crappy quality.

    Back to my regular dentist I went. She laughed pretty hard when she heard what happened. Said I didn't need any of that work at all.

    This case is incredibly tragic. I had my wisdom teeth removed with general anesthesia by an oral surgeon. What is a regular dentist doing administering it? Is that done? Will ask the dentists in the family.
    "Nature is a damp, inconvenient sort of place where birds and animals wander about uncooked."

    from Speedy Death

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    How tragic and appalling. Administering sedatives isn't as routine as it sounds. And yes - a three year old needing multiple root canals seems fishy as hell.

    I had my wisdom teeth taken out a few weeks, and I was given my general anesthetic by my surgeon - who had both an MD and a DDS.

  14. #14

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    General anesthesia is safely used far and wide in dentistry. Dentists who are authorized to use this type of anesthesia must go through special training. Those courses that are required to complete most standard dental degrees do not include the type of training necessary to administer general anesthesia. Doctors who are green-lighted to use general anesthesia in their practice undergo schooling beyond the standard realm of even predoctoral study.

    Only dentists who have completed an advanced education program accredited by the Commission on Dental Accreditation (CODA), which provides training in deep sedation and general anesthesia, are deemed educationally qualified to use general anesthesia in practice. Additionally, the American Dental Association strongly supports continuing education for this group of highly trained dentists. - found after I googled Can a dentist give general anesthesia.

  15. #15

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    The “pulp” of a tooth cannot be seen with the naked eye. Pulp is found at the center of each tooth, and is comprised of nerves, tissue, and many blood vessels, which work to channel vital nutrients and oxygen. There are several ways in which pulp can be damaged. Most commonly in children, tooth decay or traumatic injury lead to painful pulp exposure and inflammation.

    Children's pulp therapy is known by several other names, including: root canal, pulpotomy, pulpectomy, and nerve treatment. The primary goal of pulp therapy is to treat, restore, and save the affected tooth.

    Children's dentists perform pulp therapy on both primary (baby) teeth and permanent teeth. Though primary teeth are eventually shed, they are needed for speech production, proper chewing, and to guide the proper alignment and spacing of permanent teeth

    Every situation is unique. The children's dentist assesses the age of the child, the positioning of the tooth, and the general health of the child before making a recommendation to extract the tooth or to save it via pulp therapy. - found after I googled what is child root canal.

    Some of the undesirable consequences of prematurely extracted/missing teeth are :

    Arch length may shorten.
    In the case of primary tooth loss, permanent teeth may lack sufficient space to emerge.
    Opposing teeth may grow in a protruding or undesirable way.
    Premolars may become painfully impacted.
    Remaining teeth may “move” to fill the gap.
    The tongue may posture abnormally.

    How is pulp therapy performed?

    Initially, the children's dentist will perform visual examinations and evaluate X-rays of the affected areas. The amount and location of pulp damage dictates the nature of the treatment. Although there are several other treatments available, the children's pulpotomy and pulpectomy procedures are among the most common performed.

    Pulpotomy - If the pulp root remains unaffected by injury or decay, meaning that the problem is isolated in the pulp tip, the children's dentist may leave the healthy part alone and only remove the affected pulp and surrounding tooth decay. The resulting gap is then filled with a biocompatible, therapeutic material, which prevents infection and soothes the pulp root. Most commonly, a crown is placed on the tooth after treatment. The crown strengthens the tooth structure, minimizing the risk of future fractures.

    Pulpotomy treatment is extremely versatile. It can be performed as a standalone treatment on baby teeth and growing permanent teeth, or as the initial step in a full root canal treatment.

    Pulpectomy - In the case of severe tooth decay or trauma, the entire tooth pulp (including the root canals) may be affected. In these circumstances, the children's dentist must remove the pulp, cleanse the root canals, and then pack the area with biocompatible material. This usually takes several office visits.

    In general, reabsorbable material is used to fill primary teeth, and non-reabsorbable material is used to fill permanent teeth. Either way, the final treatment step is to place a crown on the tooth to add strength and provide structural support. The crown can be disguised with a natural-colored covering, if the child prefers.

  16. #16
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    No one should ever be left alone when under general anesthesia. I also have a hard time believing that someone licensed to use it isn't also required to have a current CPR certification. If the dentist did under go training- s/he didn't follow it.

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    It hasn't been publicized if the dentist had the training to administer general anesthesia and yes, the dentist and her assistants should had been trained in CPR. The only reason the poor child didn't die that day was because there was a pediatric office on the same floor and someone was able to get the pediatrician to perform the CPR. By that time however, the little girl had been deprived of oxygen long enough to cause severe brain damage.

  18. #18

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    When I used to teach PALS pediatric advanced life support course an CPR classes we would have pediatric dentists and their office staff in the classes. Most dentists that I knew weren't real willing to give anesthesia of any sort to kids under the age of 8 in the office. I did take care of kids who had outpatient dental care where both the anesthesiologist and trained recovery staff were available. I would think that any child, no matter what age, that required that extensive amount of dental work should have been in an outpatient center. Even if the child seemed ok right after the procedures, sedation is absorbed and excreted differently eve when using appropriate doses. Three different ones says to me they might have been having difficulty in initial sedation and there should be real concern over the long-term sedating side effects

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