‘I learnt about Dentistry from that’

From Volume 47, Issue 7, July 2020 | Page 611

Abstract

Readers are encouraged to submit clinical experiences, good and bad, in a culture of open reporting, so that other clinicians will learn from these experiences. Unlike articles in Dental Update, in which published articles are peer reviewed by two experts in the field of the article, this page is not subjected to review other than by the Editorial Director.

Article

A few years after graduating I was doing a root canal treatment on an elderly gentleman. His tooth was heavily decayed but he was keen to save it. I had put a rubber dam on and was irrigating with sodium hypochlorite when the patient started to complain. Thinking that some hypochlorite had managed to leak through the rubber dam, I removed it quickly and asked him to rinse out; however, what had actually happened was that hypochlorite had escaped into the soft tissues through the subgingival carious lesion in the tooth. The patient was in pain and there was some local swelling. I panicked slightly but reassured him and gave additional LA; then I quickly logged onto my Dental Update account and searched for relevant articles to find out what to do next! I apologized to him, explained what had happened, and kept an eye on him for a while.

The patient recovered and seemed satisfied with my apology so I dressed the tooth with non-setting calcium hypochlorite and cotton wool, gave him a prescription for antibiotics and sent him on his way, giving him a courtesy phone call later to check on him. Luckily, there seemed to be no long-term damage, although obviously the patient had to return for me to extract the tooth.

So from this I learnt:

  • a) It's not always in the patient's best interests to try and save their tooth.
  • b) It's always good to try and build a rapport with your patient – I didn't particularly like this man, but I had always tried to get on well with him, and I was certainly glad of it that day!