Q: I had a tooth pulled and was immediately referred to an oral surgeon to have a bunch of broken root tips removed from my sinus and jaw bone. Do I have a right to be angry at my dentist? Should he have sent me to a dental specialist from the start?
A: Another nail-biting chapter in my book Tooth Talk: “When to see a specialist.” (FREE copies will be given out at my next seminar to the public in October; drop us an email to receive the details.) This follows the chapter: “Don’t Shoot your Dentist; He’s Got a Tough Job!”
Your dentist did the right thing; he made you aware of the complication and referred you to the appropriate specialist. As far as “should he have referred you from the beginning”; that is a judgment call. Just as in medicine, general dentistry provides your dentist to legally perform any procedure; even Botox and fillers in many states including Florida.
Many general dentists are well-trained via continuing education to perform orthodontics, wisdom teeth removal and root canals. Should complications arise, a dental specialist may be needed to complete the work.
In your case with tooth extractions, several complications are quite frequent: broken root tips left behind, root tips dislodged into sinus cavities, infections of the bone marrow (osteomyelitis), bone fragments under the gum and dry sockets. Most of these will most likely be treated by the dentist who performed the extraction, but in some cases, a referral to an oral surgeon will be warranted.
Dental schools and residency programs do a great job in training young dentists how to recognize difficulties via exams and X-rays, before tackling a tough one. A doctor with good, common sense who keeps his ego at home will make a judgment in your favor every time. (Almost.)
Dr. Mitchell Josephs practices Implant, Cosmetic and General Dentistry with an emphasis on implants, porcelain veneers, and complex crown and bridge treatment. He is on staff at JFK Medical Center and is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry. He completed his residency at Manhattan’s Beth Israel Medical Center and Mt. Sinai Hospital.