Daughter's Toothache

[Spydaman]

Daughter is off to Morzine in two weeks to start a ski season but has come down with chronic toothache. She thinks it's her wisdom tooth which is partly through but the gum is now swollen and feels infected. Says it feels like there's not enough room for all the teeth and the new one is impacting on all the others. She went to an emergency dentist who had a quick look, told her she needed it out asap and gave her some antibiotics. She's now been to her own dentist who told her dentists no longer take wisdom teeth out and to take her antibiotics. Does this sound right or does she need a second opinion? She doesn't want to get to France and have to look for a dentiste immediately.

[KamSandhu44]

I have issues with my wisdom teeth, the dentist told me I'd have to go to the hospital if I ever had t have them removed.

[Fozziebear]

The antibiotics will be for the infection, once it's gone if the pains still there it'll be hospital to get them out.

[The_Doc]

The French health system is very good. She needs her EHIC card and payment can be upfront with a protracted claim-back, and she may have to go to Thonon for a decent dentist.

My brother lived in Morzine for 10 years and says he thought their care was better than ours.

There are English speaking GPs out there, but I'm not sure English speaking dentists

[anonymous-user]

Spydaman said:

Daughter is off to Morzine in two weeks to start a ski season but has come down with chronic toothache. She thinks it's her wisdom tooth which is partly through but the gum is now swollen and feels infected. Says it feels like there's not enough room for all the teeth and the new one is impacting on all the others. She went to an emergency dentist who had a quick look, told her she needed it out asap and gave her some antibiotics. She's now been to her own dentist who told her dentists no longer take wisdom teeth out and to take her antibiotics. Does this sound right or does she need a second opinion? She doesn't want to get to France and have to look for a dentiste immediately.

Dentists will not take out a wisdom tooth if it is a complex removal.

They will take an X Ray to see if you need to go to hospital or not. If it is complicated then the hospital would be required. But many are simple.

The local dentist took one of mine out 3 Months ago as she stated it would be better out. Was no issue having it done there.

Did the dentist who saw your daughter take an x ray?

When your daughter is in pain then it should be taken out ASAP. Antibiotics will only calm the issue down but once the course is finished it will just reappear.

Get in contact with other dentists if no x ray was taken and ask if they will do this for your daughter. You do not want her being away in pain having to get it done abroad with a bad infection.

BTW get her to gargle with salt which will clean the area and also get some Sensodyne toothpaste to help with the pain. Just put the toothpaste on the brush and smear onto the sore area.

[cringle]

We have to abide by the NICE guidelines for wisdom tooth removal these days. Wisdom tooth extraction is only conducted in the minority of cases now, if there is a clinical justification for it. If it is uncleanable, or the impaction is causing decay in the adjacent tooth, then this may be justifiable. A single episode of infection in the gum flap around it is not really a justification, the guidelines state a single SEVERE episode or multiple episodes in a 12 month period are a justification...if your daughter is young (under 30) then hopefully the tooth will erupt a little more and the gum flap will be smaller thus less likely to become infected. Lower wisdom tooth extraction is a horrible procedure, and can result in damage of the lower dental nerve, with permanent loss of sensation in 0.3% of cases. It is entirely possible to have a single episode and to never have another in the future. To the non-dentists here, please don't recommend treatment when you don't know what you're talking about.

[Spydaman]

Thanks for the replies. I'll get her to read them and ask for more advice if needed.

[The_Doc]

cringle said:

To the non-dentists here, please don't recommend treatment when you don't know what you're talking about.

Amemded to: "To the non-healthcare professionals here, please don't recommend treatment when you don't know what you're talking about."

Here here !!

Advice based on anecdote
Advice based on evidence based medicine

One of the above is almost worthless

Both occur in internet fora

While well intentioned, and of some use, one man's story is generally not applicable to a random other man (or his daughter). And I'm not trying to be a kill joy or triumphant about anything here. It's just: the way to give medical advice is to take a person specific history, examine the patient, use extra tests, and then draw on your learning and knowledge to recommend specific treatment.

rant over

[anonymous-user]

The_Doc said:

Amemded to: "To the non-healthcare professionals here, please don't recommend treatment when you don't know what you're talking about."

Here here !!

Advice based on anecdote
Advice based on evidence based medicine

One of the above is almost worthless

Both occur in internet fora

While well intentioned, and of some use, one man's story is generally not applicable to a random other man (or his daughter). And I'm not trying to be a kill joy or triumphant about anything here. It's just: the way to give medical advice is to take a person specific history, examine the patient, use extra tests, and then draw on your learning and knowledge to recommend specific treatment.

rant over

I was only trying to help the OP daughter. I was not implying he takes a pliers and does the job himself.

As stated the emergency dentist said that it should be taken out ASAP yet her dentist will not do it.

This is why I feel they should get a second opinion.

High horse people.

Edited by anonymous-user on Thursday 17th November 11:12

[The_Doc]

ELUSIVEJIM said:

The_Doc said:

Amemded to: "To the non-healthcare professionals here, please don't recommend treatment when you don't know what you're talking about."

Here here !!

Advice based on anecdote
Advice based on evidence based medicine

One of the above is almost worthless

Both occur in internet fora

While well intentioned, and of some use, one man's story is generally not applicable to a random other man (or his daughter). And I'm not trying to be a kill joy or triumphant about anything here. It's just: the way to give medical advice is to take a person specific history, examine the patient, use extra tests, and then draw on your learning and knowledge to recommend specific treatment.

rant over

I was only trying to help the OP daughter. I was not implying he takes a pliers and does the job himself.

As stated the emergency dentist said that it should be taken out ASAP yet her dentist will not do it.

This is why I feel they should get a second opinion.

High horse people.

Yes. I agree. Good intentions.

I think the Health Matters forum should have a sticky saying, "Medical advice is safest and most reliable when obtained from a registered professional, in a suitable healthcare setting. Be aware that a forum is little different to advice from the passengers on the bus, or the patrons of your local pub, or similar."

Good can come, but well intentioned mistakes happen and forum chat cannot replace a consultation with a trained professional.

The poster here knows about this: https://www.nice.org.uk/guidance/ta1
The emergency dentist may not be up to date with this. Sometimes locum and out-of-hours professionals are not at the top of their game...

Anyhow, chat is better than no chat. Advice must be weighted by the giver, and the recipient. Everybody satisfied.

[anonymous-user]

The_Doc said:

Yes. I agree. Good intentions.

I think the Health Matters forum should have a sticky saying, "Medical advice is safest and most reliable when obtained from a registered professional, in a suitable healthcare setting. Be aware that a forum is little different to advice from the passengers on the bus, or the patrons of your local pub, or similar."

Good can come, but well intentioned mistakes happen and forum chat cannot replace a consultation with a trained professional.

The poster here knows about this: https://www.nice.org.uk/guidance/ta1
The emergency dentist may not be up to date with this. Sometimes locum and out-of-hours professionals are not at the top of their game...

Anyhow, chat is better than no chat. Advice must be weighted by the giver, and the recipient. Everybody satisfied.

Totally agree. You should always seek a trained professional when it comes to health matters.

Watching some clips on YouTube when people are willing especially in America to perform a medical task themselves due to not having medical insurance is pretty scary.

It is great when a medical professional is willing to help on a forum like this so I commend you for doing that.

Hopefully the OP's daughter can be pain free soon.

[cringle]

"When your daughter is in pain then it should be taken out ASAP. Antibiotics will only calm the issue down but once the course is finished it will just reappear."

This statement comes across as fact. Nothing to do with high horse. I would never dream of using a personal experience with some part of my body to categorically recommend some form of intervention when not qualified to do so. The OP may have begun to lose trust in his dentist, which is unfair. He may have stormed back to see his dentist and demanded to know why the tooth wasn't going to be extracted. I would imagine if the dentist asked why he wanted it out, OP would sheepishly have said "because ELUSIVEJIM from the internet said it needed extracting"

[DocJock]

cringle explained in detail the problem with your post from the medico-legal standpoint.

You also gave incorrect advice in at least two instances.

That is why the suggestion was made that you leave dispensing medical advice to those qualified no matter how well intentioned your advice was.

Poor reactions to this, such as yours, are one of the reasons I no longer offer advice on this forum.

[anonymous-user]

DocJock said:

cringle explained in detail the problem with your post from the medico-legal standpoint.

You also gave incorrect advice in at least two instances.

That is why the suggestion was made that you leave dispensing medical advice to those qualified no matter how well intentioned your advice was.

Poor reactions to this, such as yours, are one of the reasons I no longer offer advice on this forum.

You two are clearly correct.

I will refrain from posting advice about past medical issues which affected me so not to confuse someone wanting advice.

Apologies to you both and to the OP for any misleading information.

[Lotus Notes]

The_Doc said:

The French health system is very good. She needs her EHIC card and payment can be upfront with a protracted claim-back, and she may have to go to Thonon for a decent dentist.

My brother lived in Morzine for 10 years and says he thought their care was better than ours.

There are English speaking GPs out there, but I'm not sure English speaking dentists

I echo the observations on better dental care in France.

My dentist (dental surgeon) in Lyon removed an impacted wisdom tooth with injections. The overall cost didn't surpass 100€. However, the root canal and crown work on the tooth next door cost 1000€, with only 120€ covered by the healthcare system.

Speaking to friends in France, their wisdom teeth (plural) were removed in a hospital under a general anesthetic.

So I guess it's who you see and for what reason