What three year old needs four root canals? Dentist should be charged with murder.

[Baitball Blogger]

Hawaii girl, 3, dies after dental procedure

On December 3, Ashley Boyle took her young daughter to Island Dentistry for extensive dental work, which the family states in court documents was recommended by Dr. Geyer.

The planned procedures included four root canals and multiple cavity fillings, according to the documents.

The Boyle family's attorney L. Richard Fried Jr. said on Saturday the child was given "grossly excessive" amounts of sedatives, went into cardiac arrest and later suffered brain damage.

The family charges that the staff was improperly trained for emergencies and failed to check the patient's vital signs for 26 minutes.

http://www.orlandosentinel.com/sns-rt-us-usa-dentistry-death-20140104,0,7363067.story

[RebelOne]

1. At 3 years old, she still has her baby teeth.

Extensive dentistry does not make sense at that age.

[ScreamingMeemie]

2. Wow!

I thought root canals were saved for permanent teeth. I'd tend to agree with you..

[Tx4obama]

6. I was curious too, found good answer on the link below

Here: http://answers.yahoo.com/question/index;_ylt=A0oG7l7L0shSFnkAlA1XNyoA?qid=20100105100108AA17nJg

[ScreamingMeemie]

7. Thank you Tx4!

I'm a lazy searcher tonight.

That's interesting.

[RKP5637]

45. That was very interesting, I had no idea! Thanks for posting! n/t

[CFLDem]

3. Disgusting

Especially with someone that should be trusted with one's health.

[Demo_Chris]

4. He should probably be prosecuted. nt

[Tx4obama]

9. Doctor Lily Geyer is a 'she'

[Demo_Chris]

10. Oh. Well in that case...

SHE should probably be prosecuted. Assuming, of course, that this is as fucked up as it seems.

[legcramp]

5. Three year olds have baby teeth. Baby teeth don't have "roots".

Something wrong with this whole story.

[Tx4obama]

8. The nerve is removed. See the link below...

Here: http://answers.yahoo.com/question/index;_ylt=A0oG7l7L0shSFnkAlA1XNyoA?qid=20100105100108AA17nJg

[hobbit709]

11. How did a three year old's teeth get that bad?

[avebury]

38. Exactly.

It makes you wonder what on earth the parents were feeding that child. And did the parents make any effort to brush the child's teeth? If the original damage is related to what the child was being given to eat and/or drink the the parents have to accept some of the blame for what happened.

And why didn't the parents get a second opinion first?

[SunSeeker]

12. I had a dentist make a similar recommendation. Glad I got a second opinion.

He wanted to put my son under and do 6 fillings, all on his baby teeth. I went to another dentist and she said we should just wait. Two of the teeth would fall out soon and the other four simply were decalcifications that could be watched and addressed if they formed actual cavities. She was right. The two did fall out and only one of the remaining four ended up as a cavity, which she quickly fixed with local anesthesia shots rather than putting my son under. I think my first dentist was just trying to make a buck. Dr.Geyer sounds a lot like him.

[tblue37]

13. I know someone whose son had 3 root canals by the time he was 5 years old--because she let him drink

milk and sugary drinks constantly and eat chips and candy all the time. Furthermore, he never drank water, so his mouth was never even being rinsed by water.

Her older son also developed a runaway case of lactobacillus from the same sort of thing, and he ended up needing $8000 worth of dental care when he was 18 to save his teeth.

Some parents feed their kids so much junk that they might as well give them cigarettes, too, since they are doing nearly as much damage to the kids with what they let them eat and drink!

[Baitball Blogger]

14. I had a relative who gave his baby coca-cola in a baby bottle at the age of two.

They were very, very young parents and this was so many years ago. Today they are hardcore right-wingers.

[kelliekat44]

23. Just pull out the damn teeth then!! This is crazy!!!! nt

[TexasProgresive]

15. I have a young cousin who had silver caps on several baby teeth

It had to do with some kind of antibiotic therapy which severely damaged his teeth. The dental work was so that he could eat until his permanent teeth came in.

[PCIntern]

16. As a dentist of 34 years, may I offer an opinion?

We do not have the radiographs or evidence in this case, so what this child needed to have done is unknown.
Primary teeth DO have roots, and root canals are indicated for vital,. cariously exposed teeth. If the tooth is non-vital or abscessing, then it must be removed.
Performing endodontics on children is routine and justified for many many reasons. Period.
The nature of the anesthesia practices are what need to be examined by those competent to render an opinion. I will tell you that there are quite a few practitioners who render Grade Z services in this regard and should not be doing so. I will also tell you that I voluntary suspended my anesthesia permit, which I was grandfathered into, and do not administer any systemic anesthetics or analgesics including Nitrous oxide for exactly the reason that is occurring in this thread: if anything were to happen, I would be tried and convicted by the masses who do not have one iota of an idea of what is appropriate and inappropriate in evaluating clinical situations and results, good or bad.

[Orrex]

17. K&R for this reply

[spanone]

18. thank you.

[malaise]

19. Yours is the only response that matters on this thread

Thank you PCIntern.

[sendero]

21. In such a case..

... if would be up to your attorney to convince the jury that what you did was reasonable. If he cannot do it, it probably wasn't, regardless of any medical knowledge on the part of a jury.

I realize juries are sometime made of of idiots, but the bottom line is you would be given the benefit of the doubt as all doctors and cops are in our legal system.

[PCIntern]

25. As someone who has no fewer than 200 expert testimonies and depositions under

his belt, I may say that you are wrong in this regard. The initial assumption of most people is that the professional made mistakes. The defense must first convince the jurors or the judge that if mistakes were made they were not at the level of malpractice, which is more complex than it sounds, and then that the outcome was not a result solely of the errors of judgement, diagnosis, or treatment. There is such an entity as Bad Result which does not rise to the level of malpractice. I have watched the faces of jurors for years and the manner in which they observe the proceedings and there is almost always a look of surprise when the defense posits a rationale for the circumstance. Parenthetically, that is why many many cases settle before trial: not because the defense doesn't have a wonderful case, but if the attorney feels that certain items are prejudicial against the doctor, then it is best to take the losses a priori rather than face a catastrophe. I have been party to such cases and was most upset, as a defense witness, that the settlement occurred, since the charge in many cases was specious to say the least, but I understood intellectually the need to pay and move on. Also parenthetically, I have ben a plaintiff's witness so I am immune fromthe charge of 'paid shill'.

[sendero]

37. Well even accepting..

... your entire article, I'm pretty sure based on numerous published reports, that 90% of actual malpractice and medical error causing death or grievous bodily harm is never sued over. Over all I think doctors are getting off pretty good.

[avebury]

42. You are probably correct in how many

jurors would react to this type of case. Maybe it is all the time that I spent working in a hospital years ago but I would want to see/hear the evidence presented in court. I would not automatically assume dental malpractice. Actually my initial reaction would be how did the parents allow their child's teeth to get so bad in the first place to even need this type of extensive dental work. I would be wondering if there was a case of parental malpractice. What were they giving the child to eat and drink? Were they even brushing the kid's teeth?

[Turbineguy]

29. Thanks.

I was hoping for your view on this.

[City Lights]

31. Thanks for weighing in, PCIntern! nt

[Codeine]

39. I very rarely agree with your posts, but that was fantastic, sir.

Thank you for your perspective.

[Mira]

44. Thanks for weighing in. I was disturbed

by reading about this incident - and looked for your opinion!

[enlightenment]

48. Thank you for injecting some

common sense into this conversation.

Apocryphal story from my youth. At 16, I had four badly impacted wisdom teeth (small jaw, crowded even after four bicuspids were removed as a child).

The dentist gave me nitrous - but obviously neither he nor his assistant had a freaking clue what they were doing with it. I remember the point when the hallucinations started (the scalpel descending toward my face turned into a machete, for one . . .), but I don't remember having to be literally peeled off the wall of bookshelves I apparently attempted to climb in a bid for freedom. I took their word for it, because it was obvious from the tipped over chairs and instrument trays something happened, and my first coherent memory after the machete was sitting on the floor against a wall with an O2 mask on my face. The worst part was the decision (not mine!) to continue, using local anesthetic - far too much of that, too, not that it really helped cancel out the pain of having the teeth removed with a chisel and mallet.

Anesthesia delivery is not something a poorly trained person should do.

[TBF]

20. For those who have small kids -

watch things like "fruit snacks". Those kinds of candy-like snacks are not at all healthy and our pediatric dentist told me she thinks those kind of snacks that parents mistake as somewhat healthy are a problem with baby teeth. My own daughter had several crowns, but our dentist takes her time and does not put them out if at all possible. My daughter had local sedatives and constantly monitored by the nurse as the work was being done. I was much stricter with the younger child - no fruit snacks and I would let him play at brushing his teeth but still often brush them after to make sure he doesn't have these issues. He has one small cavity at this point vs. his older sister having several crowns. So, watch what they eat and help them brush are my suggestions.

ETA - also water. With the younger child I switched him from juice to small water bottles much younger - mostly due to weight. As he gets older have switched to reusable bottles but those small water bottles were initially easy for him to grab from fridge (as opposed to a juice box). I think that helped as well.

[PCIntern]

22. wonderful advice...

everyone gets an A here...!

[TBF]

24. We learned with the first child -

and our pediatric dentist is wonderful. Not surprisingly she is incredibly popular ... we have to book our appts far in advance.

[PCIntern]

26. may I Ask, in what section of the country do you live? nt

[TBF]

27. We're in Houston. nt

[PCIntern]

30. You're fortunate also that you probably have a lot of endemic fluoride

in your water supply. Texas and Colorado do.

[TBF]

40. That could be -

Even when I was growing up in Wisconsin we had flouride and county nurses coming into the public schools to teach us about dental hygiene. I was fascinated as many folks in my family lost their teeth quite early (my mom had false teeth before age 40 after growing up in very rural area in the 1950s). These days if you are in a major city and pay some attention to brushing/flossing it is much better than even a couple of generations ago.

I don't know if dental care is covered by Obamacare, but we do have it in our employer's policy and that encourages regular preventative visits.

[Codeine]

41. Our oldest was massively spoiled by her grandfather

when my fiancee lived with him. He was always sneaking her candy and Little Debbie snack cakes, and Dr. Pepper was the fluid of choice in their home. Her baby teeth are a wreck -- she has more fillings on just one of her molars than I have in my entire mouth, and I'm in my forties! Luckily she's in the process of shedding those teeth and she's taking much better care of her adult teeth now.

Our youngest, a five-year-old boy, was handled much more strictly, and as a result has had a minimum of problems and only one filling. His last two checkups have been completely clean. He drinks water almost exclusively and sweets aren't a regular option. The difference is remarkable.

[TBF]

43. It really made a difference between my two -

I do think some of it is genetic as well but at least if you start from a point of limiting sweets and brushing/flossing regularly you've got a chance.

[cags]

28. Genetics plays a large role, my oldest daughter never had a cavity until she was 15...

and as a young mother she had way more junk than she should have had. My second daughter who never had the junk, had very thin enamel on her baby teeth. Her baby teeth were plagued with cavities and she did need a crown at one point when she was 5 years old.
Her permanent teeth are different thank goodness. Except for the fact that she was missing a permanent tooth and is undergoing orthodontic treatment to move some permanent teeth to compensate, her teeth are healthy.

So hold the judgments a bit as you never know the genetics involved.
Obviously coke in a baby bottle is totally judge worthy though...lol

[PCIntern]

32. Agenesis of permanent teeth is interestingly hereditary to an extent...

I always ask adults, "Anyone else in your family missing teeth in this fashion to your knowledge?" Lateral incisors, second premolars, lower centrals(!) and of course, Wizzies are particularly susceptible candidates.

[Blue Diadem]

46. Granddaughter has an inherited disorder, Amelogenesis imperfecta.

There were some problems with her baby teeth & she needed fillings due to teeth not filling in. Same with her permanent teeth. She's a teen now in braces but will still need work done after ortho. Her other grandmother told me she had all her teeth crowned by the time she graduated from high school due to the same condition.
People can be judgmental and cruel and I thank you for bringing awareness to genetics. I find most do not know of genetic conditions which can discolor, pit teeth, cause malformations or cause cavities due to thin enamel.

[onenote]

33. Question for the OP: did you read PCIntern's response?

You (joined by others) made some serious charges based on your inexpert opinion. Care to revise your remarks at all?

[Baitball Blogger]

35. He made some excellent points.

I look forward to hearing more of the case to hear the answers to all the good questions that were posed in this thread.

[mahina]

34. Mr. Fried is a heavyweight. The family is well represented.

For the rest of it, there are no words.

[Baitball Blogger]

36. Thank you for the info.

Please keep us posted on the development of this case.

[mahina]

49. Sorry, not my kuleana.

[mfcorey1]

47. Without a certified anesthesiologist present, no dental office should sedate a

patient. I hear of too many deaths under sedation dentistry. My sleep disorder doctor advised me that because of sleep apnea, there should never be any sedation dentistry provided to me. This is so sad. Dentistry should be a part of total medical care and not separated.