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Harrass the dentist, just for fun

Fed up with the dentist down the road who thinks you're there just to advise him every time he has a patient more complicated than a filling? Copperfield is - and he reckons it's payback time.

Fed up with the dentist down the road who thinks you're there just to advise him every time he has a patient more complicated than a filling? Copperfield is - and he reckons it's payback time.

So, you've got this patient with gout. You can't give him NSAIDs because he's on warfarin. And colchicine caused him such bad diarrhoea when you prescribed it before that he's clenching his buttocks at the thought. And steroids sent him barking once, so he's not having them, either. Who you gonna call? Well, not gout busters. Because they don't exist. Nor do rheumatologists, given the problems you normally have tracking one down. Which leaves you with a problem. And him with a very painful toe.

Can I make a suggestion? And I wouldn't restrict this solution to matters gouty, either. I would apply it to any clinical conundrum that you have. This is what you do. You call his dentist.

No, hear me out. Barely a week goes by without some drill-bearing, mask-wearing dental ‘professional' calling me with a question. The last two examples were, ‘I want to do some work on this patient but he's on aspirin, could you advise me what I should do about his anticoagulation during treatment?' And, ‘I'm doing an extraction but he tells me he had a hip replacement four years ago, so should he have antibiotic prophylaxis?'

Uh? Look, I realise I provide a bale-out service for your patients with dental abscesses who can't be arsed to make an appointment or who you can't be arsed to give one. But to extend my remit to the point that I'm answering clinical queries for you, too, is a dental bridge too far.

It's simple. You're a dentist. I'm a doctor. These questions are dental and if you can't answer them, phoning a friend will not do, a) Because this isn't ‘Who wants to be a millionaire?' (you do, by the way, that's why you're a dentist) b) I'm not your friend, because you bother me with stuff like this.

If you don't know the answer then look it up, check out the latest guidelines or ask a dental colleague. Presumably they cover this stuff at dental school. If they don't, then phone your educationalists, but don't phone me. I'm fed up with grinding my molars thanks to you trying to shift these decisions my way. Particularly when you do this by getting the punters to do the dirty work. Because, then, not only do I have to confess my ignorance to the patient, I also don't get the opportunity to shout at you for being such a tosser. Which is why I've gone on the offensive.

So what did the dentist advise for my gouty patient? If I recall correctly, his exact words were, ‘How the f**k should I know?' Good point, and one I shall be making to the next dentist that phones me.

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