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Dental hygienist diagnosing and making treatment plan

N

NervousUSA

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Joined
Jul 9, 2022
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108
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USA
Last week I was getting a teeth cleaning. I am returning to the dentist next week for an extraction of my left wisdom teeth. At the dentists office I go to, I feel that the one dentist is minimizing time with patients to see as many as possible while delegating as much as possible to a large staff.

At the cleaning I was asked if there were any changes and I pointed out a sore gum area next to my lower right 2nd molar. The hygienist told me it meant my wisdom tooth would have to be removed, and it was caused by too much space between my wisdom tooth and 2nd molar allowing food to get trapped.

When the dentist came in she gave him this diagnosis, and he asked to see my xray and then seemed to vaguely say ok, so they put extracting my lower right wisdom tooth on my treatment plan.

Now I think back I feel that I don't even know if the dentist recommended that or was just going along with the hygienist.

We then had a short discussion where he talked about referring me to an oral surgeon to have them all done at once which I declined because of unwillingness to be sedated. This was an interesting moment because when I talked about not wanting to be sedated the dentist said "Oh I think I remember you". I guess this was the first time he remembered me even though I was there last month for a dental implant which took him close to three hours and this was my fifth time there in 2022. I suspect that I act very upset when talking about not wanting sedation (a huge fear for me). I also asked him if he thought I had any risk of a serious infection and he didn't know.

I saw the hygienist type into my chart "patient is interested in having tooth removed..." and "patient doesn't want to be sedated..." but couldn't see more.

Once he left the room, I became concerned over the fact that my treatment plan has removing both on the left, but just the lower on the right (lower are partially impacted and upper fully erupted) and I don't know why.

I wasn't allowed to speak to the dentist again, who must have gone to another patient, when I asked the hygienist why the difference over my upper wisdom teeth, she said she would add removing my upper right to my treatment plan if I wanted. I was concerned she said she would do this, and make such a big treatment decision, even though the dentist wasn't there. I don't think he ever mentioned removing my upper right wisdom tooth. I said don't do that, I would need the dentists advice. Then I said why can't I keep my upper left if I can keep my upper right and she said "you think you have room for it but you don't" and I don't know what she meant. I never said I thought I had room for anything or anything like that.

Do you think the hygienist is making too many decisions and diagnosing too much here, or I could be having treatment decisions made for me by a hygienist instead of a dentist? I only want to have teeth extracted on the advice of a dentist, its a really serious thing. The hygienist also made a comment to me that made me think she generally thought all wisdom teeth should be removed, something like "this is why we say people should just get their wisdom teeth removed" or something like that.

What should I do to fix this? I am thinking of bringing a list of questions to my left wisdom teeth extraction next week and asking if it was the dentists idea or the hygienists idea my right wisdom tooth should be extracted, and if he himself does recommend it I would like him to tell me so directly, and why he recommends it? I am really struggling with the whole situation because I am extremely frightened and flustered and am afraid of coming across as antagonistic, but don't want a risky and extreme treatment not recommended by a dentist. Will the dentist get mad and think I am criticizing the hygienist? What can I say to get the information I need without rubbing anyone the wrong way?
 
Last edited:
Gordon

Gordon

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What should I do to fix this? I am thinking of bringing a list of questions to my left wisdom teeth extraction next week and asking if it was the dentists idea or the hygienists idea my right wisdom tooth should be extracted, and if he himself does recommend it I would like him to tell me so directly, and why he recommends it?
Sounds like a good idea. I'd do that.
 
N

NervousUSA

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Joined
Jul 9, 2022
Messages
108
Location
USA
@Gordon
Thanks a lot!!! I will do that.
One other thing, do you think it was unusual or a red flag that the hygienist said she could add an extraction that hadn't been mentioned by the dentist to my treatment plan after he had left?
 
Gordon

Gordon

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Staff member
Verified dentist
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Messages
7,896
If it was my practice I wouldn't be happy with them doing that at all. The hygienist is not qualified to make that diagnosis, so no.
 
N

NervousUSA

Well-known member
Joined
Jul 9, 2022
Messages
108
Location
USA
@Gordon Thanks so much Gordon, you are so kind and helpful
 
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