Annoying and rude

During the last few years that I practised dentistry, most of my patients brought mobile telephones into my surgery.

You would be surprised how many patients tried to answer their ‘phones when my fingers were in their mouths or their mouths were filled with impression (mold taking) material.

Worse still, were patients who were ‘texting’ constantly when I was trying to explain their treatment options to them.

Once, a patient arrived late, speaking on his mobile phone. He muttered to me that he was in the middle of a telephone job interview. I had no choice, but to let him continue. After half an hour, he told me he was ready for me. I told him that he had wasted my time and his appointment and had to book another one.

In the end, I put up a large sign in my surgery forbidding the use of mobile phones, which was rude and inconsiderate. This solved the problem because, to my surprise, most people obeyed it.

Stung on the tongue: a careless diagnosis

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I cannot remember the name of the person who taught us dental pathology back in 1981 at University College Hospital Dental School, but one thing he told us made a deep impression on me.  He said that it was unlikely that we would see oral cancers frequently in general dental practice, but when we did see one we would feel a certain ‘jizz’ (our teacher’s word), a feeling that we were looking at something unusual and worrying.

One day when I was in practice, a delightful late middle-aged woman visited my surgery as a new patient. She said there was something on her tongue that had been bothering her for several weeks and was making eating and speech difficult. She had been to her doctor (medical), who told her that she had had a bee sting on her tongue. She told me that she had been taking antibiotics prescribed for it for  quite a time and the condition was only getting worse.

I had never encountered anyone with a bee sting on their tongue. The lady’s story and her doctor’s diagnosis sounded strange. She showed me her tongue. As soon as I saw the huge ulcer on the side of it and its peculiar border, I felt that ‘jizz’, which our pathology teacher had mentioned. I knew that the poor lady had, almost without a doubt, a carcinoma on her tongue. I told her my suspicions, and she looked relieved, and was grateful. Clearly, she had not believed her doctor’s story. I phoned the local oral surgery department, and they admitted her promptly.

About a year later, the lady reappeared. During the surgical treatment of her cancer, she had lost several teeth and wanted a denture to replace them. Sadly, her mouth was by now so distorted that making a prosthesis was beyond my competence. I referred her to a prosthetic specialist. Unfortunately, she did not live long enough for his work to be completed.

Whether earlier intervention would have saved her life, or at least prolonged it, is a question than cannot be answered. 

In my 35 years in dental practice, I only ever saw two patients with obvious oral cancers. However, I did refer many patients to have unusual looking lesions seen by oral surgical specialists. None of these gave me that ‘jizz’ nor turned out to be cancerous.