The following story should serve as a warning to all dentists, though particularly those that treat elderly patients.
Earlier this year, a 79-year-old Chicago woman visited a local periodontist to have an implant placed. The procedure required that a particular tooth be extracted from the women’s mouth. As this was being done, the woman alleges that the specialist positioned her head at a particularly awkward and uncomfortable angle, and an exceptional amount of strain was placed on her neck. Initially, the woman felt no ill effects in the aftermath of the procedure, and she was able to leave the office under her own power. For the remainder of the day, she went about her usual business – i.e.: shopping at stores, watching television – before retiring to bed that night. When she awoke the next morning, however, she received a horrific surprise: she was paralyzed from the neck down.
The woman’s husband quickly contacted emergency services and an ambulance rushed her to a nearby hospital. There, she was diagnosed with Central Cord Syndrome (CCS), a form of spinal cord injury most commonly occurring in elderly adults. CCS usually results from hyperextension injuries to the neck area, which can occur when the neck has been either flexed forward or extended backward to an exceptional degree, causing the spinal cord to become pinched between the front of the cervical vertebrae and the ligament on the back it. CCS can reduce or extinguish motor ability in all four limbs, but usually afflicts the arms more than the legs. After many months of physical therapy, the woman eventually managed to recover the ability to use her legs and left arm; however, as of this writing, she still has not regained the use of her right arm – and doctors believe she likely never will. Not surprisingly, the woman has since filed a malpractice suit against her periodontist, citing the unusually rough treatment she received from him as the cause of her injuries.
This story serves to illustrate the sort of unique but severe risks associated with the treatment of elderly dental patients. When treating an elderly patient, a dentist must remain mindful at all times of the patient’s potentially delicate physical condition. The dentist should make every effort to ensure that the patient’s neck is not hyperflexed or hyperextended in the course of treatment. The dentist should also inquire beforehand as to whether or not the patient has a history of neck or back troubles and, if possible, even request that tests be done to uncover any hidden risk factors. |
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