Managing the patient claiming to be allergic to dental materials
I recently sent the following message to the members of the JCDA Restorative Dentistry Expert Panel
A lady called the CDA office today distraught because she has called 21 dental offices seeking treatment, and all have refused her. She tells us that she is allergic to 9 different materials using in dental offices. She claims that because of the complications she would present to a general dental office, they are refusing to treat her. Do you have any advice that we could give her please? Is there any practical “next steps” advice that we can pass on to Canadian dentists and their team, when they are contacted by patients who claim to have allergies to substances used in dental offices?
Panel Member 1
I have a patient just like this who came to see me one month ago, and I still do not know how to manage/accept her as a patient. She has seen other specialists and has refused their treatment options. She also cannot travel until the afternoon as morning appointments stress her too much.
I look forward to responses from my colleagues as I think that she may be untreatable, by me.
Panel Member 2
What are the 9 different materials used in the dental office that the patient is allergic to? Do we know?
Panel Member 3
Most dental schools have some sort of GPR/hospital program that might be able to sort out some of these issues including expertise in “supra-maxillary” issues. Consults could probably be arranged to actually identify the offending agents, and treatment could be rendered were necessary life support is available. I think if the patient is not willing to take this route then they may have an inappropriate/exaggerated sense of the condition and would most likely cause problems for the practitioner. I think the practitioners who are not treating this patient are probably being prudent.
Panel Member 4
I don’t think it’s possible to make a generic recommendation. I would want to know what the allergies are and that each has been confirmed by an allergist that they are true allergies. Only then can options for care be considered.
Panel Member 5
This is a very interesting e-mail. I have had some experience of this kind in the UK where these cases were handled by NHS regional consultant service/ hospital dental service. In some regions Community Dental Service (Senior Dental Officer (special needs)) would also deal with them. I have roughed out a sensible strategy from memory on the attached file – Allergic patient management.