A couple weeks ago, media sources shocked viewers and readers with the story of Savannah White. This 4-year-old girl was put under general anesthesia to have stainless steel crowns put on all of her remaining primary teeth. However, her mother thought she was only going in to have four cavities filled and was horrified and irate when she looked in her daughter’s mouth for the first time.
Mrs. White stated “I didn’t expect for her entire mouth to be covered in silver. We went in to have a couple of cavities done”. She also told reporters that her daughter complains daily that she doesn’t like her teeth, which is “really kind of hard to hear every single day”. When this story hit the media, the public was outraged. Comments criticizing and denouncing the dentist were left on online news sources and reporters painted the dentist as a heartless villain.
I for one think this dentist was unfairly represented.
Photos of Savannah show that she is already missing many anterior teeth that wouldn’t have fallen out on their own by age 4. Presumably, these teeth were lost due to severe decay. This shows that Savannah has a very high caries risk and it is likely that the remaining teeth in her mouth also exhibited significant decay.
The treatment rendered by this dentist is not uncommon and is an economical way to preserve what is left of severely decayed teeth in the mouth. In fact, this dentist’s work probably saved Savannah’s remaining teeth and prevented further and more severe oral infection. Dr. Richard Chaet, former president of the Arizona Academy of Pediatric Dentistry, backed up the treatment rendered for Savannah saying that the stainless steel crowns were probably very necessary.
However, there is still no excuse for what happened with Savannah White and this is great example of a moral dilemma we can learn from.
The Dentist’s mistake:
He should have done a better job with informed consent and made sure the parent(s) understood what he would be doing first. Clearly this mother did not realize what Savannah’s dental treatment would entail, and so certainly couldn’t have given proper consent for care. Other options, like SSC veneers or SSCs with esthetic windows should have been presented. This case should serve as a reminder to us all that we need to take the time to discuss risks and benefits of treatment options and not rely on paternalism. Patients, and/or their parents, should be involved in the decision making process and need to be well informed before we ever pick up an instrument.
The Mother’s mistake:
The other glaring problem is this child’s lack of proper home care. In my opinion, it is the child’s parents who should be reprimanded rather than the dentist. Savannah’s teeth were lost or crowned because of poor oral hygiene and poor diet, which for such a young child is the parent’s responsibility. There is no excuse for a four year old to have this extent of decay. With proper diet and eating habits, recommended fluoride dosage, and effective daily brushing at home, this entire incident could have been prevented. If you are a dental student or a dentist, make sure to educate your patients and their parents on the importance of home care. And please, if you are a parent, take your child for their first dental visit by age 1 to learn how to prevent this kind of rampant tooth decay!
Savannah pictured after another local dentist offered to veneer her SSCs free of charge
What do you think of this surprise “coronation”?
Ashley N. Phares, Connecticut ’13, contributing editor
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