POZ Community Forums

Main Forums => Living With HIV => Topic started by: madbrain on August 12, 2012, 07:25:46 am

Title: New dentist asked for a copy of my labs
Post by: madbrain on August 12, 2012, 07:25:46 am
I had been meaning to find a new dentist for a couple years since I moved to my new home in the San Jose east foot hills.  My old dentist is now 12 miles away. His hours were not convenient. And his fees were higher than the max covered by my insurance, resulting in a small bill every time even for the two annual cleanings & xrays, which I mindlessly submitted to my FSA.

So I was only too happy to find one this saturday conveniently located just 2 miles from home, and open on weekend. It was 4:20pm and they closed at 5pm. They were able to accommodate me on the spot. I filled out all the new patient forms in a rush. The very first checkbox was for AIDS. There wasn't one for HIV. Time was short and I wasn't in a mood to discuss the difference between the two with the receptionist, so I just checked it. I got my cleaning done while she was still inputting everything.

At the end of the visit, the dentist, presumably now having reviewed the info, asked what my viral load was. I said it was undetectable for several years. The dentist asked me for a copy of my labs "for their records". I faxed it when I got home.

I find it curious that he doesn't want to take my word for it that I'm undetectable. Has anyone else been asked for the same ? When I turned positive, I told my former dentist. They asked what my CD4 and viral loads were, which I gave them verbally, but not for documentation.

Dentists are supposed to follow universal precautions anyway. It's not like all his patients know every medical condition they have.

A few thoughts go through my mind at this time :
1) maybe I should not see this dentist again if he is not following universal precautions. There is as at least as much for me to worry about me catching bugs from him and his patients as him from me
2) maybe I should not see this dentist again because he does not trust me
3) maybe I should cut him some slack because I'm a brand new patient, and could be the first to dare check that box ?
4) maybe I should cut him some slack because he is a handsome young vietnamese man when he is not wearing a mask, which sadly interfered with my gaydar.

I have a followup appointment next saturday and not sure how I'm going to handle this.
Title: Re: New dentist asked for a copy of my labs
Post by: Ann on August 12, 2012, 08:13:54 am
1. Maybe this dentist just wants to give you the best care he can possibly give you, and knowing you current labs can help him in that regard.

2. Maybe he just likes to have things straight from the lab to eliminate any patient error due to faulty memory or confusion. Maybe he's just anal about his record keeping that way.

3. Maybe you should cut him some slack because he's trying to do a thorough job and care for your oral health - an area where we pozzies are known to have difficulties.

4. Maybe you're just horny. ;D

I'd love to have a dentist who paid so much attention to details. Quit being so paranoid! ;)
Title: Re: New dentist asked for a copy of my labs
Post by: Common_ground on August 12, 2012, 08:42:20 am
Agreed. I think he is being professional and taking both you and his job seriously.
Sounds like a keeper to me.
Title: Re: New dentist asked for a copy of my labs
Post by: mikeyb39 on August 12, 2012, 09:17:53 am
I agree with Ann, i think the doc is just trying to give the best care.  my doctor asked me aabout all of that, he didn't ask for labs, but i would have provided if he had asked.

I  had a friend  that had a heard murmur and when she went to the dentis to just get  her teeth cleaned, she had to be prescribed antibiotics, so i just think he is looking out for your best interests.

So no I don't think ints unreasonable for him to ask that.   He could update his application with HIV/AIDS instead of just AIDS, HIV is not an issue, but if you have AIDS then the treatment protocol may be different.
Title: Re: New dentist asked for a copy of my labs
Post by: drewm on August 12, 2012, 10:31:06 am
Docs frequently want to know your labs in case they have to prescribe certain drugs. I have no problem disclosing this information to doctors because I don't want them treating me with one hand tied behind their back.
Title: Re: New dentist asked for a copy of my labs
Post by: Miss Philicia on August 12, 2012, 10:51:47 am
I got to a specialty HIV dental clinic at U-Penn, and they always want a copy of my latest lab report.
Title: Re: New dentist asked for a copy of my labs
Post by: denb45 on August 12, 2012, 11:01:36 am
My Dentist of 10 yrs. has never ask me for any of this, as he has a lot of HIV+ POZ clients, however, he can call my ID Doc and ask her, he did want all of that info and likes it updated every yr.


Hugs

DEN  ;)
Title: Re: New dentist asked for a copy of my labs
Post by: Miss Philicia on August 12, 2012, 11:15:30 am
This is the way I look at it: if I was a dentist treating a lot of HIV patients I would also ask for actual labs, for the simple reason that there a lot of HIV patients that are sketchy on such things. I've been in support groups where members can't even fully recount what meds they are on, only the color of the pill. So while I personally can recount my last lab numbers if necessary, I can imagine many can not.
Title: Re: New dentist asked for a copy of my labs
Post by: bocker3 on August 12, 2012, 11:56:08 am
I see nothing nefarious in his request, as others have pointed out, he's a DOCTOR asking you for medical history.  My ID doc sends copies of all my labs to my Primary Care doc, this helps ensure proper care.

What I am missing though, is your jump from being asked for lab report copies AND equating that to not following universal precautions?  Seems like you are looking for some sort of bad behavior that isn't there.

If you like is dental care - stay -- if you don't, find another.

Mike
Title: Re: New dentist asked for a copy of my labs
Post by: onemoretime on August 12, 2012, 04:57:30 pm
agree with ann totally.  I was going to suggest the same thing.  I personally get more upset when people dont know about HIV and viral load or cd4.  so I am happy to help them in any way, to help me.
Title: Re: New dentist asked for a copy of my labs
Post by: Bbnb on August 12, 2012, 06:00:27 pm
Interesting discussion.   

I have always checked HIV/aids on the health info at my dentist. I have never been asked for labs or release information form to get those labs.  it makes sense though to have them in order to give me the best care. 

I have gone to other specialists for various reasons unrelated to HIV and I have never felt mistreated due to my HIV.  They all treat me with the professionalism that is expected. 
Title: Re: New dentist asked for a copy of my labs
Post by: Jeff G on August 12, 2012, 06:35:11 pm
I have been asked this question by all my dentist so I don't find it odd . I'm lucky , my HIV clinic also has a free dental clinic that cleans my teeth every three months . They have also replaced all my crowns at zero cost to me .     
Title: Re: New dentist asked for a copy of my labs
Post by: jkinatl2 on August 12, 2012, 11:53:48 pm
I have been asked this question by all my dentist so I don't find it odd . I'm lucky , my HIV clinic also has a free dental clinic that cleans my teeth every three months . They have also replaced all my crowns at zero cost to me .     

I want to go to your clinic.
Title: Re: New dentist asked for a copy of my labs
Post by: Jeff G on August 13, 2012, 12:03:04 am
I want to go to your clinic.

Its one of the reasons besides family and friends I decided to live here , we really do have a good clinic at UAB . 
Title: Re: New dentist asked for a copy of my labs
Post by: tednlou2 on August 13, 2012, 12:42:00 am
The university dental clinic is the next office down the hall from the HIV clinic office I go to.  They also have a Ryan White dental program free to many patients.  I needed a new dentist, so I just went there.  They can go (and have) next door to get my labs.

I asked why they wanted my current labs--whether it was to have that info in order to be more vigilant for mouth and dental issues possibly caused by HIV.  One dentist said yes, but mainly to know how much risk was involved in the event of an accidental exposure.  He said if the vl was really high, they may defer non-emergency treatment until the vl was lower.  He said if it was high, they couldn't see taking the risk of a possible exposure just for a cavity filling that wasn't even a problem yet.  But, we know they probably treat many patients, who don't know their status.  I'm not sure if they had some standard for what "high" means. 
Title: Re: New dentist asked for a copy of my labs
Post by: madbrain on August 13, 2012, 05:36:52 am
Ann,


1. Maybe this dentist just wants to give you the best care he can possibly give you, and knowing you current labs can help him in that regard.

I agree it's not a bad thing for him to know about my conditions. Detailed lab values seem slightly less important.

Quote
2. Maybe he just likes to have things straight from the lab to eliminate any patient error due to faulty memory or confusion. Maybe he's just anal about his record keeping that way.

I thought "undetectable for years" was rather unequivocal and hard to mistake - if that changed, my doc and myself would be all over it.

Quote
3. Maybe you should cut him some slack because he's trying to do a thorough job and care for your oral health - an area where we pozzies are known to have difficulties.

True.

Quote
4. Maybe you're just horny. ;D

Never was a truer thing said.

Quote
I'd love to have a dentist who paid so much attention to details. Quit being so paranoid! ;)

Thanks for the feedback, I guess I needed the check !
Title: Re: New dentist asked for a copy of my labs
Post by: madbrain on August 13, 2012, 05:38:27 am
My Dentist of 10 yrs. has never ask me for any of this, as he has a lot of HIV+ POZ clients, however, he can call my ID Doc and ask her, he did want all of that info and likes it updated every yr.

You would have to fill out some sort of disclosure form to allow that to happen, though.
Title: Re: New dentist asked for a copy of my labs
Post by: gingin on August 13, 2012, 08:39:25 am
I encountered  a dentist once that asked me how i contracted HIV, needless to say , I will never go back to him.
Title: Re: New dentist asked for a copy of my labs
Post by: wolfter on August 13, 2012, 09:13:02 am
I would never disclose to a dentist about my HIV/AIDS status.  I want subpar treatment. :o

Title: Re: New dentist asked for a copy of my labs
Post by: tednlou2 on August 13, 2012, 02:37:47 pm
I encountered  a dentist once that asked me how i contracted HIV, needless to say , I will never go back to him.

I could see how this could come from a judgmental place, but also just curiosity without thinking how it would come off.  I know I am curious like that.  But, I would only ask someone I knew well enough. 
Title: Re: New dentist asked for a copy of my labs
Post by: gingin on August 13, 2012, 03:28:17 pm
Oh, I answered him!  I said "sex" and said no more!
Title: Re: New dentist asked for a copy of my labs
Post by: LiveWithIt on August 13, 2012, 04:07:17 pm
I would ask why they needed it, and if they got upset at that question I would be pissed.

It's also a bad reflection on the dentist to think they will take more lax precautions if your last viral load test was low.

and people who have not been tested and have high viral loads are given those same lax precautions putting others at possible risk.
Title: Re: New dentist asked for a copy of my labs
Post by: OneTampa on August 13, 2012, 08:04:13 pm
Been with my current dentist over 15 years.  He uses universal precautions and has in my records that I am HIV positive and the meds I take as I update my patient profile form yearly.  I don't recall actually giving him printed lab results though.
Title: Re: New dentist asked for a copy of my labs
Post by: wolfter on August 13, 2012, 08:24:41 pm
Here is an article that written over a decade ago and the information is still relevant and it answers most of the questions and concerns here. 

http://www.cda.org/Library/cda_member/pubs/journal/jour0201/shouldknow.html

Unless people decide that this dentist just has a nefarious streak. 
Title: Re: New dentist asked for a copy of my labs
Post by: Ann on August 14, 2012, 04:06:19 am
There's a dentist in my town who will only schedule someone with hiv for the very last appointment of the day so he can make sure everything is sterilized afterwards - and he also sends his assistant home, saying that he refuses to "expose her to the risk".

I know this guy socially (in fact he's a family friend of my partner's family) and we have gone round and round and round over this issue. He's an otherwise intelligent man and allegedly a good dentist, but he insists that he has to take extra-special precautions when he knows the patient has hiv.

I insist he should be taking the same precautions with anyone. I've repeatedly pointed out to him that he was treating at least four people in our town long before they were actually diagnosed with hiv, and they would have had hiv when he treated them before their diagnosis. (Yep, living in a small town on a small island, you get to know these types of things.)

I can't get through to him that anyone he treats may have hiv, hep C, hep B or whatever and either not tell him, or don't know themselves. His emotions and personal fear of hiv takes over and common sense goes out the window. It's like talking to a brick wall.

Personally, I refuse to go to any dentist (or doctor for that matter) who has this attitude. If they're not practicing universal precautions to the same high standard with each and every patient, I won't use their services. I've gotten rid of hep C once now and I'm not going to take the chance that a dentist may be lax with his precautions because he thinks the patient before me isn't harbouring some blood-borne pathogen. I don't want hep C again - and that's one virus you're much more likely than hiv to pick up in the dentist's chair.

If your dentist insists on only giving you the last appointment of the day, consider it to be a huge red flag and question, question, question! Correctly and stringently applied Universal Precautions negates the need for such a policy. You need to question this practice as a matter of protecting your own health!
Title: Re: New dentist asked for a copy of my labs
Post by: Rockin on August 14, 2012, 09:27:13 am
I can't get through to him that anyone he treats may have hiv, hep C, hep B or whatever and either not tell him, or don't know themselves. His emotions and personal fear of hiv takes over and common sense goes out the window. It's like talking to a brick wall.

Those conversations must have been very frustrating Ann. I get so angry at this. Was he also afraid to make physical contact with you or something?
Title: Re: New dentist asked for a copy of my labs
Post by: RWR on August 14, 2012, 09:54:05 am
I had a dentist in Prescott Arizona that said it was ok. I do not think it was for His assistant She held Her breath so long that She passed out and fell on the drill.Did not see Her anymore. He is good. Never asked for labs.
Title: Re: New dentist asked for a copy of my labs
Post by: Ann on August 15, 2012, 06:49:41 am

Those conversations must have been very frustrating Ann. I get so angry at this. Was he also afraid to make physical contact with you or something?


Yes, very frustrating. My partner is also poz and he and his family have also gone a few rounds with this dentist over it (remember, he's a family friend and also distantly related). They used to have him as their dentist and they've since changed to another practice and they told him why. He just shrugs it off.

In fact, a lot of people here have changed dentists over this issue because they no longer trust that he's diligently applying universal precautions with all his patients. He has other sources of income, so I guess he doesn't really care that his practice has dwindled.

It's ironic when I think about it - I remember during one of our early conversations about his policy for hiv positive patients he said he'd rather he didn't have any hiv positive patients. He was afraid other patients might drop him if they knew he was treating pozzies. Now he's lost patients for the opposite reason. Silly man.

Like I said, he's otherwise a very intelligent man, a great conversationalist and generally a nice bloke with a wicked sense of humour. He's fun to be around - as long as the conversation doesn't drift onto hiv. He's also a semi-closeted gay man (his local nick-name is the Tooth Fairy - and it's a nick-name used with affection, not malice) so maybe that's part of where his irrational fear of hiv comes from, dunno.

I've given him chapter and verse science-wise and I've even given him articles from scientific journals about it. He stubbornly refuses to listen to the science. We've had to agree to disagree and not talk about it anymore. He's not going to change his mind so I don't waste the effort anymore - but I do warn people about his dental practice.

People need to know and he knows I do this and he says "you gotta do what you gotta do". I'm not slandering him - I'm telling the truth and letting people come to their own conclusions about his adherence to universal precautions. Most people are horrified when they find out. I would imagine that deep down, he knows he's in the wrong. He just can't get past his personal, emotional reaction to hiv.

It's odd remaining friends with someone like him, but I guess that's just part of island life. We're always going to run into each other - I see and talk to him probably at least three or four times a month - and it's easier to try to get along. A small part of me hopes he "sees the light" one day, but I'm not holding my breath.

He's not afraid of casual physical contact, he's shaken my hand, kissed me on the cheek and hugged me on several occasions, and he's even taken a sip out of my glass when he wanted to taste my drink. His assholery about hiv only comes out at his dental practice.