Disturbing - gentledentaloffice.co.uk

[letsconnect]

The award for "most unethical dental phobia site" must surely go to http:// gentledentaloffice.co.uk/en/ (I don't want to make this a live link, so please copy and paste into browser and remove the spaces after http://). Some of the nuggets on offer:


"Is professional assistance absolutely necessary?
Since the year 2000, we have observed that virtually all our patients have a malocclusion. This normally occurs in one in every ten patients. Malocclusion is a problem that individuals can't solve on their own. Perhaps this explains why a lot of our patients say: "I've brought four children into the world, I run a company, I can solve all the problems - the only snag is this dental phobia. It's getting worse." This observation indicates that not only negative experiences are playing a role. If malocclusion really does play a central role in dental phobia, then patients certainly won't be able to rid themselves of their dental phobia without the assistance of a malocclusion specialist. This is a challenge to scientific research. "

"Special anaesthesia procedure:
(ANAESTHESIA TECHNIQUE WITHOUT LOCAL ANAESTHETIC - Intubation anaesthesia without local dental anaesthetic)
a special anaesthetic procedure involving intubation anaesthesia has been developed over the years in the process of carrying out thousands of extensive dental treatments. It is possible to predict that patients will not suffer from pain or swelling - even if a great deal of treatment has to be carried out under anaesthesia. Under normal circumstances the opposite would be expected. This is a challenge to scientific research."

"Alternative Methods:
hypnosis is not appropriate for dental phobic patients because they cannot deliver the appropriate level of cooperation during dental treatment.
* Hypnosis
Hypnosis depends on the ability to cooperate. Dental phobic patients get into a panic state at the dentist and they are not therefore willing to cooperate.
* Analgesia and sedation
Analgesia and sedation are not suitable for protracted and demanding dental treatments. The swallowing reflexes are reduced and increase the risk of swallowing items or even getting them in the lungs. Conscientious dentists always use an anaesthetist. Conscientious anaesthetists always prepare analgesia and sedation as they would intubation anaesthesia."


"My body reacts to fear of dentists with:

Physical tension yes no
Shaking yes no
Feeling sick yes no
Sweating yes no
Palpitations yes no
Nausea yes no
Shortness of breath yes no
Pains in your chest yes no
Feeling of suffocation yes no
Fear of losing control     yes no

If you have ticked 2 - 3 boxes, your capacity for cooperation is very often extremely restricted. Cooperation with a dentist is virtually impossible at this stage. However, treatment at a dentist requires cooperation and this means that as far as a dental phobic patient is concerned, any treatment will probably need to be carried out using anaesthesia. " (this refers to general anaesthesia).



I'm wondering is this not only unethical, but perhaps illegal? This "group" is loosely scattered across Europe... but the website is extremely vague on that score.

[toothlessish]

I contacted these people........see I'm desperate but the fact they only offered aneasthetic put me off.

Another good one was the London office of a practice specialising in treating phobic patients, I wrote them a message explaining my situation and how unhappy I am this is the reply I got:
Hi There ****
Thank you for your email.
Unfortunately I do not know of anyone.
Yes in London we can provide ou with services at our clinic, called ***** clinic tel ************.
Regaards
Dr *******

Didn't really fill me with confidence

[letsconnect]

Interesting. No, not exactly confidence-inspiring.

Actually, I did come across gentledentaloffice (hard to miss, they must be bidding loads on AdWords) in my dental phobia days, and believed their clap-trap. Sad, but true. Needless to say, I was in tears for days afterwards...


One would like to think that commercial websites offering medical services are subject to truth in advertising laws, but maybe they're not. Pretty scary.

[letsconnect]

Hmm, apparently it's not ILlegal. Truth in advertising laws are specific to some US states (esp. California), but do not apply elsewhere. This might fall under the realm of advertising law. Again not applicable, cos it's a website.
In the case of a website, the info provided could possibly be subject to advertising standards and governing medical authorities in the given country. Problem is, this website isn't country-specific. The "Gentle Dental Office Group" are not saying under which legal juristiction they're operating. The website is very vague on that score, and the "country contacts" may be agents who then refer the client to another country.

In other words, it's a case of "buyer beware". Unethical (preying on the vulnerable) but not illegal. Unless someone with more detailed legal knowledge knows more?

[letsconnect]

Hah, I love it -

"Disclaimer

1. Content
The author reserves the right not to be responsible for the topicality, correctness, completeness or quality of the information provided."

I can see why...

Fair enough, Dental Fear Central has similar disclaimers, the crucial difference is that no medical services are on offer. Different ballgame.

[letsconnect]

Guest-toothlessish said:

I contacted these people........see I'm desperate but the fact they only offered aneasthetic put me off.

I'm curious - did you contact their London office? What did they say? Did they provide any details about the dentists working there (e. g. names, nationality)? Did they offer any other options apart from general anaesthesia?
I'd be very keen to find out more!

[toothlessish]

I emailed them filled in their 'questionaire' and wrote a message explaining my problems etc I think I followed a link for france on their website this was the reply I got:
if you want to read it

Dental anaesthesia specialists for patients with dental fright -
Europe-wide:

GentleDentalOffice® DentalPractices
GentleDentalOffice® DentalClinics

for the
ThreeAppointmentTherapy

Careful, gentle and very successful

______________________________________________________


Every tenth(!) person suffers(!) from extreme(!) fright of dental treatment.

(Information from the Institute of German Dentists/IDZ, German Association
for Dentistry and Orthodontics - DGZMK).


Extreme fright of dental treatment is (contrary to the normal fear of
dentists) a disease.

The World Health Organisation (WHO) defines it as

ICD-10, F 40.2
"specific, isolated phobia about dentist appointments"

Throughout Europe, dentists are not trained for fear of dental treatment,
much less for ICD-10, F 40.2. Usually, treating such patients overtaxes them
both technically and organisationally as well as humanly. They hardly have
any experience with such patients since, in most cases, the more this fear
rules their lives the less frequently patients go to the dentist.

Unfortunately, flyers, home pages, and advertisement of many a practice
often feign corresponding competence.

Many advertise by saying that an almost pain-free therapy was natural thanks
to state-of-the-art instruments and narcotics.

The experience of dentistry phobia patients, however, is quite contrary.
Most of them finish up in this blind alley due to unprofessionalism.

Naturally, patients with extreme fright desire specialist dental treatment.
They want perfect teeth, healthy gums - a higher quality of life, success in
their professional and personal lives.

Dr. Michael Leu (Munich) has treated more than 4,000 special dental patients
under anaesthetic. As a result, anaesthetic has proven to be very helpful.
However, anaesthetic really cannot explain why a large majority of patients
are almost instantly healed from ICD-10, F 40.2 and turn out to be regular
dental patients.

After years of working intensively with the specific problems of very many
dentistry phobia patients, we discovered many peculiarities, such as:

ICD-10, F 40.2 patients obviously have a common, hitherto unknown problem.

Malocclusion

Normally, a pronounced malocclusion does occur rather seldom.
It results from more or less obvious irregularities that occur in the
process of growing up.
Almost all of our ICD-10, F 40.2-patients had massive malocclusion problems
prior to treatment.
Hence, a correlation between dentist fright and malocclusion was suspected.
In any case, the phobia disappears almost every time the problem with
malocclusion is taken out of the way during treatment under anaesthetic.
If at all, dentists only marginally touch treatment under anaesthetic or
malocclusion.

Résumé:<br>Thus, ICD-10, F 40.2 definitely calls for a specialist.
According to our research and that of numerous media, throughout Europe,
such specialists are only to be found in the GentleDentalOffice®-Group. As
far as we know, there are only 2 or 3 other dentists who are practising in
this area in Germany. Due to the fact that there is no respective
organisation, the ThreeAppointmentTherapy cannot be offered there.

Since malocclusion is purely a special dental problem, logically, it cannot
be recognised or treated by psychotherapists.
Naturally, malocclusion cannot be influenced through anaesthetic.
Hence, treatment under anaesthetic is not suited to set ICD-10, F
40.2-patients free.
We have incorporated all of these considerations into a new way of
treatment:

ThreeAppointmentTherapy

This means:
We treat patients with extreme dental fright under general anaesthetic
according to malocclusion criteria.
As early as at the third appointment, patients no longer suffer from extreme
dentist fright and their dental treatment is already finished.

Exceptions are very, very rare.

One of our patients said in an interview with the Frankfurter Rundschau how
one feels before the third appointment - after having been treated under
anaesthetic:

"I did not panic, I was not even afraid. I could easily bear it. Where was
that gigantic wall in my head? It was simply gone!"

An especially gentle anaesthesia method, which we discovered, is really
helpful. It is called

OLA-ITN-technique.

This means that state-of-the-art anaesthesia methods are carried out without
local anaesthesia. Afterwards, patients almost never suffer from pain or
swellings which would have to be expected normally after they have been
treated for hours.


Résumé:<br>The ThreeAppointmentTherapy is quite different from the SalamiTacticTherapy
with which dentists promise that they can treat dental fright patients.

We have established the ThreeAppointmentTherapy Europe-wide in Gentle Dental
Office® Dental Practices and Clinics.

Make use of this enormous advantage in experiences for yourselves.
You will achieve highly professional and high-quality treatment results even
in extremely difficult cases.


. FIRST APPOINTMENT
Everything that could trigger fright is being avoided. Everybody can be
sure that they will not be abused, humiliated, rebuked, or even offended.
Duration: about 1 hour.

. SECOND APPOINTMENT
Pain-free out-patient treatment under full anaesthetic based on knowledge
gained from our experience with approx. 4,000 problematic dental patients.
Duration: about 6 hours.

. THIRD APPOINTMENT
The treatment is finished.
Duration: about 1 hour.





We enjoy helping you:


www.gentledentaloffice.co.uk
www.zahnarztangst.de
www.GentleDentalOffice.de

E-Mail: [e-mail]
E-Mail: [e-mail]


Phone: [phone]



Gentle Dental Office® Dental Practices
Gentle Dental Office® DentalClinics


Munich-Berlin-Hamburg-Cologne-Frankfurt-Vienna-Rome-London-Barcelona-Brussel
s-Sheffield-Birmingham
Zurich-Istanbul


Office München:
Gentle Dental Office Group
Ludwig - Thoma - Str. 9
82031 Grünwald

Praxis München:
Residenzstrasse 15
80333 München

Fax. [phone]
Tele. 0049 89 649 10 760
Mobil. 0049 170 730 60 14

Mail. [e-mail]
[e-mail]

HP. www.zahnarztangst.de


-----Ursprüngliche Nachricht-----
Von: Dr. med dent. Michael Leu [mailto:[e-mail]]
Gesendet: Montag, 15. November 2004 10:25
An: Sabine Dettmann
Betreff: WG: Kontaktformular Zahnarztangst.de



-----Ursprüngliche Nachricht-----
Von: [e-mail] [mailto:[e-mail]]
Gesendet: Donnerstag, 11. November 2004 14:55
An: [e-mail]
Betreff: Kontaktformular Zahnarztangst.de

[letsconnect]

"SalamiTacticTherapy" ??

Priceless ;D!!

Well, they may yet choke on their own salami... I'm dying to find out if they're using a loophole, or if this is illegal... this is one cool story!

[letsconnect]

Mysteriouser and mysteriouser...

[letsconnect]

Some background reading:

www.rcoa.ac.uk/docs/dental.pdf

www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolicyAndGuidance/PublicationsPolicyAndGuidanceArticle/fs/en?CONTENT_ID=4074702&chk=x3FvZn


That's not even touching the false claims being made.

[letsconnect]

Some more background reading: "Maintaining Standards", General Dental Council, November 1997 (go to www.gdc-uk.org/publications.html#ms for pdf download):

GENERAL ANAESTHESIA
RISKS OF GENERAL ANAESTHESIA
4.17 General anaesthesia is a procedure which is never without risk. In assessing the needs of an individual patient, due regard should be given to all aspects of behavioural management and anxiety control before deciding to treat or refer for treatment under general anaesthesia.
General anaesthesia for dental treatment should only be administered
in a hospital setting with critical care facilities.39
All dentists involved in arranging or providing treatment under general
anaesthesia should discuss with the patient advice and treatment
options to avoid or reduce future episodes of general anaesthesia.
A dentist who refers a patient for treatment or carries out treatment on a patient under general anaesthesia without ensuring that the relevant conditions set out below are met is liable to a charge of serious professional misconduct.

DUTIES OF THE REFERRING DENTIST
DECISION TO REFER
4.18 The decision to refer a patient for treatment under general anaesthesia should not be taken lightly. As part of this decision, a full medical history of the patient must be taken and agreement to refer obtained following a thorough and clear explanation of the risks involved and the alternative methods of pain control available. Clear justification for the use of general anaesthesia, together with details of the relevant medical and dental histories of the patient, must be contained in the referral letter. The referring dentist must retain a copy of this letter. See also 3.3

DUTIES OF THE TREATING DENTIST

DECISION TO TREAT
4.19 The decision to treat a patient under general anaesthesia should not be taken lightly. As part of this decision the treating dentist must satisfy him or herself that it is necessary and appropriate to carry out the proposed treatment under general anaesthesia. Before carrying out treatment under general anaesthesia the patient must be given a thorough and clear explanation of the risks involved and the alternative methods of pain control available. See also 3.4

CONSENT
4.20 When the decision to carry out treatment under general anaesthesia has been finally agreed by the patient, dentist and anaesthetist, written consent must be obtained. See also 3.7

INSTRUCTIONS AND RECORDS
4.21 In advance of the procedure patients must be given clear and
comprehensive pre- and post-operative instructions in writing. Careful
contemporaneous records must be kept of all the procedures
undertaken. See also 4.3

RESPONSIBILITIES OF THOSE PROVIDING DENTAL TREATMENT UNDER
GENERAL ANAESTHESIA38,13
4.22 Dentists with responsibilities for the provision of dental treatment under
general anaesthesia must:
(i) ensure that the facilities and arrangements (including location) for the general anaesthesia meet contemporary requirements.39,40
(ii) ensure that they have the assistance of an appropriately trained dental nurse. See also 3.8
(iii) ensure that the general anaesthetic is administered by an individual who:
a) is on the specialist register of the General Medical Council as an
anaesthetist. Such specialists are advised to comply with the
voluntary Continuing Medical Education requirements of the Royal
College of Anaesthetists,
or
b) is a trainee working under supervision as part of a Royal College of
Anaesthetists' approved training programme,
or
c) is a non-consultant career grade anaesthetist with an NHS
appointment, for example staff grade or associate specialist, working
under the supervision of a named consultant anaesthetist who must
be a member of the NHS anaesthetic department where the nonconsultant career grade anaesthetist is employed.
d) is supported by an individual specifically trained and experienced in
the necessary skills to assist in monitoring the patient's condition and
in any emergency. Contemporary standards of monitoring should be
adopted; the current Recommendations for Standards of Monitoring
During Anaesthesia and Recovery issued by the Association of
Anaesthetists of Great Britain and Ireland are appropriate.

(iv) be satisfied that there is a written protocol, arranged in conjunction with, and agreed by the anaesthetist, for the provision for immediate critical care. In this connection the current guidelines issued by the Resuscitation Council (UK) are appropriate. The protocol must include appropriate arrangements for the supervised transfer of a patient to a high dependency unit (HDU) or intensive care unit (ICU), which may be on a separate site. Such arrangements must be agreed between the parties providing the treatment and the HDU and ICU.

RECOVERY AND DISCHARGE
4.23 Patients who are recovering from general anaesthesia must be
appropriately protected and monitored continuously in adequate
recovery facilities. Monitoring must be undertaken by the anaesthetist
or a dedicated individual who is appropriately trained and directly
responsible to the anaesthetist. When, in the opinion of the
anaesthetist, the patient is sufficiently recovered to leave the premises, the patient must be accompanied by a responsible adult.
All patients must be assessed specifically for fitness for discharge and
must be given post-operative advice specific to the individual regarding after care arrangements. See also 3.8

TRAINING 13
4.24 All those involved in the provision of general anaesthesia or the
supervision of patients during recovery must train together as a team to deal with an emergency. Resuscitation procedures must be practised frequently in a simulated emergency as a routine training exercise.
Current guidelines such as those issued by the Resuscitation Council (UK) should be adopted.

[letsconnect]

Guest-toothlessish said:

Another good one was the London office of a practice specialising in treating phobic patients, I wrote them a message explaining my situation and how unhappy I am this is the reply I got:
Hi There ****
Thank you for your email.
Unfortunately I do not know of anyone.
Yes in London we can provide ou with services at our clinic, called ***** clinic tel ************.
Regaards
Dr *******

Didn't really fill me with confidence

Was that www.douglasmiller.co.uk, by any chance? I'm just wondering because he did get a smile award on Beyond Fear, and now a dentist in London has mentioned to me that he'd highly recommend him. But I'm a little disturbed by the way certain technologies are touted on the website. Like the misrepresentation of the uses of Emdogain. Or using acupuncture to treat gagging (the relevant literature has come to the conclusion that it's not particularly effective, as far as I can see). Also, the way the e-mail you got was worded doesn't strike me as particularly personable. If it's indeed the same guy. Just wondering because the website was mentioned in another thread. Though douglasmiller.co.uk refers to "practice" rather than "clinic", so it's probably a different site.
Anyway, if anyone has tried Dr Miller and would like to recommend him, please do so!

[toothlessish]

nope wasn't him, but I've read his site. Twas a woman and the lack of personal contact was the thing I found most depressing didn't make me feel like putting my scardyness in her hands

[letsconnect]

Thanks for the clarification !! I just wasn't too sure.
Actually, he comes highly recommended

[letsconnect]

Here's how gentledentaloffice.co.uk bypass the General Dental Council's guidelines: they ship over a dentist from Germany for the day and hire a treatment room in a London practice, where they can also take x-rays. They then ship you over to Germany (Berlin, to be precise - which apparently makes for a great break ). I've read elsewhere that it's a rip-off, with treatment costs being a lot higher than would be standard in Germany. You're then shipped back (or rather, you have to ship yourself back) to London, where the rest of the work is completed (again, by a visiting dentist who doesn't have to abide by GDC rules). No questions asked. All you have to say, "I'm scared about dentists", and they'll try and convince you you definitely need general anaesthesia.

It's almost impossible to take any action for misleading advertising and false claims (and I've never seen that amount of claptrap on one website) - they did a good job on the evading jurisdiction front (I did report them to Google AdWords, though). Just be aware - it's a case of caveat emptor.

[letsconnect]

The ad is still running - under the title "Extreme dental phobia?" in the Google ads on the top of this site. So, if you happen to disagree with their practices, feel free to click on them as often as you like... considering they're operating in a legal twilight zone...