Anti thumb-sucking device almost kills North Bay boy

A North Bay, Ont., dentist has been handed a warning after a four-year-old patient nearly died.

The Health Professions Appeal and Review Board's decision does not name the dentist. 

"Dr. H," as he's referred to, was standing in for a colleague on leave when he saw the boy in August 2012.

The child came to the office with his mother, who reported that her son had a thumb-sucking problem.

After discussing it with the boy's mother, Dr. H decided to affix an anti-thumb-sucking device into the top of the child's mouth.

A version of the device is known as a "hay rake"  — a spiky, pronged device that makes thumb-sucking unpleasant.

The report from the board doesn't specify what kind of anti thumb-sucking device was used in this case.

According to the report, a dental hygienist installed the device on Sept. 18. The dentist then "reviewed intraoral photographs of the patient's mouth and the placement of the appliance" before he signed off on the work.

But the next day, the boy was brought back into the office with problems. His sister reportedly said he hadn't been eating or drinking since the procedure was done, and had been drooling. 

The hygienist saw the child, and noted the boy was "wan and lethargic, but did not appear to be in physical or mental distress, and was coherent and communicative."

The hygienist said, at that point, she called the child's father, but was subsequently told not to take out the device.

Turn for the worse

According to the report, at 3 a.m. the next morning — less than two days after the device was put in — the boy was taken to the emergency room at the North Bay Regional Health Centre.

According to hospital staff, "the patient was significantly dehydrated ... and [in an] altered mental state. The patient required intravenous resuscitation for failure to thrive."

The hospital report says the boy had not been eating or drinking, had not been sleeping and had been throwing up.

The dentist and hygienist said they were told nothing about the lack of sleep or vomiting.  

According to the report, "special arrangements were made ... so that [the hygienist] could attend [the hospital] and remove the appliance from the patient's mouth, which she did in the early afternoon [of the same day]." 

The boy was released from hospital two days later.

The dentist has been cautioned against giving too much responsibility to his hygienist, and about using such thumb-sucking devices on kids who may be too young.

The committee also warned "not to allow pressure from patients or their caregivers to dictate his treatment decisions."

Read the report here.