Allergie a la PMMA?

J'ai un problem avec un patient difficile pour l'equel j'ai fait deux appareils proisoire en resin.

(I'm going to write the rest in English if that's ok, as apparently my written French is too awful to understand. Please let me know if anyone objects or if this is against forum rules and please reply in French! Thanks)

So the patient comes back a week later saying she has a burning mouth and a black tongue with the dentures in her pocket.

Right from the start she had great difficulties to accept the dentures and expressed her lack of motivation to make an effort to get used to them. This is only a few days I placed them.

Anyway, on examination she had black, hairy tongue but I couldn't find any gingival inflamation, although obviously she hadn't worn them for a few days.

I suggested she had used the chlorhexidine MW too long after the extractions but she said she'd hardlu used any...

What would you do in this situation? I've a good mind to just give her her money back and take the hit just to have a quiet life although being left with the lab bill pisses me off a bit.

If she really is allergic to PMMA, what are the clinical and financial options? She can't afford implants and fixed prosthetics are not an option.

Thanks for your help.

c'est peut être une candidose buccale ( stomatite et langue noire villeuse)
Traitement à la Fungizone(amphotéricine B)

Thanks for the reply :) I wasn't aware that black tongue was a presenting feature of candiasis.

I will prescribe an antifungal and see what happens.

Otherwise, if she is allergic, what would people do?

Implants

Kon

25/04/2013 à 20h30

mauvaise cuisson de la résine ?

Queixal

25/04/2013 à 20h53

Tout est dans ton message.

"J'ai un problem avec un patient difficile"

she "expressed her lack of motivation to make an effort"

dentist "take the hit just to have a quiet life "


Patient non motivé, dentiste non motivé par la paciente. Arrete tout ça va mal finir.
Tu peux l´envoyer entre temps a l´alergologue faire des tests.

Thanks for the further replies guys.

Queixal, your comments are pretty dismissive and judgemental all of which is superfluous to the discussion.

My comment that the patient "expressed her lack of motivation to make an effort" was factual, not a prejudice.

I am not demotivated by the patient, rather, the patient is unwilling to be motivated. Sometimes in this game you have to know when to say no instead of beating your head against a very hard wall.

I can only imagine that since you allow yourself to so freely judge others from your ivory tower, you own clinical perfomance in the Kingdom of Queixal must be exemplary and entire without fault. Good for you! :)

The allergologue is a good idea however and she does indeed has a referal.

She also now has a prescription for an antifungal.


Queixal écrivait:
-----------------
> Tout est dans ton message.
>
> "J'ai un problem avec un patient difficile"
>
> she "expressed her lack of motivation to make an effort"
>
> dentist "take the hit just to have a quiet life "
>
>
> Patient non motivé, dentiste non motivé par la paciente. Arrete tout ça va mal
> finir.
> Tu peux l´envoyer entre temps a l´alergologue faire des tests.

tarin

26/04/2013 à 18h09

Kon écrivait:
-------------
> mauvaise cuisson de la résine ?

oui, avec une polymérisation incomplète on a du monomer irritant. il faudrait essayer de revetir les prothèses avec du Fitt pendant quelques jours pour isoler la muqueuse .

Queixal

26/04/2013 à 18h12

I do not understand your anger. I apologize if I offended you. End of discussion.

Modérateur écrivait:
--------------------
> be quiet please

Not sure who that was aimed at or if you modified someone's post.

I hope there is no problem with my post or the English, do please let me know if there is.

Queixal écrivait:
-----------------
> I do not understand your anger. I apologize if I offended you. End of
> discussion.

No need to apologise Queixal and no anger at all on my part, I'm not here to argue with anyone, this forum is way too useful for that! I just found your post a bit critical that's all. Didn't you notice my smiley ":)" and irony? :D

@Kon, not a bad idea to put Fitt on the fitting surface but if she's really allergic to PMMA don't you think that the saliva/tongue contact with the rest will give her symptoms anyway?

I'll maybe give it a try, thanks.

Pourrait le moderateur qui a dit "be quiet please" reponde SVP (en MP si vous preferez) pour me dire si c'est moi qui est le cible de son commentaire et si oui, pourquoi?

J'ai un autre question a poser mais je veut embetter personne, ni avec mon mauvais Francais ni avec l'Anglais si ca vous ennuie.

Merci

Le Rosbif :)

riccyman

29/04/2013 à 18h44

Hey Driller.

You don't bother anybody here.

Happy you're still around.

I didn't understand the "be quiet" commentary neither.

Ask your question.

riccyman écrivait:
------------------
> Hey Driller.
>
> You don't bother anybody here.
>
> Happy you're still around.
>
> I didn't understand the "be quiet" commentary neither.
>
> Ask your question.

Merci pour ton comentaire Riccyman, j'aurait voulu avoir l'explication du Moderateur en question comme je ne veut surtout pas embeter le dirigens ici.

Peutetre c'est parceque je suis Anglais. Peutetre je devrais changer mon nom a Rosbif pour avertir les gens ;) (please notice the smiley!).

Bon, je vais demander mon question dans un autre poste.

Merci

The patient came in again today, complaining again that she has a black tongue.

It seems to be slightly brown coloured but she insists that it is the dentures that make her tongue go this colour.

There is no reddening of her gums under the dentures so for me this is not an allergy.

Any idea if the dark tongue could be due to the resin in the dentures?

Probably her mouth wash. Tell her to stop.

Yeah that's what I wondered. I'll speak to her about it.