Pain Killer Problems

A 19-year-old male presents as an emergency in the office of his parents' dentist, a general practitioner. He had never been seen by the dentist before. The nature of the emergency was severe pain, lower right mandible. A health history showed no significant findings. On clinical examination, deep occlusal caries was noted, right first molar (#30). A periapical x-ray was taken. Caries extended into the pulp and a periapical lesion could be demonstrated. The patient was assured that pain could be relieved by removal of the tooth and a routine extraction was performed. The patient was given prescriptions for antibiotics and an analgesic requiring a triplicate form and reappointed for a one week follow-up appointment.

Two days later, the patient called complaining of severe pain in the same area. He was offered an appointment that day but said he could not get off work and asked for a renewal of the pain medication which was granted. He was given an appointment for the following day. He did not show up for the scheduled appointment. The following week, the patient called again reporting severe pain and requesting additional pain medication. The dentist refused to renew the prescription, and offered to see the patient that day but the patient refused, becoming agitated at the dentist's refusal to prescribe. The dentist then called the parents of the patient to inform them of the events in the case and his suspicions of drug abuse. He then indicated that he would no longer treat the patient.