In late June, Allergic Living reported that the non-profit Allergy & Anaphylaxis Australia was warning that a 12-year-old with a milk allergy had suffered a severe allergic reaction at a dentist appointment.
Allergic Living has now heard from Chantelle Parry of Sydney, Australia, the mother of the girl who had the reaction.
Chantelle relates how her daughter Tahlia’s allergic reaction came about as the result of a dental staff communication mix-up. As she realized her daughter’s reaction was serious, Chantelle moved swiftly to administer the girl’s epinephrine auto-injector.
The “tooth mousse” used in the girl’s dental treatment is called GC Tooth Mousse Plus. It contains the ingredient Recaldent, which is made from milk protein.
Allergic Living shares the following interview with Chantelle Parry to inform other food allergy families and dentists of the need for communication vigilance at the dental office.
When did you realize your daughter was beginning to have an allergic reaction?
Chantelle Parry: “Within seconds of them applying the tooth mousse, Tahlia said, ‘Mum, I am having a reaction.’ She said her throat felt funny.”
When did you give the auto-injector?
CP: “As soon as she said this, I asked her to sit up, and said, ‘I will give you an antihistamine.’ When she said she couldn’t swallow it, I got the EpiPen out and administered it immediately.”
Had the dental office consulted your daughter’s chart about medical history and allergies?
CP: “This was our first visit to this dental practice. Upon arriving we completed Tahlia’s medical history and I recorded her [previous] anaphylaxis on the form. When we walked into the room for treatment, before commencing, I discussed her allergies again, and was assured everything they use is safe for her.”
When was it realized there was milk protein in the tooth mousse?
CP: “The dentist said Tahlia must have a latex allergy, as there was no milk, egg or peanut [Tahlia’s allergens] in the products that she used. I disagreed and said, ‘No, she only has the allergies we had discussed.’ I got the receptionist to call an ambulance.”
A few minutes after the dentist said the products were safe, “she pulled the dental assistant aside for a quiet chat in the hallway. She emerged to advise that the assistant had given Tahlia regular tooth mouse. The dentist apologized and said that although the assistant was in the room while we discussed the allergies, she had not used the milk-free alternative.”
“The dentist said she should have given clear instructions to her assistant, since she was a new employee.”
Did your daughter recover quickly? How is she doing now?
CP: “Tahlia is doing well now, although it was a scary ordeal. This was the first time she had been given an auto-injector – her previous anaphylaxis was treated in hospital, where doctors used an adrenaline injection/mask.”
“This has given Tahlia confidence that she could administer it herself if needed. She was surprised how quickly she felt better after having the EpiPen.”
What advice would you have for other parents of children with food allergies about going to the dentist?
CP: “I would advise others that it is not enough to discuss the allergies just with the dentist, but to ensure everyone who will be treating your child is present in the room and acknowledges the allergies.”
– In April 2019, an 11-year-old California girl, Denise Saldate, died from a sudden anaphylactic reaction, right after brushing her teeth with a medicated toothpaste. The toothpaste, meant to strengthen enamel, contained Recaldent.
– Following Denise’s tragedy, the American Academy of Allergy, Asthma and Immunology published an article explaining that ingestion of an allergen can sometimes occur through mucosal membranes, such as those in the mouth. The article notes that latex and gelatin allergies can also present issues at the dentist, and emphasizes that patients and families “need to inform medical and dental providers about their food and other allergies.”
– In June 2019, Allergy & Anaphylaxis Australia wrote an article for the Australian Dental Association, linked here. The article references Tahlia’s case and relates that “it is critical that dentists keep accurate and current medical histories for each patient.”
– A Canadian dentist’s how-to blog post about visiting the dentist with allergies.