AUSTIN (KXAN) – A new report from a forensic dental examiner questions why 14-month-old Daisy Lynn Torres was having a dental procedure before she died, prompting Austin Children’s Dentistry to suspend the child’s dentist.

“One can only speculate as to why any treatment was performed considering no indication of dental disease or pathology was seen in the dental radiographs (x-rays) in the dental visit dated 03/29/2016,” writes Robert Williams, a forensic odontologist.

While the initial x-rays prior to work being done showed no disease, the report does note that x-rays taken after the child’s death indicated four teeth appear to have dental work performed on them. According to the report, the child’s teeth had been prepared to have stainless steel crowns placed on them.

“It is possible that the partially erupted teeth may have had a congenital enamel defect but not necessarily requiring treatment with a child of this age,” the report notes. “No evidence that the child was in any type of pain was ever notated in the dental record and no pulp vitality test was ever performed.”

The toddler’s parents told KXAN News they went in the morning of March 29 for an appointment to fill two cavities. While she was under anesthesia, Dr. Michael Melanson came back out and told Betty Squier her daughter had a total of six cavities they needed to fill.

“They started right away with her and it wasn’t long until they called me back there saying there was complications,” Squier said in March. She was nervous to sedate her daughter for the procedure but thought it was the right choice to deal with the cavities.

The autopsy report, released by the Travis County Medical Examiner’s Office Thursday, ruled that anesthesia caused the little girl’s death. There was an anesthesiologist on-site during Daisy Lynn’s appointment. The report mentioned a difference in opinion between Daisy Lynn’s treating dentist and the forensic dentist and referenced documents, which were not included with the initial release of information to KXAN News Thursday. After KXAN requested the additional records, the Travis County Medical Examiners Office forwarded the new forensic dental report.

The report also states that written records indicate no decay was seen on a dental visit in July of 2015.

Austin Children’s Dentistry released this statement Friday:

Our office continues to be saddened by this tragedy.

We have now received the full medical examiner’s report regarding Daisy Lynn Torres and the death has been classified as “undetermined” due to anesthesia complications administered by a ertified Medical Anesthesiologist and not because of a dental procedure.

However, the report has provided additional details we did not have previously. At this time, we feel that it is prudent to suspend Dr. Melanson indefinitely until the Texas State Board of Dental Examiners has concluded their investigation. We are cooperating with all investigative organizations.

Austin Children’s Dentistry has been providing the highest standard  of care to our patients for over 40 years, and will continue to do so going forward.

We continue to keep the family in our thoughts and prayers during this very difficult time.

Jason Ray, attorney for the treating dentist at Austin Children’s Dentistry, released the following statement Thursday, before the release of the new documents:

“The ME’s report confirms what the dentist has believed all along: Daisy’s death was an anesthesia event, not a dental issue.

The report reveals no surprises to us. By the time the forensic odontologist evaluated Daisy, all evidence of dental disease had already been removed by the dentist, as expected. A treating dentist always has the advantage of pre-treatment visual exams, clinical findings, and x-rays on the patient; as well as knowing the patient’s dental history, unlike a forensic odontologist. The treating dentist in Daisy’s case will present all of the evidence that justified Daisy’s treatment if called on to do so.”

Williams examined x-rays and notes of Daisy Lynn’s treatment from before her death, according to the document obtained by KXAN. Williams also reviewed 31 additional x-rays and three dental pictures from after her death, the record states.

KXAN also reached out to Ray Friday, as well as a spokesperson for Austin Children’s Dentistry, and are awaiting a response to the new details.

Sarah Marshall, a spokesperson for Austin Children’s Dentistry, said Thursday that the office stopped office-based general anesthesia after Daisy Lynn’s death. The practice has not decided whether it will resume offering that kind of sedation.

Who is Dr. Melanson?

He graduated from Brigham Young University and Portland State University. He received his Doctor of Dental Medicine from Oregon Health and Science University in 2009.

He received his license to work in Texas in 2009. He has a clean record with the Texas State Board of Dental Examiners.

He has permits to perform nitrous certification and Anesthesia Level 2.