Decision report 201200268

Summary

Mr C complained about the care and treatment received from his dentist, including that: a root canal treatment was not completed properly; despite requesting a white filling the filling provided was grey; the dentist allowed bleach from a syringe to spill on to Mr C's suit and allowed the syringe to fall on to Mr C's thigh.

We upheld Mr C's complaint. Our investigation, which included taking independent dental advice, found that the root canal treatment (a deep filling of the root of a tooth) was not completed properly. Our adviser said that the dentist should have used a rubber dam, which would have protected Mr C's gums from the hypochlorite (bleach) used during the treatment. The adviser was also of the opinion that, although the end result could be deemed acceptable, the root filling was slightly short of the tip of the root canal. She was also concerned at the lack of detail in the dental notes, including a failure to document the working lengths of the canals or what substance was used to wash them out.

On the matter of the type of filling used, the adviser stated that it would be normal practice within the NHS to use an amalgam (grey or silver) filling. She said that white fillings can be provided but that this would be on a private basis. The adviser also commented that it is considered best practice to restore a root filled tooth with a crown (a metal and/or porcelain restoration made in a laboratory which covers the tooth) and that all the various options should have been discussed with Mr C. However, we found no evidence that this was done. Overall, the dental adviser was concerned that the standard of the records did not conform to that expected by the General Dental Council or the Faculty of General Dental Practice (UK).

On the matter of the incident with the syringe, the dentist acknowledged that this had happened but he could not at the time of the investigation, some two years after the incident, recall exactly what had happened. He acknowledged that the bleach had damaged Mr C's trousers, and that Mr C had complained about it. The dentist said that he apologised to Mr C at the time and offered a compensatory payment, which Mr C accepted. In the circumstances, we took no further action on this element of the complaint.

Recommendations

We recommended that the dentist:

• reviews his practice in carrying out root canal treatments with particular regard to the use of rubber dams - this to be discussed at his next annual appraisal;
• reviews the standard of his record-keeping with particular regard to the level of detail of the treatments undertaken and discussions on treatment options and consent - this to be discussed at his next annual appraisal; and
• issues a written apology for the failings identified.