Decision report 201104653

Summary

Mrs C cancelled an appointment for a scale and polish (dental cleaning) and x-rays that her dentist had advised her to have. The dentist wrote to her explaining why he recommended the treatment. He said that she had excess tartar (dental plaque) accumulation and that x-rays of her back teeth would help determine if there were underlying problems. He also said that in most cases where patients suffer from sensitive teeth, he uses a local anaesthetic, which helps to decrease sensitivity during cleaning. He acknowledged that a patient can choose whether to continue with treatment but went on to say that if she did not have it, her teeth would require extensive scaling which might cost more. Without x-rays, he also could not guarantee that there were no undiagnosed areas of decay etc. When Mrs C attended an appointment with the dentist some eight months after the cancelled appointment, she asked for a standard clean and polish with no anaesthetic. She said that the dentist refused to treat her and when she asked to speak to the practice manager she was told to put her complaint in writing. She was removed from the dentist's practice list and not allowed to transfer to another dentist within the practice.

Mrs C was concerned about the insistence of using anaesthetic to proceed with the clean and polish and failure to provide an adequate explanation regarding why anaesthetic was required. Mrs C was also concerned about the dentist's attitude, saying he was condescending and unprofessional. She was unhappy at being removed from his list and not being allowed to transfer to another dentist within the practice. In relation to the complaints handling, Mrs C complained that she could not speak to the practice manager and that there was no attempt at informal resolution, that the dentist's response failed to answer some of her points and that the matter was investigated and responded to by the person she was complaining about. As a result, she said that she suffered anguish and upset and that she was left without NHS dental provision when she lost half a tooth which had previously been treated by the dentist.

We accepted the independent advice of one of our medical advisers that the use of anaesthetic in these circumstances is reasonable and that the dentist provided a reasonable explanation about this. We did not find evidence to support Mrs C's complaint about the dentist's attitude and we found that her removal from the list and not transferring her to another dentist in the practice to be reasonable. On complaints handling, we found that arrangements should have been made for Mrs C to talk to the practice manager but that on the whole the complaint was handled properly - Mrs C's complaint was fully considered and addressed, and she received a written response to her complaint from the dentist.