Decision Report 201300492

Summary

Mr C complained that his front tooth had been extracted unnecessarily and that his dentist had refused to provide him with the type of bridge work to replace it that he wanted. This was on the grounds that Mr C's oral hygiene was too poor to allow it to be carried out successfully, which Mr C disputed.

We took independent advice from a dental adviser. He advised that the x-ray of Mr C's tooth did not show a clinical need for removal. He said that the x-ray did not differ substantially from an x-ray taken a year earlier, and this showed there had been little change in the prognosis for the tooth. The adviser said the tooth should have been allowed to remain in place and then monitored for any further deterioration.

The adviser also noted that Mr C had, following a change of dental practice, been provided with the bridgework treatment he wanted. The adviser said that the clinical notes did not support the refusal to provide the type of bridgework Mr C requested, as the gum disease he had would have benefited from this type of treatment. He also said that the new dentist's decision to provide this treatment suggested that Mr C's gum disease should not have prevented the treatment being carried out.

We accepted this advice and found that Mr C had had his tooth extracted unnecessarily and should not have been refused the type of bridgework he requested to replace it.

Recommendations

We recommended that the dentist:

• issue an apology in writing to Mr C for the failings identified in our investigation;
• refund Mr C the cost of the extraction and the cost of the bridgework carried out by his new dentist as a consequence of the unnecessary tooth extraction;
• provide us with an undertaking that he will address the concerns raised in this complaint through his continuing professional development (including consideration of whether it would be appropriate to undergo refresher radiography training); and
• confirm that he will ensure that patients are informed of any conditions that may impact on their treatment and that these discussions are recorded in the patient's records.