Decision Report 201300658

Summary

Miss C had root canal treatment on one of her front teeth in 2012. After the treatment, she experienced pain and swelling which did not improve with antibiotics that were prescribed by her dentist. Whilst on holiday, she visited another dentist (the second dentist) who removed the root canal filling and found that she had two perforations in the tooth. He provided a temporary filling so that Miss C could discuss further treatment with her own dentist when she got home. Miss C was later referred for specialist dental surgery so that she did not have to lose the tooth. She complained that her dentist did not carry out the root canal treatment to a reasonable standard and did not provide her with a reasonable level of aftercare.

We found that the tooth had first been root canal treated in 2006, but that this work was not completed. In 2012 Miss C's dentist had removed the original root canal filling and re-filled the tooth. We took independent advice from our dental adviser, who said that Miss C's tooth was filled well and that x-rays taken after the treatment showed no sign of any perforations. The perforations were, however, visible on an x-ray taken by the second dentist, who had used a softer filling material to diagnose the problem. Our adviser explained that the perforations could have been caused either when the first dentist removed the original filling, or when the second dentist removed the first dentist’s filling. Although the infection that Miss C developed was suggestive of a perforation after the first dentist’s treatment, there was no evidence of this on the x-ray. We concluded that there was insufficient evidence to say that Miss C's dentist had caused the perforations. Furthermore, we were satisfied that he took all reasonable measures to establish whether the procedure had been successful, and that he provided appropriate medication and onward referral to a specialist when Miss C had problems following her treatment.