Decision Report 201301692

Summary

Ms C complained that the care and treatment she received from her dentist on two occasions was unreasonable, both when a temporary filling was inserted into a tooth in her lower jaw, and when she attended a week later for a permanent filling. Ms C said that from the time the temporary filling was applied she felt sick and had a bad taste in her mouth. She also said that part of it broke off, and she swallowed it, after which she also experienced stomach problems. When she went for the permanent filling, she said the dentist injected a local anaesthetic but then did not wait long enough before starting to work on her tooth. When she complained of pain, the dentist injected her again, leaving her face temporarily paralysed on one side, so that she could not close her eye.

Our investigation included taking independent advice from one of our dental advisers, who said that the material (Cavit G) was widely used for temporary fillings, and was approved by the relevant regulatory authorities as being safe for use. The adviser said that it was reasonable and appropriate for the dentist to use this in Ms C's case, but that, very rarely, a few patients report similar side effects to those Ms C experienced. The adviser was unable to say whether Cavit G was the direct cause of these in Ms C's case, and noted that the dentist had provided Ms C with a list of its ingredients to take to her GP if the symptoms continued.

In terms of what happened with the permanent filling, the adviser explained that local anaesthetic in the lower jaw has to be placed close to the facial nerve and usually takes between two and four minutes to work. However, as the dentist cannot see the facial nerve, and each patient's physiology is different, the placing of the injection can only be an educated guess. This can sometimes mean that a second injection is needed in a slightly different place, which can have the effect of temporarily paralysing the facial nerve. The adviser found no evidence that the dentist's treatment had been unreasonable, and noted that they had offered Ms C an eye patch that day to cover her eye, and had phoned the next day to ensure she had recovered. The notes said that Ms C had told them she was fine, and that the paralysis had worn off by the time she arrived home on the day of the appointment.