Decision Report 201305432

Summary

Mrs C attended the practice for a routine check-up, and returned several days later for treatment to fill a small hole in her upper left molar. Mrs C assumed that the person who carried out the procedure was a dentist, although they were actually a dental therapist. That evening, the side of Mrs C's face became extremely swollen and next day she had a large area of bruising and was in pain. The following week, an x-ray showed that there was an infection in the tooth, and the practice prescribed a course of antibiotics. The pain settled four days later, and the bruising took another four days to disappear. Mrs C said that a dentist at the practice told her that it had been a very deep filling, which had possibly damaged the nerve, and he would have to remove the crown to treat it. Mrs C was concerned when she saw the extent of the planned work, and that it would cost over £400 to restore the appearance of her tooth.

We took independent advice on this complaint from one of our advisers, who is a dentist. The adviser said that it was reasonable not to carry out an x-ray before the procedure, but that there were communication failures. There was no evidence that Mrs C's consent was obtained in relation to the status of the healthcare professional carrying out the procedure, and during the procedure it appeared that Mrs C was not told about the degree of the decay and possible consequences of future treatment. However, the adviser also said that the treatment Mrs C received when she went back and the proposed course of treatment to address the problems were reasonable. Overall, we upheld Mrs C's complaint as although we were satisfied there was no evidence that the treatment was unreasonable, we found failures in care in relation to communication and consent.

Recommendations

We recommended that the practice:

• ensure the failures identified in relation to communication and consent issues are raised with relevant staff; and
• apologise to Mrs C for the failures identified.