Decision Report 201507904

Summary

Mrs C complained about the treatment provided by her dentist. Mrs C said the treatment she received was unsatisfactory and as a result she had been left with problems with her teeth for which she held the practice responsible. Mrs C had attended an emergency appointment with the dentist complaining of tenderness and food trapping in the upper right quadrant of her mouth. The dentist said that Mrs C had an established problem with an upper right crown and provided Mrs C with temporary treatment and advice regarding her upper anterior teeth. The dentist placed a temporary filling in the palatal deficiency (the roof of the mouth) to prevent food trapping. The dentist also prescribed Mrs C antibiotics for an infection in an upper right tooth.

We took independent dental advice who said there was evidence the treatment the dentist provided was of an unreasonable standard. The adviser said that the symptoms experienced by Mrs C were suggestive of an infection. Therefore, the dentist should have carried out some form of investigation to determine its cause, specifically, they should have taken an x-ray of the tooth, in order to make an accurate diagnosis. The adviser also said that the prescription for antibiotics had been issued without a clear diagnosis being established or recorded in Mrs C's dental records. We accepted that advice and upheld Mrs C's complaint.

The adviser also commented that because Mrs C saw the first dentist with an available appointment whenever she contacted the practice, she was seen and treated by six different dentists in the practice over several months. The adviser said this may have resulted in a failure in communication in that Mrs C was not provided with consistent messages and advice about her treatment.

Recommendations

4, A Dentist in the Lothian NHS Board area
Sector:

• health
• Subject: clinical treatment / diagnosis
• Outcome: upheld, recommendations
• Summary
• Mrs C complained about the treatment provided by her dentist. Mrs C said the treatment she received was unsatisfactory and as a result she had been left with problems with her teeth for which she held the practice responsible. Mrs C had attended an emergency appointment with the dentist complaining of tenderness and food trapping in the upper right quadrant of her mouth. The dentist said that Mrs C had an established problem with an upper right crown and provided Mrs C with temporary treatment and advice regarding her upper anterior teeth. The dentist placed a temporary filling in the palatal deficiency (the roof of the mouth) to prevent food trapping. The dentist also prescribed Mrs C antibiotics for an infection in an upper right tooth.
• We took independent dental advice who said there was evidence the treatment the dentist provided was of an unreasonable standard. The adviser said that the symptoms experienced by Mrs C were suggestive of an infection. Therefore, the dentist should have carried out some form of investigation to determine its cause, specifically, they should have taken an x-ray of the tooth, in order to make an accurate diagnosis. The adviser also said that the prescription for antibiotics had been issued without a clear diagnosis being established or recorded in Mrs C's dental records. We accepted that advice and upheld Mrs C's complaint.
• The adviser also commented that because Mrs C saw the first dentist with an available appointment whenever she contacted the practice, she was seen and treated by six different dentists in the practice over several months. The adviser said this may have resulted in a failure in communication in that Mrs C was not provided with consistent messages and advice about her treatment.
• Recommendations
• We recommended that the dentist:
• issue Mrs C with an apology for the failings identified in the treatment they provided;
• reflect on the comments of the adviser in relation to ensuring that they confirm any clinical findings with an accurate diagnosis before providing advice and treatment or issuing a prescription to a patient; and
• work with other dentists in the practice to give consideration to ensuring that, where a patient is seen and treated by more than one dentist, appropriate processes are in place so that the patient is given consistent messages and advice about their dental treatment.