Decision Report 201204438

Summary

Ms C, who is an advice worker, complained on behalf of her client (Mrs A) about a dentist. Ms C said the dentist failed to provide Mrs A with reasonable dental treatment when extracting three teeth. She said that he failed to remove a fragment of bone from Mrs A’s lower gum, resulting in infection, pain and discomfort, and that the follow-up treatment was not appropriate.

We obtained independent advice from our dental adviser. The adviser explained that fragments of bone can occur during the extraction process. They are quite often not seen until several days after the extraction and can come out themselves without any clinical intervention. The adviser said the fact that a fragment of bone remained after the extraction was not caused by inappropriate treatment, and that the dentist could not unreasonably fail to remove a fragment that was not evident to him at the time. The adviser said it seemed unlikely that the dentist would have identified a fragment of bone in Mrs A’s gum and then knowingly left it in place.

In terms of the follow-up treatment, the adviser said the records suggested that, on the whole, the treatment provided at two of the three follow-up appointments was reasonable. However, because of the dentist's poor record-keeping, it was not possible to say whether the treatment Mrs A received at the remaining appointment was reasonable. Because of this, although we did not uphold Ms C's complaint, we were critical of the dentist’s record-keeping.

Recommendations

We recommended that the dentist:

• reviews the Faculty of General Dental Practice clinical examination and record-keeping good practice guidelines and ensure that he follows these in future.