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Decision Report 201700683

  • Case ref:
    201700683
  • Date:
    December 2017
  • Body:
    Shetland NHS Board
  • Sector:
    Health
  • Outcome:
    Not upheld, recommendations
  • Subject:
    clinical treatment / diagnosis

Summary

Miss C was told by dental staff that she would require dental braces. She was subsequently told by orthodontic staff that she would not be provided with braces and she was discharged from the service. Miss C complained that the board failed to provide her with appropriate dental care.

We took independent advice from an orthodontics adviser who explained that the assessment criteria to consider whether a patient qualifies for orthodontic treatment funded through the NHS is covered by the Index of Orthodontic Treatment Need (IOTN). It would be expected that an orthodontics practitioner would provide a grade of IOTN which would substantiate their decision as to whether or not the criteria had been satisfied. We found that in Miss C's case the orthodontic staff had assessed her on a number of occasions as having a low IOTN, which was a reasonable judgement for them to make and had indicated that they had considered the IOTN criteria. As such, Miss C would not have qualified for orthodontic treatment and so we considered that the dental care provided had been appropriate. We did not uphold the complaint.

However, we did note that there was a failure by orthodontic staff to record the actual IOTN grade in the dental records, and so we made a recommendation in relation to this.

Recommendations

What we said should change to put things right in future:

  • The staff should be aware of the requirement to record the IOTN category in order to substantiate whether the criteria for providing orthodontic treatment has been met.

We have asked the organisation to provide us with evidence that they have implemented the recommendations we have made on this case by the deadline we set.

Updated: March 13, 2018