3. Miss H complains on 25 November 2023, about her experiences at the Practice and that it did not remove her tooth during an emergency appointment when she had intense pain.
4. Miss H explained that after her appointment her pain continued to worsen. She attempted to find another emergency dentist via 111 however non were available. She subsequently had to pay £395 to have a private dentist to remove her tooth.
5. Miss H would like a financial reimbursement of the £395.
6. On 25 November 2023 Miss H called the 111 service as she was experiencing intense pain in her tooth. Miss H described the pain as ‘unbearable’.
7. Miss H was given an emergency appointment at the Practice on the same day.
The dentist examined her and said the tooth would need removing but they could not do so due to lack of time.
8. The Practice provided Miss H with pain relief medication and advised her to seek another appointment via the 111 service.
9. After her appointment, Miss H’s pain intensified. She called the Practice to ask for further treatment, but the dentist had gone home.
10. Miss H called the 111 service again and was told there were no further appointments available.
11. Miss H decided to pay for a private emergency appointment to get her tooth removed. She had to pay £395 for this.
The Practice did not remove Miss Hs tooth.
15. To decide if we should conduct a detailed investigation into a complaint, we first consider whether there are any indications something went wrong with the service provided by the organisation. If so, we then explore if the organisation would be willing to take further steps to put this right and resolve the complaint.
16. In its response on 22 December 2023 the Practice explained it did not have time to remove Miss H’s tooth at the appointment. It acknowledged the removal of the tooth was necessary.
17. The records show during Miss H’s appointment the dentist diagnosed her with a ‘dead and infected tooth’. This must have been incredibly painful for Miss H, and we are sorry to hear of the distress and upset this caused.
18. Our adviser explained an extraction was one of the appropriate methods of treatment.
NHS England’s clinical standard for ‘oral surgery’ (May 2023) explains extractions are graded on three levels of difficulty. Level one procedures are classed as ‘those within the skillset of general dentists’. Our adviser reviewed Miss H’s x-ray images and dental records. They confirmed the extraction of this tooth would meet a level one category. That said, it would have been appropriate for the dentist to carry out this extraction during the emergency appointment.
19. The adviser explained one factor that could change this treatment plan would be if the dentist could not get Miss H’s tooth to go numb. In its response, the Practice said it waited patiently to numb her tooth, but it could not do so.
20. There is no evidence in the dental records to indicate Miss H’s tooth would not go numb. Instead, the records say the dentist could not extract the tooth because they ‘needed a longer appointment’. Miss H gave us a detailed account of her appointment and said there were no issues getting her tooth numb.
21. We have more evidence to conclude on the balance of probabilities the Practice did not remove her tooth due to them needing a longer appointment.
22. Our adviser explained it would not have been realistic for the dentist to remove Miss H’s tooth in the 20-minute appointment. The GDC Standard (1.7) explains that ‘You must put patients’ interests before your own or those of any colleague, business or organisation’.
23. NHS England’s ‘Clinical Standard for Urgent Dental Care’ (January 2023) says where patients are in severe pain, which cannot be managed with pain relief, treatment should be provided within 24 hours. This means the Practice had a duty to extend the appointment time or make alternative arrangements for her to be seen and treated within 24 hours.
24. We have seen no evidence to show it did this. As the Practice did not put Miss H’s interests first and carry out the extraction within the right time frame, this is an indication of a failing.
25. During this process, we approached the Practice and asked if it would be willing to pay £395 to reimburse the costs of Miss H’s private appointment to put this complaint right. The Practice agreed to this. It said it would make this payment directly to her by the end of July 2024.
26. We approached Miss H and explained the Practice was willing to take steps to resolve her complaint. She was happy with this and confirmed the payment would resolve her complaint.
27. Our NHS Complaints Standards (2023) say organisations should find ‘suitable and appropriate ways to put things right for people who raise a complaint’.
28. In this case, we are satisfied the Practice has acknowledged it did not provide appropriate care and is willing to reimburse the costs of the appointment. As this is the outcome Miss H is seeking, we consider this will resolve her complaint. Therefore, we have decided not to take any further action. We would like to thank both parties for their time and effort during this process.
1. We have carefully considered Miss H’s complaint about a practice in the Leicestershire area (the Practice). We are sorry to hear Miss H suffered significant tooth pain on 25 November 2023 and was not able to get her tooth extracted during her emergency appointment. We appreciate this must have been a distressing experience for her.
2. The Practice acknowledged it should have removed Miss H’s tooth during this appointment. It confirmed it would reimburse her £395 for the cost of her private appointment. Miss H has accepted this offer to resolve her complaint, so we have decided not to take any further action.