Leicester, Leicestershire and Rutland Integrated Care Board

4. Mrs L complains about aspects of care and treatment provided by the Practice on 10 October 2019. She says:

• the Practice provided a filling too close to the nerve • she does not know if a filling was the correct treatment for her symptoms.

5. Mrs L stated the events have caused her agonising pain and ongoing sensitivity of the tooth. She says she may lose a tooth as a result of the Practice’s ‘cover ups’. She told us she is now scared of going to the dentist, and is trying to rebuild trust with her new dentist as a nervous patient. She explained she has also been impacted financially, as she has since needed a root canal and a crown fitted due to errors with the filling.

6. By bringing her complaint to us, Mrs L would like the Practice to acknowledge it has done something wrong. She is also seeking £2000 reimbursement of her private dental fees.

7. On 10 October 2019, Mrs L attended the Practice as a filling on the right side of her mouth had fallen out. The Practice put in a new filling.

8. On 15 October, Mrs L went back to the Practice as she was experiencing pain and pressure on the gum following the filling. The dentist discussed root canal treatment (a procedure to treat infection at the centre of a tooth). The dentist gave Mrs L the option to book another appointment, she did not do this.

9. On 14 January 2020, Mrs L attended the Practice still in pain. The Practice advised her to monitor her symptoms, and if they did not settle, she may require root canal treatment.

10. In October 2023, Mrs L attended a new dental practice. She says it informed her the filling in 2019 had not been done properly and recommended root canal treatment.

11. In April 2024, Mrs L had root canal treatment.

15. Mrs L complains on 10 October 2019 the Practice provided a filling too close to the nerve.

16. In its response, the Practice explained on the day of the appointment the dentist informed Mrs L that an X-ray indicated the decay was deep and close to the nerve chamber. It said this increased the risk of her needing further treatment following the filling. The response said Mrs L understood this and chose to go ahead with the filling.

17. Our adviser explained the X-rays support the Practice’s explanation the decay on Mrs L’s tooth was initially very deep. The dentist recorded they explained this to Mrs L, and said there was a risk she would need root canal treatment or extraction. During the procedure (filling), the dentist informed Mrs L they had exposed a nerve. They put a dressing on it, which our adviser explained was appropriate in this situation.

18. The dentist asked Mrs L to come back for another appointment, which she did not attend.

19. General Medical Council (GMC) Good medical practice guidance advises medical professionals:

• “The exchange of information between medical professionals and patients is central to good decision making. You must give patients the information they want or need in a way they can understand. This includes information about: • their condition(s), likely progression, and any uncertainties about diagnosis and prognosis • the options for treating or managing the condition(s), including the option to take no action • the potential benefits, risks of harm, uncertainties about, and likelihood of success for each option.”

20. We consider the dentist acted in line with GMC’s Good medical practice by explaining the decay on the tooth was deep. Mrs L provided consent to go ahead with a filling, rather than other options such as a root canal or extraction.

21. In considering all of the evidence above, we can see the filling was carried out close to the nerve, but this was appropriate treatment as the decay was initially very deep. The Practice informed Mrs L this on the day of the appointment and told her this increased the risk of her needing further treatment following the filling. She chose to go ahead with the filling.

22. Mrs L also complains she does not know if the filling the Practice carried out on 10 October 2019 was the correct treatment for her symptoms.

23. In its response, the Practice explained prior to the filling, it informed Mrs L if the filling did not settle her symptoms, she may require a root canal or extraction.

24. Our adviser explained as a practitioner, it is always best to try and fill a tooth first and see if this helps the patient’s symptoms, before deciding to carry out any other treatment. The dentist gave Mrs L the option to have a root canal. Our adviser said if Mrs L had chosen to go ahead with an alternative treatment this would also have been appropriate, as was filling the tooth. It was Mrs L’s right to choose and she decided to go ahead with the filling.

25. The records show Mrs L reattended the Practice a few days after the filling with soreness and she needed antibiotics. Our adviser explained this would have raised a red flag, and the records show the dentist advised her to come back for the first stage of root canal treatment. Mrs L did not go back, and this is her choice.

26. Mrs L did not go back to the Practice until January 2022, therefore there is no indication the treatment in 2019 caused any further issues, as she had not reattended.

27. Our adviser explained the dentist advised Mrs L correctly and carried out appropriate treatment at each stage. We have therefore not seen indicated failings here.

28. We thank Mrs L for bringing her complaint to us. We hope our explanations go some way to reassure Mrs L we have taken her concerns seriously and we have explained our decision clearly.

1. We have carefully considered Mrs L’s complaint about a filling she had at the Practice (part of Leicester, Leicestershire and Rutland Integrated Care Board) on 10 October 2019. We are sorry to hear about Mrs L’s experience and how difficult she found it.

2. We have not seen any indications of failings in respect of Mrs L’s complaint the Practice put the filling too close to the nerve. We have also seen indications the Practice took appropriate action by carrying out a filling to treat Mrs L’s symptoms. We have therefore decided not to take any further action in relation to this complaint.

3. We will explain our decision below.