A dental practice in the Blackburn area

3. Mrs F complains about the following aspects of the care and treatment she received from the Practice.

4. Dentures the Practice provided in November 2022 were poorly fitting, but on 22 September 2023 the dentist refused to replace them on the NHS as they said NHS dentures are not good enough. They recommended she get dentures privately, at £900. She does not believe the Practice had the right to insist on private dentures.

5. She disputes the dentist’s claim that it gave her different treatment options after she wrote to the Practice on 10 October 2023 to say she was struggling to eat. She says she got no response to her letter. This caused stress and delays to care which left her in undue pain and discomfort.

6. Mrs F wants the Practice to offer her financial compensation for the impact of what it got wrong. She wants it to make systemic changes to ensure this does not happen to other patients.

7. Mrs F had partial dentures, which she paid band 3 NHS dental charges for. The dentures became loose and ill fitting. The Practice fitted a clasp to help secure one of her dentures, but she still had issues. She had an appointment at the Practice on 25 September 2023 to discuss options but later decided to seek treatment at a new practice. She had a new partial denture fitted by her new NHS dentist in March 2024 and had no issues with it.

11. Before we decide if we should conduct a detailed investigation of a complaint, we look at whether there are signs the organisation has got something wrong. We do this by comparing what should have happened with what did happen. We have done this and have seen the Practice does appear to have made a mistake.

12. Mrs F says the Practice never gave her any treatment options despite saying it did in the complaint response. She says when she raised her concerns the Practice did not support her or give a clear route forward to resolve her issues. She also complains the Practice wanted to make her pay for private dentures when she should have been able to get them on the NHS.

13. The GDC standards say dentists must give patients treatment that is in their best interests. The Practice said it did relay three options to Mrs F during an appointment on 25 September 2023. It recommended she either get denture adhesive to stabilise the fittings, get new NHS dentures (but there was a waiting list) or pay £900 privately for new dentures. It said she wanted to time to think about the options as she did not want to pay for more dentures.

14. The dental records document the three options the Practice says it gave Mrs F. Our adviser said these were in line with best practice. So, this shows the Practice acted in line with the GDC standards. But we can see there is a discrepancy between what the records say and what Mrs F believes she was told.

15. The records only give us a snapshot of what was discussed in the consultation. So, we cannot know exactly what was said. The dentist documented that as she was unhappy with two NHS dentures they did not think she would be happy with a third one. We can see nothing to suggest it pushed for her to privately pay for dentures. But from an independent point of view, we can see how Mrs F may have come away from that discussion with that impression.

16. But we can see what the problem appears to have been here. Our adviser said the Practice did not explain the underlying cause of Mrs F problems with the denture, either in her appointments or in the complaint response.

17. The GDC standards say dentists should give patients full, clear and accurate information that they can understand, before, during and after treatment, so they can make informed decisions.

18. Mrs F got her dentures straight after tooth extractions. Our adviser explained that when teeth are removed the gum is prone to changing which means immediate dentures often become poorly fitting after three to six months. Our adviser said it was still right to suggest she get another denture in September 2023 but as she had recently had another tooth extraction in the area it is likely she would have experienced the same issues again.

19. While there was nothing wrong with the treatment plan, this missing information meant Mrs F did not understand her full clinical picture. The Practice did not act in line with the GDC standards in the information it gave her. It should have explained why her dentures had become loose. If she had understood what the underlying cause of her issues were, we think she would have been more likely to work with the Practice to find the right solution for her.

20. The ‘NHS Complaint Standards’ says organisations should acknowledge when things have gone wrong and take action to put it right. We have spoken to Mrs F about what we have seen, and she feels the Practice should recognise its mistake.

21. We shared our views with the Practice. It has reflected on this and acknowledges how important it is to communicate clearly with a patient. It has agreed to write to Mrs F within 30 days to offer a formal apology that it did not communicate the underlying issue with why her dentures were becoming loose and for the impact this had for her.

22. Mrs F wanted a financial remedy to recognise that her only option appeared to be private dentures. She was fortunate enough to get her replacement denture at a new NHS practice. So, she did not incur any private costs. We think the Practice’s apology and the learning it has taken from this complaint is enough to put things right in line with the ‘NHS Complaint Standards’.

23. We are grateful to Mrs F for bringing her complaint to us. We hope she is reassured by the Practice’s apology and knowing it has reflected on her concerns and taken the matter seriously.

1. We have carefully considered Mrs F’s complaint about the Practice. We think the treatment options the Practice suggested were right. But we saw the Practice did not communicate why she was experiencing issues with her dentures as it should have. If it had, we think she would have been more reassured that it could help resolve her problems with her denture. The Practice has reflected on this and agreed to write to Mrs F and apologise to her.

2. We are sorry to hear about Mrs F’s experience under the Practice’s care. We recognise this has been a worrying and distressing time for her and hope the information below clearly explains how we reached our views.