3. Mr A complains that between 2010 and 2017, the Practice did not do enough to treat his gum disease. He also says it did not clearly advise him about his upper teeth collapsing.
4. Mr A says his misplaced trust in the Practice has caused tooth loss, deformed gums as well as pain and discomfort. He says this has affected his wellbeing.
5. By bringing his complaint to us Mr A is seeking payment to have restorative dental treatment.
6. Mr A complains about a seven-year period before he moved to a new dentist in 2018. During this time, he also saw a specialist at a local specialist centre.
7. The Practice’s complaint response indicates that on 24 July 2014 the dentist discussed in detail Mr A’s severe bone loss due to periodontal disease (gum disease) and also that a number of his teeth were mobile and had poor long-term prognosis. The dentist said he needed to address his gum disease in the first instance. The Practice referred him to the specialist centre for the further management of his periodontal issues.
8. The response also indicates several discussions referencing the poor prognosis of Mr A’s teeth in 2015 and 2016.
9. In December 2021 Mr A got further information about the reports he had had from the specialist centre. He found the reports said he had high levels of plaque and bone recession.
10. Mr A raised a formal complaint with NHS England (NHSE) on 29 April 2022 and the Practice contributed to NHSE’s complaints response dated 5 September 2022.
11. Mr A responded to NHSE on 3 October 2022 before it issued its final response on 8 November 2022. Mr A then approached us on 15 February 2023.
14. The law says a person needs to make their complaint to us within a year of becoming aware of the problem. We cannot investigate complaints brought to us after one year, unless we consider there is a good reason to do so. We have discussed this with Mr A to understand the reasons why he could not do so. We have also considered the time the organisation has taken to respond to Mr A.
15. Mr A says he did not have concrete evidence of his concerns until he got information about the reports from the specialist centre in December 2021. He says this is the date he first knew he had a reason to complain. We can understand Mr A’s concern and he says this is when he found out the dental problems he had are ones which develop over a very long time.
16. Mr A says that in February 2022 he found out he was not the only one who felt they had been let down by the Practice. He says people in his local area were also complaining. Mr A spoke with a former dental nurse who recommended a book to him. He says the book explained the medical terms used in the report and reinforced his concerns. Mr A raised a formal complaint with the Practice on 29 April 2022.
17. Taking into consideration Mr A’s submissions and the NHSE complaints responses, we consider Mr A was aware of a problem much sooner than December 2021. We note it is not necessary to have ‘concrete evidence’ before raising a complaint about treatment. The discussions with his dentist reflect the dentist discussed gum disease on several occasions and even referred Mr A to a specialist in 2014. It was clear from those discussions that there were significant problems with his dental health. Even if Mr A remained unaware of his cause to complain in 2014, he would have been aware by 9 March 2016 when the dentist again discussed the poor prognosis of his teeth. Mr A discussed at that time the possibility of a temporary denture when he decided to have his teeth removed and wished to consider implants.
18. We consider Mr A would have been aware between 2014 and 2016 about his deteriorating oral health. He could have complained about the treatment the Practice had provided from that point without needing to know about specialist dental terms. Mr A did not complain to us until February 2023 which would make Mr A’s complaint between six and eight years outside of our time limit. We note that even if we took Mr A’s date of awareness as December 2021, his complaint would still be two months outside of our time limit.
19. We can only put the time limit aside when we see reasonable grounds for the delay in bringing the complaint to us. Local complaint handling did take some of that time. NHSE issued its response on 5 September 2022, around four months after Mr A complained. He says it did not clearly address his concerns about his collapsed teeth. NHSE issued a final response on 8 November 2022. Local resolution took around six months and ten days to complete.
20. On 30 November 2022 Mr A called us to discuss what he should do next. We emailed our complaint form to him the same day. On 14 December 2022, Mr A asked for a hard copy of the complaint forms, as he was having trouble completing the online form on his tablet. We posted our complaint form to him the next day. We received the completed complaint form on 15 February 2023 two months after sending it to Mr A.
21. At the time Mr A complained to NHSE he was already outside of our time limit. For this reason, we do not consider the time it took to respond was the cause of Mr A coming to us outside our time limit. We understand Mr A then had some difficulties with and questions about our complaint form. He also says there was a postal strike which will have caused further delays outside of Mr A’s control. Again, we do not think that is the main cause of any delay.
22. There was a three-month delay between us sending our complaint form and Mr A sending it back to us.
23. Mr A told us he had trusted the clinicians who treated him over that time. We are sorry to hear he has lost faith now. We appreciate it took some time for Mr A to come to terms with how badly he had been let down. We have not seen a significant barrier stopping Mr A from acting or complaining sooner than he did. At the time Mr A asked for our complaint form, eight years had passed since the period of care he was complaining about ended. We have to think about how difficult it would be to investigate care and treatment from as far back as thirteen years ago. Part of the reason we have a time limit is to ensure records are more readily available and clinicians are better able to provide meaningful answers.
24. Our decision not to investigate is not to diminish Mr A’s experience. We are sorry to hear of the adverse effect this has had on his life. Unfortunately, Mr A’s complaint has come to us outside of our time limit and we have not seen sufficient reason to set it aside. For this reason, we will not take further action on Mr A’s complaint.
25. We thank Mr A for bringing his complaint to us.
1. We have carefully considered Mr A’s complaint about a dental practice in the Durham area (the Practice). We are sorry to hear about the ongoing dental problems he has suffered with over the last several years. We understand the pain, discomfort and tooth loss is difficult to live with.
2. We have decided that the complaint falls outside of our time limit, and we have not seen sufficient reason to put our time limit aside to consider it further.