A dental practice in the Hounslow area

2. Miss A complains that on 10 December 2024 the Practice carried out pre-crown work without adequate pain relief, and with a poor attitude which in resulted in her tongue being cut open.

3. Miss A says she was distressed and covered in blood and in significant pain. She felt traumatised and unable to return to the dentist in question, cancelling her appointment on 16 December to have her crown fitted and attending another dental practice on 17 December. She says the events on 10 December left her unable to care for her child. She says the care she received on 10 December contributed to the loss of her tooth. She says she is still unbale to discuss the events even now.

4. Miss A would like compensation to cover the cost of the restoring her tooth with an implant.

5. Miss A attended the Practice on 9 December 2024 for an emergency appointment. She presented with severe pain from her lower left second molar (LL7) tooth. The dentist performed an examination, took X-rays and diagnosed cracked tooth syndrome (a suspected crack that might not show up on an X-ray). The dentist discussed treatment options which included extraction, root canal treatment (RCT) (a dental procedure focused on removing infected or inflamed tissue from inside a tooth) or a crown (a custom-made cap that completely covers a damaged or weakened tooth above the gum line). The dentist advised Miss A that the crown had a success rate of not more than 50% with risks that included tooth fracture and nerve involvement. The dentist’s clinical assessment did not indicate any nerve involvement at the time. The dentist advised Miss A that the crack may have developed into the roots of the LL7, and if so RCT would fail should this occur.

6. Miss A elected to proceed with the crown, and the Practice offered her an appointment the next day (10 December) following Miss A’s request to treat the issue as soon as possible.

7. On 10 December 2024, the dentist re-examined Miss A’s LL7 tooth. There was no swelling surrounding the LL7 and the dentist re-tested the symptoms again using a cotton wool roll. Miss A reported pain following release of pressure. The dentist repeated the treatment options and the risks with Miss A. Miss A elected to proceed with the crown preparation and provided consent to proceed with the treatment.

8. The dentist administered local anaesthetic and checked that Miss A’s tongue and left side of the lip was numb before starting the crown preparation. The dentist says Miss A told them she felt the numbness in her lip and the tongue on the left side. The dentist then proceeded with the treatment. As the dentist started to drill the tooth, Miss A said she was in pain and discomfort. The dentist stopped and asked Miss A to wait in the reception area to allow more time for the anaesthetic to work to ensure she was comfortable with the treatment. After ten minutes, the dentist called Miss A back into the surgery. Miss A says that the dentist then continued to drill her tooth whilst she was in pain. The dentist’s account is that there was no indication that of pain during drilling of LL7.

9. During the procedure, the dentist asked Miss A to relax her tongue as the position of the tooth was quite far back and was not easily accessible. The dentist stopped several times to allow Miss A to relax.

10. Towards the end of the procedure, the bur (part of the tool the dentist was using) caught on the floor of Miss A’s mouth and caused a bleed. The dentist stopped, apologised and told Miss A what had happened. The dentist applied a gauze pack to the wound to stop the bleeding. The dentist asked Miss A if they could finish the procedure and Miss A agreed. The dentist took impressions and placed a temporary crown on the tooth.

11. The dentist advised Miss A the wound from the bur could take up to a week to heal. They provided extra gauze packs, instructions on what to do should the bleeding continue including carrying out warm saltwater rinses to help heal the wound and to take painkillers as required.

12. Miss A booked another appointment for 16 December 2024 the crown to be fitted. Miss A subsequently cancelled this appointment.

13. The dentist attempted to contact Miss A several times via telephone, regarding crown fit appointments with no success. Miss A sought emergency dental care several times with other dentist practices on 17, 23 and 31 December, and again on 5 January 2025 when Miss A’s LL7 was extracted. Miss A had several courses of antibiotics during this period.

16. Before we decide if we should conduct a detailed investigation of a complaint, we look at whether there are signs the event complained about had a negative effect which the organisation has not put right. Having done so we cannot link the events complained about with the negative impact Miss A has claimed.

17. Miss A says the dentist approach and demeanour during the appointment was unpleasant. She says the pain she experienced during the preparation for the crown was excruciating. Miss A says the impact of this appointment was a month of being in pain while looking after a newborn, going back and forth to different dentists, taking three courses of antibiotics in the space of three weeks. She says that during her baby's first Christmas and new year’s she was unwell (vomiting, diarrhoea) and not able to look after them properly. She says she lost her tooth and has to get an implant placed due to having only one molar on the left side. She says that the situation has caused her and her family a lot of stress, pain, worry and wasted time.

18. It is not possible for us to consider the dentist demeanour or attitude during this appointment as we were not present and there is no independent evidence for us to consider.

19. It is not disputed that the dentist caught the floor of Miss A’s mouth with the burr. Miss A will have undoubtedly found this distressing. Any pain she was in at the time was of a short-term nature. We can see that the dentist has apologised for this. Our guidance on financial remedy says that an apology is usually sufficient to put right short-term minor pain which can be managed by the use of non-prescription medication and where the person affected can still function normally. We think therefore the Practice’s apology is sufficient for that part of the complaint. The wider impact Miss A has claimed appears to relate to the deterioration and loss of her tooth, which we will consider next.

20. We do not think we could link the wider impact Miss A has described to the events of that appointment. That is because Miss A was only partway through her treatment with the Practice. It had arranged a further appointment to complete the treatment. But Miss A decided to cancel the follow up appointment on 16 December and seek a new dentist the next day (that Miss A has confirmed she does not wish to complain about). There was an opportunity for the original dentist to complete the crown work on 16 December, but Miss A elected not to attend. We understand that she had found the previous appointment distressing, but the dentist had not yet finished the treatment. Therefore, it is unlikely that we would be able to link the treatment received on 10 December with the loss of Miss A’s tooth. We must also note she saw three other dentists after this and received three courses of antibiotics and the tooth still had to be extracted.

21. Clearly Miss A was distressed by the experience and suffered short term pain and distress. That cannot have been very pleasant for her. Even if we were to consider this complaint in detail, we consider the apology already provided by the dentist sufficient to put things right.

1. We have carefully considered Miss A’s complaint about the Practice and decided to take no further action. We have decided we cannot link the events complained about to the loss of Miss A’s tooth and the Practice has apologised to Miss A for the discomfort she suffered. We acknowledge that the events were both painful and distressing for Miss A. Our decision is not meant to diminish this in anyway.