PSOW Individual Decisions

Mr D complained about the care and treatment his wife had received from the Practice. He complained about communication including that she had attended an appointment which was cancelled without prior warning. He also complained that he had requested copies of his wife’s records on 13 March 2024, in order to inform a formal complaint about her care, and these were not provided despite him supplying the required consent from his wife. Mr D complained that his wife had not received permanent fillings despite multiple appointments and instead said she had been lectured on dental hygiene. The Ombudsman found that Mr D had provided the required consent for his wife’s records to be released to him but the Practice had not actioned this. Mr D had therefore been unable to submit a formal complaint of his concerns. The Ombudsman also found Mr D had informed the Practice that his preferred method of communication was email. The Practice agreed to, within 4 weeks, issue Mr D with an apology and explanation about why he was not provided with his wife’s dental records. It also agreed to provide a copy of the records to enable him to submit a formal complaint. The Practice also agreed to confirm to Mr D that the system had been updated with his preferred method of communication. The Ombudsman considered these actions were reasonable and the complaint was closed on this basis.

Mr C complained about the care he received from the Practice. Mr C said that the Practice failed to discuss his treatment with him in detail or tell him that the person who would carry out the treatment would be a dental therapist, rather than a dentist. Mr C also complained that the Dental Therapist used amalgam (a mixture of metals) in the filling, to which he did not consent, and that he was unhappy with the quality of the work she performed. The Ombudsman found that Mr C had received a response to his complaint from the Dental Therapist who carried out his treatment. However, he had not received a formal response from the Practice. As a result, the Practice had not addressed Mr C’s complaint fully. The Practice agreed to provide a formal and final complaint response to Mr C, addressing his concern that treatment was performed without his informed consent. This would include whether it was the responsibility of the Dentist who prescribed his treatment or the Dental Therapist who carried it out, and whether appropriate informed consent was documented. It also agreed to offer Mr C an appointment for him to have his tooth reviewed. The Practice agreed to do this within 1 month of the Ombudsman’s decision.

Ms A complained about the dentalcare and treatment provided by the Dental Practice for her son’s injured front tooth. Ms A said that the Dentist had given contradictory and incorrect advice about her son’s treatment plan and the need for specialist referral. Ms A was also concerned that Dentist who had provided her son’s care had written the response to her complaint. She said that the response was not objective and had failed to answer the complaint that she made. The Dental Practice also wanted to charge her for providing a copy of her son’s dental records. In response to the investigation, the Dental Practice agreed to review the requirements around providing written treatment plans for NHS patients to prevent misunderstandings about care in the future. The Dental Practice also agreed to provide the following to Ms A: a) a fulsome apology for the for the shortcomings in communication and the poor response to her complaint b) a more comprehensive and objective response to her complaint c) a copy of her son’s dental records free of charge As Ms A’s son had already been referred by the Dental Practice for specialist care and his injured tooth had been restored, the Ombudsman considered that it was proportionate to discontinue the investigation based on the actions agreed.

On 16 September 2019 Mrs X attended the Practice and complained of pain to her tooth and that it smelt. On 18 September a porcelain crown was fitted to the left second premolar tooth (“the UL5”). Mrs X said that the “wrong tooth” was treated, she said that the left second premolar tooth (“the UL4”) should have been treated. Mrs X said that the Dentist had not explained the procedure. Mrs X said that a few days later the UL5 fell out. Mrs X complained that she has been left with a gap in her teeth, she now speaks with a lisp and is unable to smile or have photographs taken. Mrs X sought quotations for private dental work for restoration to the UL5 by an implant. The Ombudsman found that comparison of X-rays taken on 1 April 2020 and 16 April to those taken on 3 March 2021 corroborated that there was no problem with UL4. He found that UL5 was appropriately treated with a crown, the “wrong tooth” was not treated. The Ombudsman found that the uncertainty of treatment with Mrs X and UL5’s limited prognosis should have been discussed. He also found that Mrs X should have been presented with options – removal of the tooth, restoration with either a crown or a large filling, but a crown was preferable. He found that an implant is not provided by the NHS that only offers dentures. The Ombudsman upheld the complaint on the basis that options were not given to Mrs X. The Practice agreed to implement the Ombudsman’s recommendations within 1 month to apologise to Mrs X for the failings, ensure its dentists are reminded to discuss and consider treatment options, and to make a redress payment of £367 as a reasonable contribution towards a denture for UL5 (reflective of a percentage for treatment to the UL5 by denture only).