SPSO Individual Decisions

C complained about the care and treatment that their child (A) received from a dentist at the dental surgery. C raised a number of concerns, including that the dentist failed to detect decay in A's tooth and provide appropriate treatment for this, and failed to carry out a radiograph (a type of dental x-ray) on A's tooth sooner. We took independent advice from a dentist. We found that the dentist failed to record the presence of a mark on A's tooth during their third appointment, assess if there had been any deterioration of that mark, carry out further investigations and carry out radiographs at an earlier stage. We also found that the dentist's notes had extremely limited detail added and were below the expected standard. Given the failings in the detection and treatment of the decay in A's tooth and in carrying out a radiograph sooner, we upheld C's complaint.

Mr C complained that the dentist unreasonably failed to diagnose the cause of his facial pain. Mr C said that he attended his dentist but was told there was nothing wrong with his teeth. He continued to see his GP about his facial pain and several medical investigations were carried out. Fourteen months after Mr  C had attended his dentist, he saw a specialist who found out that he had a long- standing infection. We took independent advice from a dental adviser. We found that the treatment decisions and management of Mr C was reasonable in the circumstances, as was the failure to diagnose an infection. We did not uphold Mr C's complaint. Related reading View Decision Report 201707103 as a PDF (23.64 KB) Updated: January 23, 2019

Miss C complained about the dental care and treatment provided to her after she was diagnosed with gum disease. She complained that the dentist did not offer to refer her to a specialist for treatment, and instead recommended that she have her teeth professionally cleaned every three months. Miss C also complained that the dentist had not taken x-rays to assess for bone loss in the four years since she was diagnosed with gum disease. Miss C felt that as a result of the dentist's ineffective treatment of her gum disease, her condition had become worse. We took independent dental advice. We found that whilst the treatment provided by the dentist to Miss C was reasonable in some respects, we found that they had not offered Miss C the opportunity to see a specialist for her gum disease when she was first diagnosed. We also found that the dentist had failed to follow guidelines with regards to charting the progression of the gum disease. We further found that the dentist had failed to record basic periodontal examination (BPE) scores, which according to the relevant guidance should be recorded at every appointment. We also found that the dentist failed to follow good practice and take radiographs when Miss C's BPE score was four (any score of four or above is considered to require monitoring and/or treatment). On this basis, we upheld Miss C's complaint. Miss C also complained that the dentist did not reasonably respond to her complaint. We found that the complaint response did not tell Miss C that she could bring her complaint to us if she remained dissatisfied. Therefore, we upheld this aspect of Miss C's complaint.

Ms C complained that her dentist failed to examine her or treat her reasonably or appropriately. She said that it was only shortly afterwards, when she changed to a new dentist, that she learned the extent of her problems, which she said the first dentist had allowed to develop. We took independent advice from a senior dental practitioner and we found that as the appointment concerned had been on an emergency basis, Ms C had been given immediate treatment on the particular problem she presented with. The appointment was not routine, and so the dentist had not been expected to make a full examination of Ms C's mouth. We found the treatment he gave her had been appropriate in the circumstances. Related reading View Decision Report 201401911 as a PDF (10.94 KB) Updated: March 13, 2018

Ms C complained about her dentist. In particular, she said that his care and treatment had been unreasonable and inappropriate and that this caused her pain and upset. Ms C also said that the dentist had delayed in making a referral for her to a dental clinic and that when she attended the clinic, the referral was unnecessary. She further said that unsuccessful work had been carried out on one of her teeth which then had to be extracted at her own expense. We took independent advice from a senior dental practitioner and our investigation showed that when Ms C first saw the dentist it was for an emergency appointment. She was immediately given appropriate treatment. She attended again and after an x-ray, treatment options were discussed and Ms C made decisions about her preferred treatment. Later, because a problem with one of her teeth was not settling, it was agreed with Ms C that she should be seen at a dental clinic and a referral was immediately made. However, the dental clinic had problems with their email and it was not received. As soon as this was discovered, the dentist made a further referral and Ms C was seen. Although she complained about her treatment it was established that it had been reasonable and appropriate in the circumstances. Related reading View Decision Report 201401913 as a PDF (11.2 KB) Updated: March 13, 2018