SPSO Individual Decisions

C complained about the care and treatment that their child (A) received from a dentist. A injured their front tooth and attended their dental practice for an emergency appointment. The dentist noted there was a 1mm extrusion (tooth displacement) but decided that no treatment was needed. C complained that the tooth wasn’t treated with a splint. The dentist said that dentists are able to use their own clinical judgement to decide whether or not to follow the guidelines in each case. In this case, the dentist decided that the tooth would recover on its own and made the decision not to splint the tooth. We took independent advice from a dentist. We noted that there are standards a dentist should follow. This includes providing patients with treatment that is in their best interests and keeping up-to-date with current evidence and best practices. If a dentist chooses to deviate from established practice and guidance, the reason why should be recorded. We found that the dentist did not record the reasons why they decided not to follow the guidelines and they did not inform C that there were guidelines that applied in this case. We also considered that the decision not to follow the guidelines in this case was unreasonable. Therefore, we upheld C’s complaint.

Mr C complained about the treatment he received at his dental practice. His dentist had said that he required a filling and the filling was performed by a dental therapist. Following the filling, Mr C experienced pain from the tooth and was told that a nerve had been damaged and that he would require either extraction or root canal treatment and then that he would require a crown. Mr C felt that the dental therapist had not carried out the filling in an appropriate manner. Mr C was also dissatisfied that when he made a formal complaint to the practice that he received responses from the dental therapist, head of practice and the dentist. Related reading View Decision Report 201804659 as a PDF (23.59 KB) Updated: July 24, 2019

Mrs C complained about the care and treatment she received from her dentist. When Mrs C developed toothache, she was advised by a different dentist that her tooth needed to be extracted. Mrs C questioned why her tooth was left to decay to such an extent without any prior treatment. She complained that the first dentist failed to record the findings of an x-ray taken of her teeth which led to her tooth not being monitored properly. The dentist acknowledged that they did not record the findings of the x-ray, however they expected any subsequent dentist to review the patient's dental records, including the x-ray. We took independent advice from a dentist. We found that it would not be reasonable to expect a subsequent dentist to review the x-ray, as they would expect a report of the findings to be included in the patient's records. We concluded that Mrs C's dentist had failed to record the findings of the radiograph in line with the relevant guidance, and we upheld the complaint.

Mr C complained about some dental work he had done. He was unhappy because he did not think he had been given sufficient information about the procedure. He had a replacement bridge fitted (a device to replace a missing tooth), and was unhappy with the colour and size of the crown. Mr C was also concerned that, when the dentist tried to remove the crown, he was unable to do so. We took independent dental advice on this complaint. The adviser noted that it was not clear exactly what information Mr C had been given in relation to his proposed treatment, because there was not enough detail in his notes. However, he said that from the evidence available, it was reasonable for the dentist to have suggested that a new bridge was necessary. He also said that, while the replacement bridge had not been an appropriate fit, the dentist had taken appropriate action in offering to replace it. He also noted that crowns can be difficult to remove, and that the dentist had acted with appropriate caution in choosing to drill the crown off, rather than try and remove it by force. On the basis of the advice we received, we were satisfied that, while Mr C's dental treatment was not as straightforward as Mr C would have liked, the dentist's actions were reasonable, and he acted in Mr C's best interests.

Mrs C went to her dental practice to have a tooth removed and a neighbouring tooth filled. She returned to the practice several weeks later complaining of toothache and saw another dentist. Mrs C decided to have the problematic tooth extracted. Mrs C said that before the extraction she clearly told the dentist that her toothache was originating from the tooth that had recently been filled. Shortly after the extraction, she returned to the dentist complaining that he had removed the wrong tooth. The dentist said he had tapped on both neighbouring teeth several times to find out which tooth was causing Mrs C pain, and that she several times identified the one he extracted as the problematic tooth. Mrs C did not recall the dentist tapping her teeth but even if he did, she said that she did not know if she could have said which tooth was causing pain when tapped, given the recent extraction and that she had painful toothache in the same area. Mrs C later had the problematic tooth extracted and remains very distressed at the effect of the three adjacent missing teeth. We did not uphold the complaint. We found that the dentist carried out an appropriate examination, which led him to a reasonable diagnosis, and that the extraction of the tooth was reasonable. We also found it reasonable that that the dentist failed to apologise for the extraction. When this report was first published on 24 October 2012, it was incorrectly categorised as being about Greater Glasgow and Clyde NHS Board.  This was due to an administrative error which we discovered on 31 October 2012, and for which we apologise. Related reading View Decision Report 201104543 as a PDF (12.64 KB) Updated: March 13, 2018