SPSO Individual Decisions

C complained on behalf of their child (A) who was a patient of the practice. A's care was disrupted by COVID-19 and they were not seen by the practice for four years. C complained that the practice unreasonably charged them for white fillings after there was a delay in A being seen for routine check ups and the care could have been provided at a time when it would have been free of charge. C also complained that the practice failed to reasonably respond to C's complaint. We took independent advice from dental adviser. We found that the decision to charge for the care and treatment provided was reasonable. It was not possible to evidence whether appointments had been sought prior to their appointment, and the decision to charge for the treatment provided was reasonable. Therefore the complaint was not upheld. We found that while the content of the practice's complaint response was reasonable, there were significant delays in the practice providing a response and there were a number of times when C requested to escalate their complaint and this was not actioned, which we found unreasonable. Therefore, we upheld this complaint.

Mrs C attended the dentist for restorative crowning treatment of one of her teeth, having recently completed a course of private orthodontic treatment. Following completion of the crown preparatory work, Mrs C complained that her retainer felt slack and that there was subsequent movement in one of her teeth between then and her re-attending for the crown fitting a week later. The dentist considered that the movement was an orthodontic relapse issue and did not accept liability for the cost of the remedial orthodontic work required. Mrs C complained that there had been no movement prior to the crown preparatory work and that the movement could, therefore, only be attributed to this work. We took independent dental advice from a general dental practitioner. We found that the treatment provided by the dentist was carried out appropriately and that this could not reasonably be responsible for the movement of Mrs C's tooth. We noted that any movement was likely to have occurred over a period of months, due to orthodontic relapse, rather than the short period of time between the crown preparation and crown fit appointments. We observed that the dentist's notes from an earlier appointment suggested that the tooth in question was not in a stable position and that relapse had already occurred. Therefore, we did not uphold Mrs C's complaint. Related reading View Decision Report 201608807 as a PDF (23.98 KB) Updated: January 23, 2019

Mr C complained that the care and treatment he received from the dentist was unreasonable. Mr C had a lump on his tongue and was concerned that he was not referred to oral health or a dental hospital which he said resulted in there being a delay in him being diagnosed with oral cancer. We took independent advice from a dental adviser. We found that the clinical examination carried out by the dentist was reasonable and, given that the dentist suspected that the lump on Mr C's tongue was a result of trauma, it was reasonable that a topical anaesthetic mouthwash was prescribed and an appointment was made to review Mr C. However, we also found that the dentist had not recorded in Mr C's medical record anything about: • the history of Mr C's complaint, his past dental history, past medical history and social history. • the diagnosis considered at the time. As good record-keeping is an important part of a patient's care and treatment, we upheld Mr C's complaint.

Mrs C complained that, despite attending the dentist over the years with tooth pain, the cause of her pain was not identified or treated appropriately. She was ultimately referred to a periodontal (gum) specialist. Mrs C complained that she had not been informed of the presence of gum disease, and that she had to wait several months for this specialist assessment and treatment. Mrs C felt that the lack of earlier treatment had placed her dental bridgework at increased risk. We took independent advice from a dentist. We found that Mrs C's dental records confirmed discussions having taken place with Mrs C regarding her gum disease. We noted that Mrs C's gum health had deteriorated rapidly at the time she was referred to the periodontal specialist, and we considered this referral was appropriate. We considered that the actions of the dentist were appropriate and did not contribute to the increased risk of Mrs C losing her dental bridge. Therefore, we did not uphold Mrs C's complaint. Related reading View Decision Report 201707895 as a PDF (23.82 KB) Updated: January 23, 2019