SPSO Individual Decisions

Following the extraction of a wisdom tooth in hospital, C's follow-up care was undertaken by their family health service dentist. C suffered altered sensation following the tooth extraction. Over the course of eight months, C arranged three consultations with their dentist at which the altered sensation was discussed. C was concerned that the dentist's actions had not addressed the altered sensation and raised complaints about this with them and, subsequently, with this office. We took independent advice from a dentist. We found that the dentist provided reasonable care to C and did not uphold the complaint. When this report was first published on 21 September 2022, it was incorrectly categorised as being about a medical practice. This was due to an administrative error which we discovered on 20 October 2022, and for which we apologise. Related reading View Decision Report 201900994 as a PDF (110.88 KB) Updated: October 20, 2022

C underwent re-root canal treatment from the dentist in an attempt to treat an abscess (a painful swelling caused by a build-up of pus) which had formed under one of their teeth. After attempts to resolve the issue were unsuccessful, C was referred to a specialist. C complained that the re-root canal treatment was not carried out by the dentist in a reasonable manner and limited further treatment options for C. We took independent advice from a specialist in dentistry. We found that the treatment provided was reasonable. While the treatment did not resolve the presence of C’s abscess, it was not unreasonable. As such, we did not uphold this complaint. Related reading View Decision Report 201904615 as a PDF (24.02 KB) Updated: September 22, 2021

Mr C visited his dentist due to pain in one of his teeth and agreed to a proposed course of treatment with the dentist. Mr C believed this would be provided under the NHS. Mr C found the communication around the cost of the treatment confusing saying that the dentist had not properly explained the costs or what was required before the procedure, and Mr C was concerned that he was over-charged. Mr C also complained about the standard of treatment he received and that the dentist failed to handle his complaint reasonably. We took independent advice from a dental adviser. We found that the dentist failed to communicate the treatment plan and options in a reasonable way and that Mr C was not in a position to give informed consent; the breakdown of treatment options (NHS and private/independent) were not in line with relevant regulations; unacceptable materials were used; the findings of x-rays were unreasonably reported on; there was an unreasonable standard of care especially periodontal (gum) care; there was an unreasonable standard of record-keeping; and there were discrepancies in what was charged. We also found that the dentist failed to deal with the complaint in line with the complaints handling procedure. We upheld all aspects of Mr C's complaint.

Miss C complained to us about the standard of dental treatment provided to her adult son (Mr A) by the dentist over a number of years. In particular, she raised concern that there were delays in referring Mr A to hospital for specialist treatment and that the dentist had failed to listen to her concerns that Mr A should have been provided with braces. We took independent advice from an adviser in general dentistry. Whilst we did note some failings in record-keeping, we found that there was no delay in referring Mr A to hospital. We also found that there was no evidence that Mr A needed braces. We did not uphold the complaint, however, we highlighted our concerns about record-keeping to the dentist to use as a learning opportunity. Related reading View Decision Report 201705833 as a PDF (10.94 KB) Updated: December 2, 2018

Miss C raised a complaint about the care and treatment she had received from her dentist over an extended period of time. Miss C had suffered from pain in one of her lower teeth and was advised she would require root canal treatment. Miss C continued to be in pain; the treatment had to be repeated and also caused problems with an adjacent tooth. Miss C said she was told the tooth required extraction and was referred to the dental hospital for further treatment. Miss C was dissatisfied with the way the dentist managed her dental care. We took independent advice from a dentist. We found that the dental treatment which Miss C received was appropriate and in accordance with usual practice. The symptoms which Miss C had reported were uncertain, therefore a period of monitoring was required. The suggestion by the dentist for root canal treatment or extraction was reasonable in view of the dental records and x-rays which were taken. We did not uphold the complaint. Related reading View Decision Report 201705986 as a PDF (11.05 KB) Updated: December 2, 2018

Mr C complained to us that staff at the dental practice unreasonably informed him that he was exempt from NHS charges for dental treatment. Mr C said that, when he started a course of dental treatment at the practice, he told the staff that he was in receipt of carer's allowance and they completed a form and said that he would be exempt from NHS treatment costs. He was subsequently contacted by NHS Counter Fraud Services who said that he had fraudulently claimed exemption as he had completed the form stating that he was in receipt of income-based Jobseeker's Allowance, which was not the case. Mr C was asked to pay the costs of the NHS treatment along with a penalty charge. He maintained that while he had signed the form, he had not ticked the box which stated that he was in receipt of income-based Jobseeker's Allowance. We took independent advice from an adviser in general dentistry and concluded that there would have been a discussion with staff about whether Mr C was exempt from charges. There was reference in his dental records that Mr C thought he was exempt from charges as he was a full time carer. We were unable to establish who had ticked the box to indicate that Mr C was in receipt of income-based Jobseeker's Allowance, but the form did contain Mr C's signature. The staff maintained that they would not have ticked the box as they do not know the patient's financial situation and that the onus was on the patient to ensure that they were signing a form which was accurate. It was noted that following Mr C's representations, NHS Counter Fraud Services had waived the penalty charge aspect and therefore he was only liable to pay the costs of the dental treatment. We did not uphold the complaint. Related reading View Decision Report 201701087 as a PDF (11.35 KB) Updated: March 13, 2018

Mrs C complained that, at an emergency dental appointment, the dentist did not communicate adequately with her. Mrs C said that the dentist told her that previous treatment carried out had not been done correctly and that corrective work would be required. Mrs C said that no explanation was given to her of the work required or costs. We took independent dental advice. The adviser said that the dental records showed that the dentist was unhappy with the previous work carried out on Mrs C's teeth, but that it was not clear whether these concerns were communicated to Mrs C. We found that the records showed that the dentist communicated to Mrs C that the appointment in question was only to deal with the pain she was suffering from at that point and not to decide on future treatment. Whilst we considered the dental records could have been clearer in showing what was communicated to Mrs C, we were satisfied that the dentist adequately explained that the emergency appointment was only to treat the tooth that was causing pain, and not to create a treatment plan for the future. We did not uphold Mrs C's complaint. Related reading View Decision Report 201601748 as a PDF (11.09 KB) Updated: March 13, 2018

Mrs C complained that she had been given a bill by her dentist which included costs for work which was either corrective or had already been paid for. Mrs C also complained that she was being charged for work that had not been carried out. Additionally, Mrs C complained that the dentist had failed to communicate with her about her treatment needs, in particular that she had once been given a treatment plan with no costs on it. We took independent dental advice. We found that what Mrs C had believed to be a bill was in fact an estimated treatment plan and therefore she was not being charged for work at the time of her complaint. We did not uphold this aspect of Mrs C's complaint. However, we found that it was unreasonable that she had on one occasion been presented with a treatment plan with no costs on it and therefore we upheld this aspect of Mrs C's complaint.

Mrs C complained that her dentist had failed to provide her with appropriate treatment for an infection in her gum. Mrs C said that this had caused her stress and anxiety as she felt she had not been diagnosed correctly. We took independent dental advice and found that both the examination and the treatment Mrs C received were reasonable and appropriate. We did not uphold the complaint. Related reading View Decision Report 201601426 as a PDF (10.76 KB) Updated: March 13, 2018

Mrs C complained that her dentist had failed to provide her with appropriate treatment for an infection in her gum. Mrs C said that this had caused her stress and anxiety as she felt she had not been diagnosed correctly. We took independent dental advice and found that both the examination and the treatment Mrs C received were reasonable and appropriate. We did not uphold the complaint. Related reading View Decision Report 201601424 as a PDF (10.76 KB) Updated: March 13, 2018

Mrs C complained that her dentist had failed to provide her with appropriate treatment for an infection in her gum. Mrs C said that this had caused her stress and anxiety as she felt she had not been diagnosed correctly. We took independent dental advice and found that both the examination and the treatment Mrs C received were reasonable and appropriate. We did not uphold the complaint. Related reading View Decision Report 201601310 as a PDF (10.76 KB) Updated: March 13, 2018

Mr C complained to us about the care and treatment he had received from a dentist. He had attended the dentist for emergency treatment, who had extracted a badly broken tooth. Mr C was given an antibiotic and advised to return to the surgery for a more detailed examination to be carried out to assess what other dental treatment was required. Mr C returned to the dentist two days later and complained of pain and swelling. He said that he had been unable to eat. It was noted that a small swelling was present at the border of the lower jaw and there was pus discharging from the area where the tooth had been extracted. The dentist diagnosed a dry socket (an infected wound at the site of an extraction) and Mr C was prescribed another antibiotic and an antiseptic mouthwash. A dressing was not applied, as this was too uncomfortable for him. Mr C attended his GP on the following day, as he was still in some pain. He was then admitted to hospital later that day with a submandibular (inside the lower jaw) abscess, which was spreading into the tissue spaces. This was leading to extensive swelling, which was threatening his breathing. He was also suffering from a fever. Mr C was admitted in order that the hospital could drain the infected fluid from the abscess. There was nothing to indicate the presence of the abscess when Mr C had the tooth extracted on his first visit to the dentist. However, when Mr C attended again two days later, the dentist noted unusual symptoms, including a spreading infection, that did not fit the normal pattern. The development of an abscess of the type Mr C experienced following dental extraction is a very rare occurrence. After taking independent advice from our dental adviser, we found that that the dentist should have arranged an urgent referral to the local maxillofacial surgery department (the specialty concerned with the diagnosis and treatment of diseases affecting the mouth, jaws, face and neck) when Mr C had returned complainin

Mr C said that when he consulted his dentist for the first time, she carried out an initial examination and told him he required six fillings. Three of these were carried out nine days later, but when Mr C returned to to have the remainder of the work done, he said that the fillings she had completed earlier were sensitive. The dentist replaced the filling in the tooth that she decided was the problem, and arranged a date for the rest of the work to be done. However, before returning, Mr C obtained a second opinion. He said he was told, after examination, that the teeth remaining to be filled did not require work. Mr C complained that dental work was carried out unreasonably when none had been required. As part of our investigation we took independent advice from a dental adviser, who reviewed Mr C's dental records and relevant x-rays. We also looked carefully at the complaints correspondence. We upheld Mr C's complaint, as the adviser agreed that there was no evidence to suggest that Mr C required the number of fillings that had been suggested.