Decision report 201200269

Summary

Mr C complained about the care and treatment provided by his dentist in 2010. He said that a denture and replacement filling were not completed properly, and that an existing cavity (area of decay) was not discovered and/or treated.

We upheld Mr C's complaint, as our investigation found that the treatment was not of a reasonable standard. We took independent advice from our dental adviser, who commented that there was no record in Mr C's dental notes of the purpose of his first appointment with the dentist. Although the next three appointments followed what would be considered best practice, the adviser said that there appeared to be problems with the denture from the start. She also noted that subsequent adjustments appeared only to make matters worse. There was a lack of detail in the notes about a treatment plan or discussion of treatment options relating to the filling. The adviser was concerned that the filling was done after the construction and fitting of the new denture and said that normal practice would have been to do the filling first.

On the matter of the undetected cavity, the adviser said that this was likely to have been present during the treatment but might not have been visible in the mouth. It should, however, have been detectable on an x-ray. She noted that the later removal of this tooth by Mr C's new dentist caused further problems with the denture. X-rays were taken in May 2010 but the records do not make it clear what type they were; on which teeth they were taken or the reason for taking them. The adviser said that Mr C had had considerable work done on his teeth since these x-rays and further x-rays should have been taken before making the denture, as these might have revealed the cavity.

Overall, the dental adviser was concerned that the standard of the records did not conform to that expected by the General Dental Council or the Faculty of General Dental Practice (UK).

As the practice waived the cost of treatment after Mr C complained to them, we made no recommendation about this, although we did make recommendations to address the other failures our investigation found.

Recommendations

We recommended that the dentist:

• reviews her practice in relation to this complaint - this to be discussed at her next annual appraisal;
• reviews the standard of her record-keeping with particular regards to the level of detail of the treatments undertaken and discussions on treatment options and consent - this to be discussed at her next annual appraisal; and
• issues a written apology for the failings identified.