Dental neglect – but whose? - dental case study

...Mr M remembered D well as he attended over 70 times in the period that he was a patient at the surgery. His notes constituted a long list of caries and fillings with occasional antibiotics...

Mr M had worked for the same dental practice for 35 years and was looking forward to his retirement.

One morning a letter of claim arrived at the surgery from solicitors representing a patient Mr M had treated for over 20 years from the age of four.

Mr M remembered D well as he attended over 70 times in the period that he was a patient at the surgery. His notes constituted a long list of caries and fillings with occasional antibiotics and, in the later teen years, numerous root canal treatments and crowns. In the claim it was alleged that many of the fillings and treatments were incomplete and required to be re-filled and crowned.

The patient also alleged that he was never given any advice on diet or oral hygiene. Nor was he ever referred to the dental hospital where he might have been offered preventative treatment such as fluoride washes and sealants. Such measures might have prevented the extensive dental decay suffered by D and the remedial treatment that he now required at a cost estimated in excess of £8,000.

Analysis and outcome

Two dental experts were consulted by MDDUS on the case and both acknowledged the need for extensive remedial treatment. In answer to criticisms of his practice Mr M stated that he had persistently advised D and his family on the importance of sound dental care including regular brushing and diet (avoidance of sweets, etc) but suspected this was mostly ignored. Sadly there were no clinical notes in the records of this advice being given nor evidence of BPE charting.

The patient records were also incomplete in regard to radiographs – with missing pre- and post-operative films from numerous treatment sessions.

The experts acknowledged that there was clearly an element of contributory negligence on D’s part for his poor dental health but that Mr M did share some liability.

MDDUS had no option but to settle the case although this was at a nominal sum in view of the patient’s contributory negligence.

Key points

  • Ensure patient records are complete including all radiographs, charts and notes of all treatment and advice provided.
  • Ensure that you assess and record patient compliance regarding any preventative dental advice.

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