BACKGROUND: A 43-year-old woman, Mrs L, attends her dental practice for an emergency appointment complaining of a severe toothache and swelling. She is seen by Mr B who on examination finds a grossly decayed and infected lower left molar with swelling of the associated tissues indicating infection spreading into her jaw. Extraction of the tooth is clearly indicated and the dental records state: “ext LL6 with forceps uneventful”. Mr B also prescribes an antibiotic for the infection.
Three weeks later the dental practice receives a letter from the Citizen’s Advice Bureau (CAB) written on behalf Mrs L. It states that later in the evening after her visit to the dentist she experienced symptoms of sickness and high fever. Her husband brought her to the local A&E where she was diagnosed with blood poisoning and admitted to hospital. She was discharged three days later.
In the letter Mrs L alleges that it is clear the blood poisoning was a result of her dental treatment and she demands a refund of the dental fees and recompense for three days lost earnings from her job as a cleaner.
ANALYSIS/OUTCOME: Mr B sends the CAB letter to the MDDUS along with a suggested draft reply. A dental adviser liaises with the dentist on some of the wording.
In his reply Mr B confirms that Mrs L did indeed attend his surgery for an emergency appointment at which a molar was extracted. He explains that in the majority of cases extraction is sufficient to resolve the symptoms and alleviate pain and swelling but sometimes infection is too deep-seated and additional treatment is required. This is especially the case where infection is already present and the patient is a smoker with poor oral hygiene.
Dr B points out that Mrs L has a history of neglected dentition and that she rarely attends her dental practice except for emergency appointments. For these reasons he refuses to refund the treatment fees or offer compensation for the days off work. He further suggests that Mrs L be advised to regularly attend for dental treatment in order to prevent similar problems in future.
- Advise high-risk dental patients of any potential complications after treatment.
- Ensure patients are reminded at every opportunity of the importance of proper dental hygiene and the need for regular dental check-ups and treatment.