Unstable implant

...Mr W demands he be refunded for the cost of his implant which he says is unstable and has required repeated tightening...

BACKGROUND: Mr W is a 64-year-old businessman with two dental implants in the lower left quadrant. These were provided by a specialist oral surgeon – Mr S – on referral from the patient’s regular GDP.

A letter has been sent to the Dental Complaints Service (DCS) by Mr W complaining about the treatment provided by Mr S. The patient states that one of his implants is “unstable” and that over the last few years he has attended Mr S on five occasions to have it “tightened”. Each visit has involved costs in excess of £100 but the problem has yet to be resolved.

Mr W demands that he be refunded for the cost of the implant and all subsequent “adjustments”.

The DCS has referred the complaint back to Mr S for local resolution.

ANALYSIS/OUTCOME: Mr S contacts MDDUS for assistance in dealing with the complaint. He drafts a letter of response and forwards it to a dental adviser for review. In the letter he first expresses regret at Mr W’s dissatisfaction with his dental care and welcomes the chance to clarify the treatment provided.

Mr S recounts in the letter how two implants were placed in the lower left quadrant without incident or complications. Impressions were taken for restoration and linked crowns were fixed to abutments – the superstructure secured by cement to the rear abutment and a gold screw on the mesial. Mr S explains that using a screw and soft cement facilitates easier access for necessary upkeep.

Mr S further explains that it was not an “unstable” implant that has required further treatment; it is the gold screw fixing the crown to the mesial abutment that has periodically needed tightening. This would be considered regular maintenance that might be expected with an implant/crown of this type and can be carried out by most GDPs on a routine basis. For this reason Mr S states that he cannot be expected to refund treatment costs.

The letter further advises that Mr W has the right to take the matter to the ombudsman and contact details are provided.

No further contact is made by Mr W in regard to the complaint.


  • A clear explanation and confirmed understanding by patients of treatment decisions can often forestall complaints and claims.
  • An expression of regret at patient dissatisfaction does not amount to an admission of liability.

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