Dental history
A patient, a woman in her thirties, attended a dentist for a period of six years. Then she changed to a new dentist when she moved to a different part of the country. She was registered as an NHS patient, and over the next three years she had a number of fillings and scalings. Bitewing radiographs and an OPG were obtained in the first year of treatment, further bitewings were taken two years later and a periapical a year after that. At that point the patient was registered as a patient with a private capitation scheme.
During the initial course of treatment, four teeth were restored, one restoration was extremely deep. The patient did not reattend until two years later when she had a further four fillings. Following the administration of an inferior dental block the patient had a vasovagal attack and as she was somewhat distressed the dentist was only able to carry out minimum replacement restoration on LL6. The patient reattended a year later. The UR6 was refilled. At this appointment the patient joined the private scheme. Seven months later the UR4 was filled and although the cavity was extremely deep there was no obvious exposure of the pulp. The patient was pregnant at the time and did not wish to have root canal treatment.
A month later the UL6 was restored following the fracture of a portion of the tooth. Three months after that the patient attended complaining of pain with hot and cold sensations at the UR4. At this visit a sedative dressing and temporary filling were placed. Three months later the UR4 was finally filled without root canal treatment, although the cavity was extremely deep. This was the last time that the patient was seen.
The complaint
Four months later, the patient wrote a letter of complaint following a visit to her original dentist. This practitioner, in his report, alleged that some of the treatment was substandard, and that there were a number of restorations which needed doing. Our member forwarded details of the complaint and her records to us. A response was prepared in which she made it clear that she did not agree with the conclusions of the patient's former dentist. She also refused to reimburse the patient on the basis of the information that had been provided.
Then the member received a letter from the private scheme to whom the patient had submitted a complaint, offering to conciliate in the matter. Unfortunately the conciliation process failed to satisfy the patient and the matter was submitted to the Institute of Arbitrators. The basis of the claim was that the member had carried out substandard excessive treatment. The total cost of treatment suggested was £8,900. The DDU submitted a defence following detailed discussions with the member. She accepted that there were some areas of vulnerability, but said the majority of the work was aimed at improving existing restorations rather than dealing with inadequate treatment.
Arbitration
The arbitrator awarded the patient £977 as the costs for repair and replacement of the items which the arbitrator had felt were ineffectively carried out or had not been carried out when they should have been.
It is accepted that different practitioners will prescribe different treatments for the same patient. Patients who move from one practitioner to another often have more treatment than those who stay with one practitioner only.
This page was correct at publication on 10/05/2002. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.