An elderly patient of many years’ standing at the practice attended as an emergency with an infection associated with a failing root filling at lower right 7. The patient’s general dentition was complex, and heavily restored. He also had restricted opening and was unable to lie flat for long.

The dentist, a DDU member, reviewed the LR7 and though he told the patient the prognosis was poor, the patient wanted to attempt repeat root filling. All treatment options were discussed and recorded, including referral to a specialist, but the patient insisted that treatment was carried out at the surgery. At the first appointment, the dentist started the root treatment, but before the second appointment the patient fell ill and there was a long hiatus in the treatment, with many cancelled appointments and failures to attend.

Not unexpectedly, the patient experienced a flare-up of infection, with significant swelling and limited opening. He chose to attend a different practice for treatment. The emergency dentist advised that the infection was severe and LR7 required extraction and was critical of the first dentist’s management of the patient. Before long, the patient complained to the first dentist, demanding compensation for the loss of the LR7, pain and suffering, taxi fares and even loss of earnings for his family who had taken time off work to assist him.

The DDU reviewed the clinical records and noted that the dentist had done all he could in difficult circumstances to treat the patient appropriately. The issue of the spreading infection had arisen due to the patient’s non-attendance for treatment. With help from the DDU, the dentist drafted a response to the complaint, explaining the treatment that had been provided and the significance of the failure to return for treatment. Our member offered to refund the patient the cost of the care that had been carried out, as a gesture of goodwill. On reflection the patient acknowledged that our member had acted in his best interests, and accepted the small refund. He did not pursue the claim for compensation.

This case demonstrates the importance of keeping good records. Without full detailed records of the treatment options that had been discussed, and of the patient’s repeated non-attendance, it would have been very difficult to refute the patient’s complaint. For dentists treating a patient who complains about treatment provided by another dental professional, the DDU emphasises the importance of ascertaining that the patient’s recollection of treatment is accurate before criticising a fellow practitioner. If there are serious concerns about another dentist’s work, the DDU advises following the GDC Standards guidance on raising concerns.

Effective records

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