Permanent molar extraction

Child brushing teeth

A dentist found himself facing a claim for compensation as a consequence of the erroneous extraction of a 6-year old patient's tooth

The child had been referred to the dentist's clinic for the extraction of several deciduous teeth, some grossly carious, under general anaesthetic. Unfortunately, the dentist mistook a small permanent lower molar for the appropriate deciduous tooth. The permanent molar was reimplanted immediately and splinted to the adjacent sound deciduous teeth.

Subsequent reviews by the hospital consultant found that the molar tooth was not painful or sensitive and the gingival tissues around it all appeared healthy. The indication was that the tooth was responding well to treatment and there was no cause for concern.

In the meantime the dentist apologised to the patient and the parents, who went on to make a formal complaint to the clinic. As a DDU member, the dentist sought our assistance and the DDU dento-legal adviser helped the member to respond to the complaint.

Hospital reviews in the following months confirmed that the molar tooth remained healthy and no further active treatment was envisaged.

The child's parents nonetheless instructed solicitors to bring a claim for compensation, alleging that the error could lead to serious complications and long-term dental health problems for the patient.

The DDU instructed an independent dental expert witness to examine the child and provide an opinion on the case. The examination took place over a year after the date of the incident and found that the permanent molar did not exhibit signs of periodontal attachment loss. It was not tender to percussion or mobile. It appeared that root formation was continuing normally and, on balance, the expert agreed with the hospital consultants that the prognosis was good. However, the expert advised caution as there was little research evidence on which to base the opinion.

After obtaining the dentist's consent, the DDU put forward an offer to settle. The claimants' solicitors chose to wait and see what happened to the child's tooth.

Eventually, they accepted that there was no immediate indication of further problems with the permanent molar, but during further negotiations it was acknowledged that, but for the error, the child and the parents would not have had the anxiety and inconvenience of multiple hospital appointments. Also, there remained some concern for the future of the permanent molar. An amicable settlement of £2,000 plus legal costs was finally reached.

Ian McLaren
Claims handler

This guidance was correct at publication . It 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.

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