The patient initially attended our member’s colleague complaining of severe pain at LR5. The dentist attempted an extraction but the tooth fractured and part of the root was retained. Our member saw the patient two weeks later. He was now complaining of post-extraction tenderness from LR4. Our member took a periapical radiograph and having analysed it recorded NAD at LR4. She advised the patient that the retained root would need to be extracted.
At the extraction appointment, the member took an OPG radiograph before removing the remains of the LR5 root surgically. Despite the improved healing at the LR5 socket, the patient continued to present with ongoing symptoms of pain and tenderness, which by two months after the initial extraction had become a cause for concern.
The patient obtained a second opinion. A further two periapical radiographs were taken before a diagnosis was recorded of root fracture of the LR4. The patient returned to our member who extracted the LR4 and provided a lower partial denture free of charge.
Several months later the patient complained to the GDC in relation to the treatment provided by both our member's colleague and our member. The allegations raised at the GDC included a failure to examine the patient's tooth appropriately and diagnose the fracture at LR4, resulting in a prolonged period of pain. In addition, the patient brought a claim for clinical negligence, seeking compensation in relation to pain and suffering.
The DDU dento-legal adviser worked closely with our inhouse legal team to provide a robust response to the GDC investigating committee in which we clearly set out the position – that the member denied failing to examine the patient appropriately. The fracture line was not clearly visible on the individual radiographs exposed as it was very faint and possibly incomplete.
However, it was conceded that if a comparison of the two views had been made, our member would have been able to detect the fracture. Throughout the treatment our member was sympathetic to the patient and did her best to alleviate the patient's problems. With no admission of liability, an apology was offered to the patient for the pain and distress.
The investigating committee meeting did not take place until more than a year after the extraction. The outcome was a letter of advice issued to our member advising that care needed to be taken in analysis of radiographs and that the taking of the OPG before surgical removal of the retained root at LR5 was not clinically justified. There was no referral to a fitness to practise hearing. The compensation claim was not resolved for a further year, before finally being dropped, having been successfully defended by the DDU.
The patient initially attended our member's colleague complaining of severe pain at LR5. The dentist attempted an extraction but the tooth fractured and part of the root was retained. Our member saw the patient two weeks later. He was now complaining of post-extraction tenderness from LR4. Our member took a periapical radiograph and having analysed it recorded NAD at LR4. She advised the patient that the retained root would need to be extracted.
This page was correct at publication on 01/08/2010. 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.