A patient attended her general dental practitioner in severe pain from an upper premolar which had fractured. The dentist found extensive decay in the tooth and a fracture that extended below the gum, rendering the tooth non-restorable. He diagnosed irreversible pulpitis/apical periodontitis and advised extraction. The patient readily agreed and extraction was carried out at the same appointment.

The patient claimed that some weeks later, whilst on holiday in the UK, she began to experience discomfort in the region of the extraction site. This discomfort increased over two or three days, accompanied by gradually increasing swelling of the left cheek, extending to the lower border of the orbit. The patient contacted a local dental practice, where a periapical radiograph of the extraction site revealed a significant portion of the buccal root of the patient’s tworooted upper left first premolar tooth remaining in situ. The retained fragment was extracted the same day, and the patient returned from her holiday one day earlier than planned.

The patient contacted her dentist’s practice to complain about the need to have sought emergency treatment while on holiday. She rejected the dentist’s goodwill offer to refund the NHS Band 2 cost of the original extraction, and wrote to him seeking further compensation for the emergency treatment.

The member sought the DDU’s assistance in responding to the claim for compensation. With the patient’s written consent, the DDU obtained and considered the clinical records from the subsequent dental practice. In view of the extent of the retained root left visible on the post-extraction radiograph, which would have been apparent following extraction, the DDU advised our member of his vulnerability in respect of failing to have recognised and advised the claimant of the retained root, and provide appropriate advice and/or treatment to arrange its removal. Our member agreed that this was a matter which required settlement.

With the member’s consent, an offer was made to the claimant to compensate her in general damages for pain, suffering and loss of amenity in respect of the infection and need for the retained root to be extracted as an emergency procedure, and in special damages for the cost of the original and subsequent extraction procedures. The claim was settled for £500 with no legal costs.

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