A dental practice in the Chorley area

3. Mr O complains dentists at the Practice failed to refer him for further investigations on his ulcer between December 2016 and February 2018.

4. He says this caused a delay in diagnosing the ulcer as cancerous. He also says this delay meant he required more invasive treatment, as he required laser treatment and two surgeries. After his surgery, he says his lower set of dentures did not fit and this caused him months of difficulty eating. He also says he had to take early retirement as he was concerned the surgery would affect his speech. He was left with no feeling on the tip of his tongue, dry mouth, and reduced movement in his jaw and tongue from the invasive surgery. There has also been a financial impact from the new dentures, which require relining every few years.

5. Mr O says he wants financial compensation for the distress this has caused him as well as the dentures he requires, and their relining costs, as this will be a significant expense in the future.

6. Between 2012 and May 2016, Mr O was noted to have frictional keratosis (benign oral white lesion caused by chronic trauma to the site), which his dentists put down to irritation from his dentures. The irritation improved so nothing further was done. In December 2016 and July 2017 dentists at the Practice noted ulceration. In March 2018, he saw another dentist, who referred him to an oncologist at a local hospital.

7. In April 2018, Mr O had his appointment with the oncologist. In June 2018 he underwent laser treatment to the ulcer. He had then had further appointments and a biopsy.

8. On 28 October 2019, Mr O had his first surgery. At this stage he knew his ulcer was cancerous. On 22 November 2019, Mr O had a second surgery, as the surgeon had not removed enough.

9. In January 2020, Mr O attended a different dental practice to get dentures. He was told these would require relining, at a cost, every few years.

10. On 19 January 2021, Mr O complained to the Practice about the delay in referring him to an oncologist for investigation. He received a final response on 20 May. We received a copy of this, with the complaint form from Mr O, on 4 June 2021.

Delay in referral for further investigations on cancerous ulcer

12. The law says a person needs to make their complaint to us within a year of becoming aware of the problem. We cannot investigate complaints brought to us after one year, unless we consider there is a good reason. We have discussed this with Mr O to understand the reasons why he could not bring his complaint to us sooner. We have also considered the time the organisation has taken to respond to Mr O.

13. We are very sorry to hear about what happened and that Mr O has had a difficult time going through extensive treatment to remove the cancer. We are also sorry to hear about the complications this has caused, and that his dentures no longer fit, resulting in a financial impact. We have kept this in mind when considering Mr O’s complaint to see if there is more we can do to help resolve this.

14. We have first considered Mr O’s date of knowledge. This was when he had an appointment with a new dentist in March 2018. Mr O said the new dentist asked him whether his previous dentist had said anything about his ulcer. The new dentist advised he would be referring Mr O to an oncologist at Hospital A. This is the date when Mr O reasonably would have known his previous dentist may have gotten something wrong by not referring him for further investigations.

15. Mr O says, at the time he was referred he did not know what the outcome would be, and there was a possibility his ulcer was not cancerous. We also appreciate Mr O did not know, until after surgery, he would have to change his dentures and that there would be a financial impact as well as physical. These are reasons Mr O has given us for the delay. Our casework policy (SMG 2.238) is clear that the date of knowledge is when the person could first reasonably know an organisation may have gotten something wrong, not when the person experiences its impact.

16. Mr O would therefore have needed to bring his complaint to us by March 2019, to be within our one year time limit. Mr O had not yet complained to the Practice by this time. He did this in January 2021, so we are satisfied the Practice’s complaint handling was not the cause of the delay. He has told us he was reluctant to raise a complaint because of lockdown. However, his date of knowledge was a year before lockdown started. He has also told us he was unaware there were time limits as he has never complained to us before. Information about our service is widely available in the public domain. Lack of knowledge about our time limit is not enough for us to put it to one side.

17. We have considered the reasons Mr O has provided. Unfortunately, these reasons do not persuade us to put our time limit to one side. We will therefore not take any further action on this complaint.

18. This outcome in no way diminishes the effect these issues have had on Mr O. We understand how difficult things have been for him and appreciate why he has raised these concerns. We are sorry there is nothing further we can do, but we must consider our time limit by law.

1. We have carefully considered Mr O’s complaint about a dental practice in the Chorley area (the Practice). We have decided the complaint falls outside of our time limit.

2. We are sorry to hear about Mr O’s concerns and that he has had to undergo extensive treatment to remove his cancer. Mr O feels this could have been avoided had he been referred sooner. We consider that Mr O first became aware his previous dentist may have made a mistake when his new dentist queried his ulcer, and then referred him to an oncologist. This means Mr O’s complaint is out of time. Unfortunately, the reasons Mr O has provided for the delay in bringing his complaint to us are not enough for us to put our time limit to one side.