A dental practice in the Southend-on-Sea area

3. Miss V complains about the dental care and treatment she received at the Practice between 10 July 2023 and 14 December 2023. Specifically, Miss V says the Practice, after an unnecessary wait for treatment, caused a fracture to one of her teeth when doing a filling on 6 November 2023

4. She says this has caused her further pain and her gum and teeth health have deteriorated. She also says the Practice is refusing to treat her now that a complaint is ongoing. She also says the Practice is requesting her to pay for treatment.

5. Miss V requests that treatment be provided free of charge, and a financial remedy as outcomes.

6. Miss V has a history of heart issues. On 10 July 2023 Miss V was advised to wait for 6 months for treatment on two of her teeth. On 6 November 2023 she had treatment, which was a filling on one of her teeth. Miss V says this treatment caused the tooth to fracture. She says she saw another dentist who told her that she had the option of a root canal treatment or an extraction however she would have to pay for these.

9. The law gives us discretion to decide if we should carry out a detailed investigation into a complaint. Our Service Model Guidance gives more information about occasions when we decide not to investigate a complaint. That includes on the basis of it being impractical to do so or the likelihood an investigation would not reach a satisfactory conclusion. It also includes if the outcome(s) the person seeks are unachievable for us.

10. We have reviewed the information provided to us by Miss V and the Practice on this matter. Following this we have decided it is impractical to investigate this issue further.

11. Miss V returned to the Practice on 6 November 2023 for an appointment. She had a filling in one tooth. Mrs V says that this filling caused her significant pain and she could not eat. Miss V says the Practice told her that she would have to pay for hygienist treatment for a scale and polish, as well as having to pay for any further treatment such as a root canal or an extraction. Miss V says that these are available on the NHS and she should not have to pay for them.

12. Miss V says she saw a different dentist shortly afterwards who said there were a number of options however she would have to pay for them or go elsewhere on a private basis. She explained that she could not afford this because she is on benefits.

13. The Practice said it advised Miss V she needed to wait six months for treatment because of her history of heart attack. It confirmed it saw Miss V on 6 November 2023 and placed a temporary filling at UL6 (upper left tooth six), with post treatment discomfort for up to two weeks. The Practice goes on to say that Miss V telephoned reception to explain that she was having pain three days later. She was told by the receptionist she would need to call back for an emergency appointment on 13 November 2023.

14. The Practice say she did not call back for an emergency appointment and then cancelled the appointment on 15 November 2023. The Practice said it offered an alternative appointment on 16 November 2023 with a different dentist to the one who originally treated her on 6 November 2023.

15. Following the consultation on 16 November 2023, the Practice say it arranged appointments for root canal treatment with another practitioner on 11 December 2023, which Miss V cancelled because she did not want to be in pain over the Christmas period. The Practice say it emailed Miss V to say that the treating dentist strongly recommended she attend the appointment for root canal treatment.

16. The Practice also say Miss V enquired about additional procedures including implants or crowns. However at this particular time these would be inappropriate as the root canal treatment is yet to be completed.

17. The Practice confirmed in an email dated 6 December 2023 that the limitations of root canal treatment have been explained to Miss V. Should an extraction be consented to the possible replacement options are: • An upper acrylic partial denture • A bridge or • An implant

With the last option, this would not be funded under the NHS.

18. We have contacted the Practice who explained that they would be able to offer root canal treatment on the NHS and potentially an extraction. The Practice said this would be at another of its practices in the area. It said an implant would not be funded by the NHS as this is not within the bands of NHS treatment.

19. The Practice has confirmed to that Miss V would not have to pay for this NHS treatment as she qualifies for free NHS treatment.

20. The NHS complaint standards say staff can offer a range of ways to put things right for the individual. Organisations empower staff to identify suitable and appropriate ways to put things right for people who raise a complaint.

21. The Practice have provided an opportunity for Miss V to have the treatment she needs at no cost to her. We have contacted Miss V to advise that she has the opportunity to have treatment that would be free. This is an outcome that Miss V is seeking.

22. Miss V has said that despite the offer of free treatment at a sister site of the Practice she would want an implant without any cost. She says this is because on 6 November 2023 the treating dentist fractured her tooth.

23. The Practice has explained that for ongoing treatment, irrespective of the fracture, it would need to consider looking at a root canal treatment first. Miss V could then have other necessary NHS treatment, such as a bridge. Providing an implant free of charge would not be something that is provided under NHS treatment.

24. The NHS website clarifies that implants are usually only available privately and are expensive. It says they are sometimes available on the NHS for patients who cannot wear dentures or whose face and teeth have been damaged, such as people who have had mouth cancer or an accident that's knocked a tooth out.

25. Mrs V wants an implant or compensation for the cost of that as a remedy. This is not something we would be able to achieve for her because we would never be able to compel the Practice to complete an implant as an outcome.

26. The only option would be to look at a financial remedy should a failing be found. If we found failings and an impact, we would not recommend financial remedy for a more expensive treatment like implants if a lower cost NHS treatment were available. This outcome is therefore unachievable even if failings were found. So it seems we would be unlikely to be able to achieve more for Miss V if we looked into this complaint further.

27. Miss V has been advised by both the Practice and ourselves that she would be able to have necessary treatment under the NHS so she does have treatment options available to her.

28. Miss V says that the Practice are refusing to treat her. The Practice have explained that as there is a General Dental Council (GDC) complaint ongoing it has suggested and offered treatment at their sister site.

29. Miss V also says there is no treatment plan for her. The Practice has advised she would need to decide what treatment she would like. Once she has, a treatment plan would be provided by the sister site.

30. It had not been apparent at the start of the complaint process that there was an ongoing GDC complaint. Miss V has confirmed this is ongoing. The GDC complaint is in relation to the same and similar issues as this complaint to us.

31. There is the possibility that the GDC may resolve the case. Also there has been an offer by the Practice to resolve the complaint to the Ombudsman by progressing treatment at a sister site, which would achieve the main outcome that Miss V is seeking i.e. free treatment.

32. Having considered all the circumstances carefully, we have decided not to investigate this complaint further. The Practice has offered steps to resolve the complaint to Miss V and we do not think we would achieve more for her. There is also another organisation already looking into Miss V’s complaint. These are reasons we do not think an investigation by us would be practical or achieve a satisfactory answer or outcome for Miss V’s complaint.

33. We realise how difficult this matter has been for Miss V and we thank her for bringing this complaint to us. We hope the Practice’s offer of treatment with a sister site, and the outcome of the GDC complaint will bring some closure for her.

1. We have carefully considered Miss V’s complaint about a dental practice in the Southend-on-Sea area (the Practice). We are sorry to hear about Miss V’s experience. We appreciate her distress in not having dental treatment.

2. We have declined to consider Miss V’s complaint about the care and treatment further. This is because there is currently an ongoing complaint with the General Dental Council. It is also because the Practice has offered practical steps to allow Miss V’s to have treatment and we do not think we would achieve more for her.