A dental practice in the Swindon area

4. Miss A complains about the care and treatment provided by the Practice, on 26 March 2024. Specifically, she complains that:

• Practice staff did not communicate that she would require private treatment, or the cost of treatment, prior to removing her tooth filling.

• four days after staff applied a temporary dressing, her tooth cracked, and part of the tooth fell out.

5. Miss A says she would not have agreed to have her filling removed if staff told her to repair the tooth would require private, costly treatment.

6. She says she has been left with a damaged tooth, which required private dental treatment at another Practice at a cost of £2500 and suffered with severe mental distress.

7. Miss A is seeking a financial sum and acknowledgement the Practice made mistakes.

8. Miss A attended the Practice for a check up on 26 March 2024. She complained of nerve pain in an upper right tooth. The dentist took an X-ray of her tooth and found that her filling was touching the nerve.

9. The records show the dentist discussed the options for treatment with Miss A. They explained that they could leave the tooth ‘as is’ or could remove the filling to investigate the tooth to decide if it should be treated with a root canal or filling. The records show the dentist advised Miss A that she may need to see a private colleague if a root canal was complicated and that ‘pt [patient] aware this is a prvt [private] option.’

10. Miss A returned to the Practice later the same day to have the filling removed. The dentist recorded that it looked like her tooth had been perforated by a previous treatment. They applied a temporary dressing with a sedative dressing to help with Miss A’s pain

11. The dentist explained it was beyond their ability to do a root canal on a perforated tooth and explained Miss A would need to see a private colleague for this option. They explained she could also choose to do nothing/monitor the tooth, or have it extracted.

12. The records show Miss A became upset and left the Practice. In her complaint to us, Miss A explained this was the first time she knew she might need private treatment, and she was panicked on hearing of the damage to her tooth. She complained to the Practice the same day.

13. The dentist sought advice/a second opinion from a colleague the following day, who agreed to attempt root canal treatment on the NHS. The Practice booked Miss A an appointment for the treatment on the NHS on 2 April 2024. Miss A declined this appointment.

15. When we decide whether to investigate a complaint, we consider if an investigation would be practical. This includes considering whether we would be able to reach a satisfactory conclusion. In this case, we do not feel we would be able to do so.

16. Miss A explained the dentist at the Practice told her that she needed to have her filling removed to assess the root. Once this had been done, she says the dentist told her she may need to see her specialist colleague, a private dentist, to fix it as they were unable to.

17. She says the dentist covered her tooth with a temporary dressing. She says she would not have gone ahead with the filling removal had she known they could not permanently refill the tooth, or that she would need private treatment.

18. Miss A explains that, after the temporary dressing was applied, she started to panic and asked to leave the room. She says she was very upset and very worried, and she had a panic attack. We recognise how distressing this was for Miss A.

19. She explained that on 30 March after receiving the temporary dressing, the tooth cracked completely.

20. Miss A says the Practice offered her a 30-minute appointment with another NHS dentist at the Practice on 2 May 2024. She explained she didn't believe a short appointment would be sufficient, therefore she refused to attend.

21. Miss A had the treatment privately at a cost of £2500, which she would like reimbursement for, as well as an apology from the Practice and acknowledgement of failings.

22. In its response, the Practice explained it apologises for the upset Miss A feels. The dentist says they explained to Miss A that if the treatment required once the tooth was examined was complex, she would have the option to see a specialist in root canal treatment, with private costs, and apologised if she felt this was not made clear.

23. The dentist explained it was not their intention to leave Miss A with a temporary dressing indefinitely. They explained the plan at the time was to seek a second opinion from another dentist and proceed with root canal treatment on the NHS if Miss A’s nerve was intact.

24. Miss A’s medical records show that on 26 March at her morning appointment, the dentist discussed with Miss A their concerns about the tooth she was experiencing pain in.

25. The note states ‘discussed with [patient] options for [tooth].

1. Leave as it is.

2. investigate condition of the tooth and decide if [root canal treatment] or filling is the best option. Patient aware [extraction] may be required if root canal treatment is not successful.

[Patient] also given the option to see [another dentist] if root canal treatment more complicated. [patient] is aware this is a [private] option.’

26. The records show Miss A agreed to the removal of her filling and returned to the Practice later that day. They also indicate she was aware she might need private treatment.

27. The records show the dentist removed the filling and identified it ‘looks like the tooth is perforated from the previous filling.’ The dentist filled the tooth with a temporary dressing and again advised Miss A of her options, which were to do nothing and monitor the tooth, refer for private treatment, or extract the tooth.

28. The dentist informed Miss A it was beyond their scope to complete root canal treatment on a perforated tooth.

29. The records say ‘Miss A was given the option to see [the other dentist] for a second opinion’.

30. We can see the dentist sought advice from an NHS colleague the following day, and they advised they could attempt the root canal treatment. The Practice informed Miss A of this and booked her an appointment for 2 April to complete the treatment. Miss A declined this appointment.

31. Although Miss A believes a 30-minute appointment was not long enough, we can see the Practice did promptly offer an appointment to treat her tooth on the NHS. Miss A declined a further appointment and decided to seek private treatment.

32. As such, if we were to investigate the complaint, we would likely not be able to say that the impacts Miss A has told us about are linked to the Practice’s actions. It appears she may have been able to avoid spending money on private treatment, as she was offered the procedure on the NHS. The treatment also may have helped to treat the later damage to her tooth.

33. We recognise Miss A disputes that the dentist told her she might need private treatment. The records (from the time of the morning appointment) do indicate this was explained to her. In any case, even if we did find failings in the way the dentist communicated, we would be unlikely to be able to make recommendations to remedy this. As above, this is because we would not be able to say this communication was linked to her financial loss or permanent damage to her tooth (and associated distress).

34. An investigation would therefore not be practical, or reach a satisfactory conclusion. As such, we will take no further action on the complaint.

35. We recognise Miss A has been through a difficult time and we are happy to hear she has now received successful treatment on her tooth.

1. We have carefully considered Miss A’s complaint about Eurodental (the Practice).

2. We recognise how distressing it must have been for Miss A when she was suffering from dental pain and when her temporary dressing fell out.

3. We have decided that further investigation of the complaint would not be practical. This is because we would likely not be able to say that the Practice’s actions caused Miss A’s financial loss, or damage to her tooth. She declined the Practice’s offer of an NHS appointment. and we do not know what would have happened if she had been seen again.