A dental practice in the Warrington area

4. Miss I complains that between 10 November 2021 and 27 June 2022 the Practice did not fully communicate the kind of treatment available through the NHS or give in depth information about the treatment it was suggesting for her. She also complains it did not tell her of the possible risk of dry socket (inflammation of the alveolar bone) after an extraction (removal of teeth).

5. Miss I says she had nerve damage, bleeding, bruising, swelling and general pain. She says she was left with a temporary crown and she had to get private treatment. Miss I also says if she been told that certain treatments were not available through the NHS, she would have asked for different treatment.

6. Miss I wants a financial payment.

7. On 10 November 2021, Miss I went to the Practice to have a filling. Four days later, she was in a lot of pain and contacted the Practice about getting an appointment for more treatment. The next day the Practice offered her an appointment for 16 February 2022.

8. At the appointment Miss I had a tooth removed. A few days after her appointment, Miss I contacted the Practice in a lot of pain. She went to the Practice on 22 February and the dentist confirmed she was suffering from dry socket.

9. On 1 March, Miss I emailed the Practice with new symptoms of increased teeth sensitivity, including of a wisdom tooth. She emailed the Practice again on 9 March to say the wisdom tooth had settled down, but she had found something in a cavity in her tooth. She went to the Practice for an appointment on 17 March and possible treatments were discussed.

10. The next day the Practice advised Miss I that her dentist had no appointments available soon. It asked if she would be happy to see another dentist and she agreed. At this time, Miss I thought her treatment plan was for root canal treatment and preparation for a bridge.

11. Miss I went to appointments with the new dentist on 6 and 27 June. The dentist took impressions of her mouth. After the last appointment, the Practice contacted Miss I asking her to pay for treatment for the first extraction, a root filling and a crown under an NHS band 3 charge.

12. In January 2023, Miss I had private treatment to continue her dental treatment.

15. Before we decide if we should do a detailed investigation of a complaint, we look at whether there are signs the organisation got something wrong. We do this by comparing what should have happened with what did happen. We have done this and have not seen any signs that something went wrong.

16. GDC guidance says dentists must: • ‘Communicate effectively with patients • Recognise and promote patients’ rights to and responsibilities for making decisions about their health priorities and care • Give patients the information they need, in a way they can understand, so that they can make informed decisions • Give patients clear information about costs.’

17. Miss I’s dental records include an email the Practice sent to her in February 2022 with details of ‘Treatment plan and associated costs’. This suggests that after the first treatment in November, the Practice clearly communicated the treatment Miss I would have and the costs of this.

18. The records also note that the dentist discussed treatment and related costs with Miss I during her appointment on 17 March 2022. At this appointment the dentist noted she had decided to first have root canal treatment and then a crown on the affected tooth once the root canal had settled. At this time Miss I already had the information about NHS costs from the email sent in February.

19. We cannot say exactly what was discussed between the dentist and Miss I at each appointment. But the records clearly show the dentist did discuss treatment options. This seems to be in line with the GDC guidance. If Miss I was unsure at any time, she could have checked this with the Practice.

20. Miss I also says the Trust did not tell her about the potential side effects or risks of extraction.

21. The records detail her appointment with the Practice on 16 February, when her tooth was extracted. The dentist noted they discussed the common complications that can happen during and after an extraction The Practice also gave Miss I a letter of advice after the extraction. This letter tells patients about ways to help reduce the risks of common complications of extraction.

22. We understand Miss I experienced a dry socket, increased sensitivity and damage to the tooth next to the one that was extracted. Our adviser explained this is a risk of tooth extraction and the dentist did seem to have communicated this information in line with the GDC guidance.

23. Based on the evidence we have seen, the Practice communicated the treatment available to Miss I, the costs related to these treatments and the potential risk of complications during and after procedures. We are sorry that Miss I had these complications, but the evidence shows this could not have been avoided and was not because of mistakes by the Practice.

24. For these reasons we have not seen any signs the Practice did anything wrong. We will take no further action on this complaint. We hope our explanation has given some reassurance about what happened. We are pleased Miss I has now been able to get the treatment she needed to resolve her dental issues.

1. We have carefully considered Miss I’s complaint about a dental practice in the Warrington area (the Practice). We are very sorry to hear about Miss I’s experience and the dental problems she has had. This has clearly been a distressing time for her.

2. We have carefully considered the evidence and we have seen no sign that anything went wrong in the way the Practice handled Miss I’s treatment. We have seen the Practice acted within the relevant guidelines to offer treatment. We have decided to take no further action on Miss I’s complaint.

3. We understand this may not be the decision Miss I was hoping for. We hope the information below explains how we have fully considered her complaint and gives her some reassurance about what happened.