A dental practice in the Slough area

4. Mr A complains about the care and treatment received from the Practice when he was given braces in August 2021. He believes the treatment has been substandard and holds the Practice accountable for this.

5. Mr A says because of the substandard treatment he:

• has experienced pain in his jaw • experienced discomfort with his bite • was unable to enjoy a full diet • was unable to pronounce words properly • suffered with low self-esteem.

6. By bringing the complaint to us Mr A would like a financial award of £3,000-£4,000 to cover the cost of private treatment to resolve the issues.

7. Mr A started his orthodontic treatment in August 2021, attending regular appointments at the Practice until November 2023, when his braces were removed and he was given a removable retainer.

8. In December 2023, Mr A returned to the Practice complaining of a clicking jaw and was concerned that his bite was uncomfortable. The Practice provided some advice to help. It also bonded buttons to his teeth to allow for elastics to be attached to move the position of his front teeth to assist in his bite issues. The Practice recommended Mr A speak to his general dentist for further guidance.

9. This treatment continued until May 2024 where, according to the records, Mr A had got used to the new alignment of his teeth. The buttons were removed and the Practice provided guidance on how to use the retainers going forward.

10. In August 2024, Mr A visited the Practice again as he was experiencing jaw pain. It was noted the retainers were not fitting well. The orthodontist recommended Mr A should go to his dentist who may be able to recommend a mouth guard to help with the jaw pain.

11. As Mr A remained dissatisfied with the treatment he raised a complaint with the Practice in September 2024. Mr A confirmed he had sought the opinion of another dentist who questioned the appropriateness of the treatment provided by the Practice.

12. The Practice responded in November 2024 and provided a timeline of events. The Practice concluded it was likely Mr A would have experienced these problems with or without orthodontic treatment.

13. The Practice confirmed it is their view that Mr A was treated in line with good clinical practice and treated with his best interest in mind.

14. As Mr A remained unhappy, he approached our service in July 2025.

17. The Health Service Commissioners Act says we cannot investigate a complaint if there is, or was, a legal remedy that the aggrieved could or could have pursued, unless it is (or was) not reasonable to do so. We do not consider whether legal action would succeed, but whether it would be a reasonable option to look in to.

18. In considering whether there is an alternative legal remedy, we need to first consider whether there is a legal cause of action. It appears there is a potential clinical negligence action open to Mr A. This is because Mr A believes the care and treatment provided by the Practice were substandard and that this caused him both emotional and physical harm.

19. Negligence, in law, is an act or failure to act (omission) that does not meet the level of appropriate care expected, resulting in injury or loss. If a doctor or health professional is negligent when giving medical treatment, this is called ‘clinical negligence’.

20. As a legal remedy appears to be open to Mr A, we then need to consider whether it is reasonable for him to pursue the matter in that way. In doing this, we have considered the amount of compensation he is seeking and whether we are likely to recommend it in relation to the injustice claimed. We discussed the figure Mr A is hoping to achieve by sharing our Severity of Injustice (SOI) scale with him.

21. Mr A has adjusted the amount he is seeking during his correspondence with us. He previously explained that he was seeking a lower financial award and would save up to allow him to receive the treatment he seeks.

22. While we appreciate his efforts in reducing his request for financial remedy, it is the principal role of our service to investigate failings, that have had an impact and to put these matters right. Working towards a partial financial remedy to put the potential failing right is not in keeping with aims of our service.

23. During our recent discussions Mr A confirmed he is seeking between £3,000 and £4,000, which he estimates is the full cost of the corrective treatment he believes he requires.

24. Mr A has confirmed he has not taken any legal action prior to approaching us. The law says if there is a legal remedy available it should be explored, unless it is not reasonable. We consider several points when assessing whether a complainant has provided reasonable grounds to not pursue legal action.

25. We discussed potential barriers to legal action with Mr A. He raised concerns about his lack of experience with legal processes, the potential cost of pursuing a claim, and the fact that he would likely need support from his parents, who are uncomfortable with court proceedings.

26. We consider whether our service or the legal route is better placed to achieve the level of financial remedy Mr A has requested. If it were determined that the dentist provided substandard treatment, it is likely that both our service and the courts could achieve the outcome he is seeking.

27. We further consider whether pursuing legal action would cost more than or take up a disproportionate amount of the remedy sought. Mr A has raised concerns about legal costs. However, dental negligence claims can be more straightforward than medical negligence claims, as they typically require only one specialist which can make the process less costly. There are also ‘no win, no fee’ firms that may be able to support him.

28. We have also taken into account Mr A’s individual circumstances.

29. Mr A raised concerns that his age and inexperience may make pursuing legal action challenging. While this is a consideration, Mr A is an adult and has not advised us of any need for reasonable adjustments that would indicate particular difficulty. His father initially handled the complaint with the dentist while Mr A was a minor, but Mr A has since taken over the complaint himself.

30. Mr A has been able to engage with our process, without input from his parents. Our process will likely mirror much of the legal process that would need undertaking. He has communicated with multiple of our staff members by email and telephone, despite having no prior experience of doing so.

31. While we would continue to support Mr A in navigating our process, our role is to independently review complaints rather than act as an advocate. A legal representative, however, would act on Mr A’s behalf and may therefore provide more support throughout that process than the support he would receive through ours.

32. Mr A also explained his family had had some negative experiences with the legal process. We appreciate this has added to his worries about this route. We have not received any specific reasons why Mr A himself could not explore this route.

33. Having considered the available information, the existence of a legal remedy, and the level of financial remedy Mr A is seeking, we consider that legal action should be explored. We were not persuaded that the reasons provided were reasonable not to pursue legal action.

34. We explained to Mr A that he may return to us if his attempt to pursue a legal route is unsuccessful. Before doing so, we would require correspondence from three separate legal firms confirming that they will not take his case forward. This is to demonstrate a change in circumstances that would justify revisiting our consideration.

35. We would ask that Mr A come back to us promptly if he is unable to proceed with legal action. This is because we are unable to investigate complaints brought to us more than 12 months after someone becomes aware of the problem. We can put this time limit to one side if we think there is a good reason to do so, and we would consider any legal advice or action sought.

Conclusion

36. We recognise the significant impact these events have had on Mr A. We hope our explanation shows our careful consideration of his complaint and reassures him about the next steps for seeking legal advice, and when he can come back to us if needed.

1. We have carefully considered Mr A’s complaint about a dental surgery in the Southeast of England (the Practice).

2. Mr A complains about the care and treatment received from the Practice when he was given braces in August 2021. We are sorry to hear about the circumstances of Mr A’s complaint. We understand the challenges he has faced and how difficult it must have been dealing with the issues raised. We recognise his strength of feeling and how important it is for him to receive answers regarding the treatment.

3. Having reviewed the available evidence, we have decided not to take further action at this time. This is because we consider it is reasonable for Mr A to explore legal action on the matter he has brought to us. We explain the reasons for this below.