A dental practice in the West Northamptonshire area

3. Mr O complains the Practice did not identify or treat his son’s unerupted tooth quickly or correctly in February 2024.

4. Mr O says as a result his son’s tooth is now trapped between two teeth and he is facing the possibility of surgeries to have the tooth removed.

5. Mr O said his son is distressed by the thought of having surgery that could have been prevented sooner if treated.

6. Mr O wants an apology, service improvements and financial compensation.

7. The Practice gave Mr O’s son’s dental care and treatment between November 2019 and September 2024 over approximately 10 appointments.

8. Mr O registered his son with a new dental practice and he had his first appointment in April 2025. The dentist took an X-ray of his son’s teeth and found a lower left tooth trapped in the gum by the surrounding teeth.

9. Mr O said his son’s new dentist said his son would need multiple surgeries to remove the tooth.

13. Before we decide if we should conduct 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 found any indications that something has gone wrong.

14. Mr O complains the Practice did not find or treat his son’s unerupted tooth quickly or correctly in February 2024. He says his son now faces surgery in the future which is upsetting and could have been avoided.

15. The Practice said the unerupted tooth was seen in 2019 and typically erupts between age 11 and 12 however, the first sign of a tooth not erupting was not until February 2024.

16. The records show the Practice documented from May 2019 that Mr O’s son, then eight years old, had unerupted upper and lower teeth. The Practice gave regular advice to support and encourage him to have good oral hygiene. The Practice continued to document his son’s teeth throughout his time at the Practice. At each appointment it noted if his baby teeth remained unerupted or were loose and ready to make way for his adult teeth.

17. The records show at an appointment in mid-February 2024, when Mr O’s son was 12 years old, his lower left five (LL5) tooth had not erupted but he was not experiencing any problems. The Practice gave his son advice on how to clean his teeth appropriately. The Practice did not complete X-rays during this period.

18. This is in line with NLH which tells clinicians ‘Children and adolescents are particularly sensitive to ionizing X-rays. The consequences of radiation can be far-reaching and can affect the rest of their lives. Therefore, a sensitive approach to radiation is necessary, especially for children and adolescents.’

19. The records show in September 2024 the Practice intended to take an X-ray of Mr O’s son’s lower left four (LL4) tooth because a gap in his gum had closed and the tooth had not erupted.

20. The Practice noted the X-ray would be taken at the next scheduled appointment because its X- ray machine was broken at the time.

21. As the dentist needed to assess the position of the tooth, this is in line with IAPD recommendations paragraph 1 which says, ‘Clinicians should base the frequency of radiographic examinations on their clinical examination and oral diagnosis’.

22. Mr O then moved his son to a new family dentist, that himself and his wife had joined, before the Practice could perform its intended X-rays.

23. Our adviser told us the LL4 tooth normally erupts between the age of 10 and 12.

24. Our adviser said there are no guarantees an adult tooth would have erupted normally if the unerupted tooth had been seen sooner. In these situations, orthodontic assessments would be needed for Mr O’s son’s teeth to assess what treatment if any would be needed.

25. Mr O said although his son was not in pain or experiencing any problems he could have been spared the need for surgery had the unerupted tooth been seen sooner.

26. Based on the evidence we have seen, the Practice recognised Mr O’s son had unerupted teeth throughout his period of care, and its treatment involved watching how his teeth were developing while he was a patient at the Practice.

27. The Practice considered the clinical need to expose Mr O’s son to X- rays in line with recommendations and article advice to X-ray but only when it was appropriate.

28. As Mr O’s son was 12 in 2024 the Practice continued to watch to see if his teeth would develop normally which was appropriate given his age. When an X-ray was considered appropriate to assess the closed gap for his LL4 tooth, its machine was damaged. Mr O removed his son from the Practice before it was able to complete its intended investigations.

29. We are unable to say taking sooner X-rays or removing the unerupted tooth would have impacted or changed Mr O’s son’s potential need for surgical treatment in the future.

30. We understand the frustration this has caused Mr O and his son at the possibility of needing surgery to remove his teeth. We hope our explanation goes some way in explaining how the Practice acted in line with recommendations and guidance in providing his son’s dental care.

1. We have carefully considered Mr O’s complaint about a Practice in Lincolnshire. We are sorry to hear about Mr O’s experience with the Practice not identifying his son’s unerupted tooth. We understand how distressing it is to feel your family are not getting the care they need.

2. Having investigated his complaint, the evidence suggests the Practice treated Mr O’s son in line with relevant guidance. We hope he is reassured by what we have seen.