A dental practice in the City of Kingston upon Hull area

3. Miss R complains that a dental Practice in Hull between February to November 2024 did not pick up on or inform her about her teeth having decay and infection, and did not fully explain the importance of having treatment urgently.

4. Miss R states as a result of this, she has needed to have treatment on 14 teeth, including five which needed to be removed. She states she also had an infection under three teeth. She states this has caused her significant distress and anxiety as well as ongoing pain for months.

5. Miss R is seeking service improvements and financial compensation.

6. Miss R first attended the Practice in February 2024 for a dental exam. She attended dental exams throughout 2024.

7. Miss R attended the Practice for an emergency pain appointment on 12 December 2024. She was diagnosed with irreversible pulpitis and had an extraction on the same day.

8. Miss R returned to the Practice on 30 December 2024 as she had severe pain in one of her teeth. She was prescribed antibiotics.

9. Miss R had a full appointment on 9 January 2025 as she was experiencing pain in all of her back teeth. She was diagnosed with localised periodontal disease (serious bacterial infection which damages the gums, ligaments, and bone supporting your teeth). This is also known as periodontitis, or gum disease. She was also diagnosed with tooth decay, three unrestorable teeth, and three periapical abscesses (infection around the root of the tooth).

10. Miss R complained to the Practice on 9 January 2025. The Practice issued its final response in March 2025, and Miss R came to us on 31 July 2025.

14. Before we decide if we should conduct a detailed investigation of a complaint, we look at whether there are signs the organisation has 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.

15. Miss R complains her dentist did not pick up on her teeth having decay and infection, and did not fully explain the importance of having treatment urgently. She states this happened at her dental appointments between February and November 2024.

16. We will consider each appointment to consider whether or not she received appropriate care and treatment at each appointment.

February appointment

17. Miss R attended the Practice for an adult dental exam on 1 February 2024.

18. The records state the dentist discussed with Miss R the presence of periodontal disease (gum disease) which is irreversible, and the goal is to keep the gums from getting worse and to keep the teeth as long as possible. She was told if oral health does not improve and maintained the disease could progress further which could result in eventual loss of teeth.

19. The records state Miss R if her oral health improves by her next appointment, they will commence non-surgical periodontal treatment. The records state Miss R understood and agreed to this. She was also referred to the hygienist because of the clinical signs of gum disease.

20. During this appointment, the recall interval was set at three months, and the records state this is ‘due to the patient having high perio risk’. This is in line with the NICE, Dental Recall, which state ‘The shortest interval between oral health reviews for all patients should be 3 months.’

21. The records for this appointment also note Miss R was offered an X-ray screening, but she declined and said she would do this next time. Our adviser explained a dental X-ray would show any secondary decay lesions underneath teeth identified on the dental notes but an X-ray wouldn’t show the full extent of decay (carious lesion) unless any old fillings had been removed and teeth underneath been assessed clinically.

22. Miss R has the right to decline any X-ray or treatment in line with the General Dental Council guidelines ‘Standards for the Dental Team’, 30 September 2013, which state:

‘Patients can withdraw their consent at any time, refuse treatment or ask for it to be stopped after it has started. You must acknowledge their right to do this and follow their wishes.’

23. We have seen in the records Miss R was given information about the condition of her teeth, and a treatment plan was discussed. We have not identified any indications of failings in relation to this appointment.

May appointment

24. Miss R attended the Practice on 30 May 2024 for an adult exam.

25. During the appointment on 30 May 2024, the records state ‘grade 2 severe bone loss- pt aware wish to keep as is- made aware maybe lose the teeth.’

26. At this appointment the records state the dentist discussed with Miss R about the irreversible nature of gum disease. The records state ‘gum disease aetiology (causes), treatment, and prevention explained.’

27. Prevention and Treatment of Periodontal Diseases in Primary Care, states, ‘Explain to the patient the causes of periodontitis and the potential benefits of successful treatment: stabilisation of disease, increased oral comfort and reduced risk of tooth loss.’

28. The dentist has acted in line with these guidelines according to the dental records.

29. We cannot say the dentist did not provide sufficient information about Miss R’s condition during this appointment. We can also see Miss R declined further treatment as the records state she wished to keep the teeth as they were.

30. Miss R also complains she was not given appropriate information about treatment she required. At this appointment, non-surgical periodontal treatment was explained, and the records state Miss R understood and agreed with the treatment. This is in line with Prevention and Treatment of Periodontal Diseases in Primary Care, which state:

‘Explain to the patient what treatment options are available, what these involve and the potential benefits and risks of treatment, for example stabilisation of the disease and reduced risk of tooth loss but potential post treatment recession’.

31. We understand Miss R feels she was not sufficiently informed about the extent of her condition, but we cannot say the dentist did not explain this as it is set out in the records. Whilst she states she was not informed about the need for treatment, a treatment plan was offered and agreed to in this appointment. We have not identified any indications of failings in this appointment.

July appointment

32. Miss R attended the Practice on 18 July 2024 to commence non-surgical treatment for her periodontal disease.

33. On 18 July 2024 Miss R attended the Practice again and was informed of her periodontal disease and the risk of tooth mobility and tooth loss. On this date Miss R commenced treatment for her periodontal disease.

34. The records state there was a full periodontal assessment, and Miss R attended for non-surgical hygiene phase therapy. This is the initial step in treating gum disease, and the primary goal is to disrupt bacterial plaque, remove hardened tartar, and reduce inflammation, which helps the gums to heal without surgery.

35. This is in line with Prevention and Treatment of Periodontal Diseases in Primary Care, which states, ‘For teeth with Grade II or III furcation involvement (bone loss as a result of gum disease), especially those that are holistically assessed as being of ongoing value to the patient and their dentition, provide non-surgical treatment with the aim of achieving medium/long term retention of the tooth.’

36. The records also state on this date ‘diagnosis made and discussed.’ This appointment was not with the dentist, but we note Miss R was actively receiving treatment for her periodontal disease. We have not identified any failings in relation to this appointment.

October appointment

37. Miss R attended the Practice for a dental exam on 22 October 2024.

38. During an appointment on the 22 October 2024, after her dental session with therapist on 18 July 2024, Miss R had a full mouth assessment and X-rays were carried out.

39. The X-rays show there was secondary decay shown on the five of the teeth. Secondary decay refers to a new cavity which develops underneath or immediately adjacent to an existing dental filling, crown, or restoration.

40. According to dental notes, Miss R was then made aware of the damage (decay lesions), but she declined to have fillings or dental treatment.

41. According to the dental record, during the appointment of 22 October 2024, the dentist ‘advised fillings, patient declined. the patient was made aware of risks fracture, lose tooth/teeth, pain swelling - pt declined’. This is acceptable within patient’s rights and in line with GDC standards to obtain valid consent, referenced above.

42. Our adviser explained the X-rays in October 2024 show teeth with certain amount of decay (carious damage), but the full extent of damage cannot be determined unless the filling been removed and clinical assessment to be done, and this was clearly declined by the patient in the records.

43. The patient has the right the decline treatment and we cannot state the dentist had not made it clear enough to Miss R.

November appointment

44. Miss R attended the Practice on 19 November 2024 for her periodontal treatment. At this time, she said her tooth hurts when she flosses, but generally was not experiencing any pain.

45. The records state Miss R had an X-ray and this was showed to her with full explanation. The records state there was the option to remove an old filling and replace with a provisional filling, and if there were any problems she could proceed to have an extraction or root canal treatment. The records state Miss R wished to keep it as it is for now and she was made aware of the risks. She consented to non-surgical periodontal treatment.

46. The records also state she needed to maintain good oral health or the treatment may fail and the disease may progress further, which could result in bone loss and teeth mobility leading eventually to loss of teeth.

47. The records show Miss R was told about the problems with her teeth and the treatment was offered appropriately. This is in line with the General Dental Council, Standards for the Dental Team, which states, ‘You must listen to patients and communicate effectively with them at a level they can understand. Before treatment starts you must: explain the options (including those of delaying treatment or doing nothing) with the risks and benefits of each; and give full information on the treatment you propose and the possible costs.’

48. We recognise Miss R considers the dentist should have been clearer about the urgency and necessity of the treatment. The records reflect multiple conversations took place about Miss R’s condition and need for treatment, and whilst we do not wish to dispute Miss R’s version of events, we cannot say these conversations did not happen.

49. We also note Miss R told us she would have had fillings if she had been told this was necessary. We have seen in the records Miss R was informed about the need for fillings but declined the treatment.

50. As we were not there, we cannot say exactly what was said during these appointments. We recognise Miss R says she was not informed about the need for fillings or the extent of her gum disease. We cannot say she was not told as we have seen multiple references to this in the records.

51. We cannot say the dentist was not clear about the extent of the damage and need for treatment.

52. We have not identified any indications of failings and do not propose to take any further action this case.

53. We recognise this has been a difficult experience for Miss R and we were sorry to hear about her concerns. We thank her for bringing this complaint to our attention.

1. We have carefully considered Miss R’s complaint about a dental practice in Hull (the Practice). Having completed our consideration of this complaint, we have seen no indication anything went seriously wrong.

2. We understand this has been an upsetting experience for Miss R, and we know it is difficult to face having dental work when you did not think this would be required. We were sorry to hear about her concerns.