Dental negligence

Tom2018

All dentists referred to below are located at the one dental clinic.

I had a tooth filling done by either Dentist A or Dentist B. Filling seemed fine at the time. I don't know specifically which dentist did that particular filling, though no doubt records would clarify that. Later developed what seemed, to me, to be a blister on the gum. Though I didn't connect these two events.

At subsequent check-up (just over two years ago) Dentist B noticed blister, took an X-ray and prescribed anti-biotics which I took. This didn't impact on the blister. Went to subsequent check-up appointment(s) with Dentist B over the next year or so, blister still there, but Dentist B did not make any reference to it. As they did not make any reference to it, I assumed it wasn't much to be concerned about.

Was at dental clinic recently where this time my check-up was with a locum. This locum (Dentist C) stated the blister (or "swelling" as Dentist C referred to it, even though it appeared to be physically smaller at this stage to me) could potentially rupture at any point and that I would need to get an X-ray.

Make next available appointment and this time saw a new dentist (Dentist D) who is now at the clinic (Dentist B doesn't appear to be there currently). I had to have root canal treatment and Dentist D explained that the original filling was deeper down into the tooth as it is "not an exact science". This caused the infection and lack of blood supply to the tooth. He informed that if it had ruptured the infection can be difficult to contain and in worst scenario can be fatal. He informed me the tooth is dead though it is currently left in place after the treatment. In addition, he believes the infection rotted away some of the underlying bone.

Since Dentist B did not make reference whatsoever to the blister/swelling on subsequent appointments should I contact a solicitor to make further enquiries on my behalf with the practice in relation to this, or alternatively should I write a letter to the senior dentist at the practice to ask for an explanation as to why Dentist B made no reference to the infection on the subsequent visit(s)?

This was private treatment, not NHS.

Any suggestions would be much appreciated. Thanks.

pearl123

Tom2018 wrote: »

All dentists referred to below are located at the one dental clinic.

I had a tooth filling done by either Dentist A or Dentist B. Filling seemed fine at the time. I don't know specifically which dentist did that particular filling, though no doubt records would clarify that. Later developed what seemed, to me, to be a blister on the gum. Though I didn't connect these two events.

At subsequent check-up (just over two years ago) Dentist B noticed blister, took an X-ray and prescribed anti-biotics which I took. This didn't impact on the blister. Went to subsequent check-up appointment(s) with Dentist B over the next year or so, blister still there, but Dentist B did not make any reference to it. As they did not make any reference to it, I assumed it wasn't much to be concerned about.

Was at dental clinic recently where this time my check-up was with a locum. This locum (Dentist C) stated the blister (or "swelling" as Dentist C referred to it, even though it appeared to be physically smaller at this stage to me) could potentially rupture at any point and that I would need to get an X-ray.

Make next available appointment and this time saw a new dentist (Dentist D) who is now at the clinic (Dentist B doesn't appear to be there currently). I had to have root canal treatment and Dentist D explained that the original filling was deeper down into the tooth as it is "not an exact science". This caused the infection and lack of blood supply to the tooth. He informed that if it had ruptured the infection can be difficult to contain and in worst scenario can be fatal. He informed me the tooth is dead though it is currently left in place after the treatment. In addition, he believes the infection rotted away some of the underlying bone.

Since Dentist B did not make reference whatsoever to the blister/swelling on subsequent appointments should I contact a solicitor to make further enquiries on my behalf with the practice in relation to this, or alternatively should I write a letter to the senior dentist at the practice to ask for an explanation as to why Dentist B made no reference to the infection on the subsequent visit(s)?

This was private treatment, not NHS.

Any suggestions would be much appreciated. Thanks.

Are you serious?
If your teeth or a tooth is not in a good state then problems will arise. I had the wrong tooth pulled - should I contact a solicitor. No it's just one of those very, very unfortunate things.

If you are not happy with your dentist then I suggest you move to another dentist, as that would be more productive.

Tom2018

Yes, I am serious.

Dentist B did not make any further reference to the "swelling" on subsequent visits. No treatment was offered to eliminate the infection.

Treatment could have been undertaken at an earlier point before damage occured to the underlying bone.

If it was not for the locum suggesting further analysis of what was happening, and I had instead seen dentist B again, I suspect there is reasonable chance again they would not have said anything and I would still not have had the treatment which I have just had.

brook2jack

Without seeing you, your notes and xrays no one can say for certain anything.

however in general, a tooth with a lot of decay in it will need a deep filling. A tooth with a deep filling can die off days, months or years afterwards and develop an abcess, that is no ones fault it can just happen.

A dead tooth will need not necessarily show up on an x ray in the early stages and a "blister" on the gum can be caused by many things so antibiotics might have been the right thing. If it had shrunk then the dentist might have thought it was healing, particularly as you had no pain.

A dead tooth will eventually show up on the x ray with a dark space around the root where some bone is lost, however a root canal treatment will heal this up and the bone loss will heal.

In other words you had a filling , it needed root treatment at some point afterwards, it has not caused you discomfort and the tooth is root filled now ie despite the fact it took some time the tooth is root filled now which is what might have happened a little sooner., but you are not in a worse situation.

Tom2018

brook2jack wrote: »

ie despite the fact it took some time the tooth is root filled now which is what might have happened a little sooner., but you are not in a worse situation.

There may be, according to Dentist D, decay to the underlying bone. Presumably this would not have occurred if dentist B had attempted some treatment at subsequent check-ups.

TBagpuss

OK, the issue would be whether you could show that the original dentist was negligent in how they did the original work, and/or whether they were negligent in failing to carry out further investigation on your subsequent check-ups. Then, if you could prove one of those thongs, you would also have to show that the harm you suffered was as a result of that negligence.

I am not an expert in medical negligence but I suspect that you might struggle to prove either.

The fact that the original filling was deeper in the tooth than normal (which I think is what you are saying) sounds, from the comments made by the later dentist, to be one of those things which varies - it isn't an exact science, so proving that the dentist was negligent to do the filling in that way sounds as though it would be difficult to prove.

You then appear to have had no problems for several years - again, I would imagine that this would make it much more difficult to prove whether any current problems were due to the filling having been done in a negligent manner, or whether it was simply bad luck - after all, the fact that you needed a root canal filling in the first place suggests that there was a problem with the tooth, it may be that the later issues were due to the underlying issue, rather than to the filling.

You had a swelling, which you didn't consider to be a problem and didn't mention or ask about at any of your later appointments. I would imagine that it would be a question of fact for a court to decide whether a reasonably competent dentist would have noticed and investigated further, or not. If the answer is that yes, they would, then it may be that your dentist was negligent not to do so. This would be complicated by the fact that if you didn't raise it, and they didn't raise it, there's little proof as to what size / shape / appearance the swelling had. Maybe it was more obvious when you saw dentist C, even if you didn't notice it being larger, or a different colour.

Then you'd have to establish that if they had investigated sooner, you would not have suffered the harm that has now happened.

What do you want to achieve? If you concern is to make sure that this doesn't happen again, then contacting the head of the surgery, raising your concerns and suggesting improved training is the way forward.

If you want them to pay for any treatment you now need, then again, contacting them and asking them to do the remedial work for free would be the way to start, explain that you believe that the work would not have been needed if they had not overlooked the swelling / done the original work correctly. They may be willing to reach an arrangement with you even if they don't consider the original dentist was at fault.

If what you want is compensation, then by all means look for a solicitor who specialises in medical / dental negligence, and talk to them about whether you have a claim of any kind. I imagine that they would need to arrange for you, and your records, to be reviewed by another dentist to advise about whether there were grounds for a claim.

brook2jack

Tom2018 wrote: »

There may be, according to Dentist D, decay to the underlying bone. Presumably this would not have occurred if dentist B had attempted some treatment at subsequent check-ups.

When you take an x ray to see if a root treatment is needed you are looking for a black space at the bottom of the root. This is where infection has caused the bone to be eaten away. Once the tooth is root filled that damage will heal, it is not decay and is a normal finding on a tooth that needs a root treatment.

The exception is where the infection is there’s a very very long time then you might develop a cyst which a root treatment won’t cure and needs other treatment.

brook2jack

In reply to Tbagpuss from the sounds of it the root treatment would have had to have been done anyway as any tooth that has a filling has the potential to die off and need a root treatment. The debatable point would seem to be should it have been done earlier and has any damage been done by having it done now rather than some time ago.

Tom2018

TBagpuss wrote: »

You had a swelling, which you didn't consider to be a problem and didn't mention or ask about at any of your later appointments. I would imagine that it would be a question of fact for a court to decide whether a reasonably competent dentist would have noticed and investigated further, or not. If the answer is that yes, they would, then it may be that your dentist was negligent not to do so. This would be complicated by the fact that if you didn't raise it, and they didn't raise it, there's little proof as to what size / shape / appearance the swelling had. Maybe it was more obvious when you saw dentist C, even if you didn't notice it being larger, or a different colour.

Dentist B had noticed the swelling (a blister was what I perceived it as) just over two years ago, and indeed immediately took an x-ray, then prescribed antibiotics. It was still there when I returned subsequently in 6/12 months later for check-ups with Dentist B. As they did not make any reference to it again on those subsequent visits, I assumed it wasn't much to be concerned about and so I didn't mention it - it was still there though.

I don't know why they didn't make reference to it on those subsequent visits, as it seemed to be obvious to the locum (Dentist C) that something needed to be done ASAP.

To me, the blister felt smaller when the locum saw it, compared to when Dentist B saw and x-rayed it just over two years ago.

brook2jack wrote: »

The debatable point would seem to be should it have been done earlier and has any damage been done by having it done now rather than some time ago.

Yes, this is correct.

bugslet

I can honestly say that I'm glad I never pursued dentistry ( well anything to do with the public probably) and instead went into business.

OP, just chill, this is not the end of the world, something unfortunate may have happened and even if it did, it's really not worth the hassle. Life is never 100% perfect, accepting that will make your life a lot calmer.

(Text removed by MSE Forum Team)

Tom2018

brook2jack wrote: »

When you take an x ray to see if a root treatment is needed you are looking for a black space at the bottom of the root. This is where infection has caused the bone to be eaten away. Once the tooth is root filled that damage will heal, it is not decay and is a normal finding on a tooth that needs a root treatment.

Just to clarify, the damage which you refer to which can heal, is damage to the bone?

brook2jack wrote: »

The exception is where the infection is there's a very very long time then you might develop a cyst which a root treatment won't cure and needs other treatment.

Approximately what sort of time frame is a very very long time beginning from? In this case, over two years. Over two years since the x-ray was originally taken by Dentist B.

Dentist D who undertook the root treatment, did say something about if he looked down under the tooth there may well be a hole there. I think he meant in relation to the bone.

What are the other forms of treatment, which you refer to, which would potentially be considered in such an instance?