Poor restorative treatment.

Poor treatment leads to man’s front tooth being lost.

A 55-year-old man from North London (Mr. F.), lost a tooth after his local dentist failed to provide proper restorative treatment. His dental problems persisted for years and led to frustration and depression.

Photograph of a tooth crown with an inflamed gum

“When I saw the dentist, she said I needed a crown, I was starting to feel a little bit concerned because the filling had failed twice. However, the dentist reassured me that a crown would do the trick.”

In this case which occurred and was legally reported , the dentist also failed to spot and treat decay, the patient was awarded compensation.

The dentist in question’s failure to provide proper restorative treatment led to Mr F. unnecessarily losing a tooth and his consequent costs and suffering.

Mr. F had been a patient in East Finchley, London, since 2002 and had always had regular check-ups at the practice in question but his problems began in 2009 when a filling that his dentist had placed kept falling out.

“When I saw the dentist, she said I needed a crown, I was starting to feel a little bit concerned because the filling had failed twice. However, the dentist reassured me that a crown would do the trick.”

So in 2010, his dentist fitted a crown. The patient thought this would be the end of his dental problems, but only a few months later he was back again because the area surrounding his tooth had swollen significantly.

“It was so painful, I was having real trouble sleeping and eating solid foods,” the patient recalled. “ The dentist prescribed antibiotics and told me to wait and see if the swelling went down, but a few weeks later it was still very sore. She referred me to see a specialist for root canal treatment and to have the crown re-cemented.”

His dentist then restored the tooth which Mr. F had seen the specialist for – and received successful treatment for. Over the next four years, Mr. F experienced episodes of pain and went back to see his dentist on multiple occasions. The crown was even replaced at one point, but in November 2014, the crown fell out again.

“This time my dentist said the tooth would either need to be extracted or temporarily restored,” he explained. “She said there wasn’t much of my tooth left. But I didn’t want to lose it so opted to have it restored.”

The dentist undertook further work on the tooth and re-cemented Mr. F’s crown. Yet in October 2015 he was referred to a hospital to have the tooth extracted due to the pain flaring up again.

X-ray of front tooth with root canal failure (post through side of root)

The x-ray film taken at the hospital revealed that screws placed by the dentist into the tooth to support the crown had in fact perforated through the side of the tooth into the bone, causing the infection and causing him significant pain.

Alas this was not an isolated case, and the specialist didn’t take an x-ray and so was unaware of the error either.

Analysis of his dental records revealed that she had failed to achieve the standard of care expected under those circumstances. She had missed significant problems and fitted an ineffective crown consistently providing poor restorative treatment.

This led to infections, problems with the crown, avoidable treatment, and the eventual unnecessary extraction of his tooth. The dentist had also failed to spot and treat decay on adjacent teeth that had been clearly visible on X-rays taken by her.

“I’d lost all confidence in my dentist,” Mr. F explained. “She was meant to be providing treatment, but actually she was just making my problems worse. It was very upsetting as I’ve always taken pride in my teeth. By the end of the ordeal my never ending dental problems had made me feel really depressed. I’d still have my tooth if it wasn’t for the dentist.”

The specialist was named also as he had failed the expected standard of care in that he had not taken an adequate x-ray of the tooth in question. Generally, a specialist will be held to a higher standard of care given their specialist training.

There were several clinical and legal factors at play. There was clearly a duty of care but a failure of standard of care in the provision of the diagnosis, the crown, the post, review and follow up. The dentist did not admit any liability.

Many dentists are excellent, they do their best and provide very satisfactory work. Some alas either because of inability or carelessness don’t provide the care expected. In such a case you may wish to review your options.

Author – Stephen Bray DDS

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