Re: Dental malpractice (UK) - Some questions - mostly legal

From: Andrew (mossyglade_at_RemoveThisBiTntlworld.com)
Date: 10/06/04 

Date: Thu, 7 Oct 2004 00:15:11 +0100

"G Xpetros" <chpetros@hotmail.com> wrote in message
news:c4f75ed3.0410041406.7f648744@posting.google.com...
> Hello Andrew,
>
> Since I practice in the UK, I have to tell you that complaining to the
> GDC was the right thing to do. However, you must understand that the
> GDC cannot simply erase a dentist for lifetime based on a single
> complaint. Such things follow a tiered structure. If the dentist does
> such a substandard work as you've described, rest assured that there
> will be further complaints and these will be dealt more severely. From
> my limited knowledge of dento-legal matters in the UK, I know that
> taking away one's license is only done for serious professional
> misconduct. It is standard practice not to confuse misconduct with
> negligence or malpractice. The situation you have described (as I
> understand it is carious lesions that haven't been treated rather than
> caries under the first fillings that wasn't removed, please correct me
> if I'm wrong) sounds like supervised neglect and would not even
> remotely be classified as serious misconduct.
> I know you feel like a great injustice has been done on you and
> personally I would feel the same thing if I were you, but perhaps
> you'll feel better if you consider
> (i) further complaints done by other patients may result in the
> dentist being removed from the registers
> (ii) this may actually serve as a "wake-up call" and the lady begins
> to understand that quick money isn't the most important thing in the
> world. I've seen this happening (it happened with me, although on a
> much smaller scale; there was no complaint, lawyers or regulatory
> bodies involved, it was just guilt that got to me).
> Now to more practical issues. You say you lost a tooth, had
> considerable pain and underwent extensive remedial work because of the
> treatment done (or lack of treatment done). This could justify
> expenses for an implant paid (provided you meet the requirements for
> one), expenses for the remedial work as well as compensation for loss
> of quality of life for these 6 months. I think you might be able to
> make a claim for it. The 9K pounds you mentioned seems very reasonable
> for a settlement.
> You need to start asking around for lawyers specialising on claims,
> preferrably those specialised on medical and dental cases. A warning
> though: be very-very careful with the lawyers you end up using. There
> have been several cases of overcharging and in the end you might win
> the claim only to get ripped off by the lawyer. Aside from bad
> dentists, the UK also has many bad lawyers.
> I wish you the best of luck in your case and hope that this whole
> thing hasn't shattered your faith in ythe dental profession; some of
> us are actually quite nive if you get to know us. As for my colleagues
> posting on this forum, I would like to say that in situations like
> this it's best not to take it too personally or to ask for blood,
> since none of us was there when the treatment took place. Keep a cool
> head guys. My usual reply towards a patient asking me for a second
> opinion on treatment done by another dentist is "I can tell you what I
> see right now, bhut you must understand that I wasn't there to witness
> what took place during the treatment". I believe that this is the best
> approach for all parties involved.
>
> George

Thanks for your comments and interest George. It's good to hear from a UK
dentist (not that I have any complaints about the US ones - quite the
reverse).

I did contact the amalgam removal dentist and discuss removal of my amalgam
fillings. She was very keen to do so and told me it wouldn't cost as much as
I thought and I was then given appointments along with the estimate - not
after I'd OKed the estimate, so a little bit of pushing there, but my main
grievances are A) That I understood I'd have a good mouthfull of sound teeth
with all my old fillings replaced with sound new ones. I was not told
that she would leave decay in place and hide it under new fillings, so yes,
I got rid of my amalgam but I was left with teeth that despite major work on
them still were in urgent need of treatment. B) It was not until part way
through the treatment that she told me that amalgams are leaky and
composites are not and therefore replacing amalgam with composite can
sometimes lead to a build up of pressure in the tooth, pressure that was
previously escaping - doesn't this indicate that she knew she was sealing in
decay?? C) When I told her I had pain all over the place and had been
grinding teeth, her response was to paint flouride varnish onto teeth and
tell me not to clench them. She also told me to use Sensodyne toothpaste!!
D) When I had severe pain in #21 (please forgive US nomenclature but its
what I've grown used to now), pain that responded to whisky and where there
was a spot that looked mighty like a leakage, she applied the varnish and
left the decay to continue until the tooth died, the night before an
emergency appointment with her as it happened. At this point the pain was
gone and there was no great urgency to have the tooth out, but she told me
that RCT was controversial and clearly she wanted to take the tooth out. She
gave me only seconds to decide and I actually didn't realise she was going
straight ahead until she pulled it out. I thought she was just
investigating. I just wish I'd had a competent RCT dentist - or a world
class expert like WB there. Please note that regarding this tooth, I told
her that that another dentist said its hole was too large to fill
and it needed a crown. She said she could fill it - and then left the hole
unfilled for three months. It was another four painful months before it
died. E) She told me that it was fine to have a gap in my occlusion - ie one
side contacting before the other and that the jaw would compensate. At the
end of my treatment with her, it felt like there was quite a few mm gap at
one side when the other side was closed. That led to bed bruxism. F) She did
this enormous amount of work (16 teeth) in just 3 shortish sessions - and
without a single x-ray. She said she did not see the point of x rays as when
she drilled into the tooth she would see what it was like inside.

Prior to meeting this dentist my teeth had worked well and been pain and
problem free for many years.

I spent a lot of time presenting all this to the GDC and don't understand
why
they have not acted on it.

Thanks for your warning about UK lawyers. Care to pass on a recommendation
to me??

Your description elsewhere of life as an NHS dentist and the effect it has
on dentists is very interesting. I had no idea it was so bad. All I knew is
that it is nearly impossible to find an NHS dentist now as more and more of
them are turning to private practice. You are probably right in surmising
she is an NHS dentist with some private patients as I recall when I was in
for one of my £500 sessions, I overheard a guy before me was being charged
something like £8 or £10!!

Regarding time taken, Steve took more time X-raying my teeth and planning
his work (before he even switched the drill on) than the UK lady dentist
took on doing 18 or so fillings.

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