Dental implants are hailed as the gold standard for replacing missing teeth because they look and function just like natural teeth. They are titanium posts placed into the jawbone with a custom-made dental crown but they should only ever be given to patients who have healthy gums and enough bone to hold the posts in place.
In September 2018, Christine Brown successfully settled a complicated claim against both a dental practitioner and the firm at which he was formerly a director for their respective parts in failing to correctly treat gum disease. Instead, the claimant (C) was fitted with dental implants which quickly failed.
C was 57 at the start of treatment for her periodontal disease. D1 was a dental practitioner at the dental clinic that was owned and operated by D2 (a company) of which D1 and his wife were directors.
In 2009, D1 advised C to have her upper teeth removed and replaced with dental implants and bridges at a cost of £5,300 which was to be guaranteed for ten years. He removed most of her upper teeth, leaving three in place, and fitted dental implants and bridges.
Soon after, C noticed the implants were sloping which upset her. She was told by D1 that it was her lip that had dropped rather than the teeth sloping. The bridgework became loose on several occasions requiring re-cementation. Food collected at the back of the bridge, but D1 informed C that nothing could be done about this.
Five years later C was reviewed by another dentist at the same clinic where she complained that one bridge had felt mobile for months and had now come out completely. On examination, the bridge was easily removed and three of the implants were all mobile. C was advised the implants had failed and would need to be removed over a few months.
After facing further problems, C sought a second opinion at another dental clinic where it was noted that her bone was only a thin ridge, and that another three implants had failed. She also had bone loss, narrow implants, poor bone quality and her bite was wrong. C underwent further implant removal and needed a bone graft.
Having paid over £5,000 for the treatment which had a decade-long guarantee, C brought a case against D1 and D2 for breach of contract and negligence. She claimed that she had unnecessarily suffered severe pain from the initial failed dental procedures and the additional restorative work. She was forced to tolerate an upper partial denture that had poor retention and meant she had to restrict her diet to soft foods and this impacted on her social life and mental health.
In her claim, C alleged that there was a failure to adequately manage her ongoing periodontal disease. She alleged that the defendants wrongly used dental implants and a bridge without replacement of missing posterior teeth. Some dental implants were overloaded, two were fitted where there was insufficient space, and mini-implants were used that were not designed to take the normal functional load.
A complicated case
The case was complicated to pursue because the dental clinic was taken over by a new owner and the dentist did not respond to our correspondence and the company failed to disclose any medical records. The new owner provided C's dental records from April 2014 onwards when the dental clinic's records became computerised, but C's paper record cards and manual film X-rays were missing.
Proceedings were issued against D1 and D2 in April 2017 and served upon them shortly after. We successfully applied for judgment in default against both defendants as they failed to file a formal acknowledgement at court a formal acknowledgement. D2’s solicitors made contact for the first time in July 2017, but only to communicate their intention to apply to have the judgment against D2 set aside. A month later, D1 resigned as a director of D2 and did not respond to any communication.
At the beginning of 2018, C invited D2 to make an interim payment of compensation in the sum of £80,000. As D2 did not respond, C applied to the court for an interim payment to be heard at the same time as a hearing fixed by the Court to give directions; however, without giving notice to C, D2 successfully applied to vacate the hearing. The hearing was adjourned, but whilst awaiting judgment on D2's application, C and D2 exchanged Part 36 Offers in settlement for sum of £75,000 on the basis that D1 and D2 were each responsible for the whole of C’s claim against both defendants.
In October 2018 the Court entered judgment against D2 to pay C compensation of £75,000 plus an interim payment on account of costs of £40,000. While the compensation was paid, C failed to receive payment for costs. C then issued an application for an order that D1 pay C's costs in respect of claims against both defendants.
Prior to the hearing in February 2019, D2's new solicitors wrote to the Court confirming that they were also acting for D1 who did not object to paying C’s costs but did object to making an interim payment (immediate payment). Neither defendant attended the hearing, which was adjourned, and C then filed an amended application relying on D1's agreement that he would pay C’s costs.
In the meantime, C issued a petition to wind up D2 and a winding-up order was granted in April 2019.
At the adjourned hearing in April 2019 D1 backtracked from his agreement to pay C’s costs. But at a further hearing in July 2019 the Court dismissed this and ordered that C's Part 36 Offer in settlement almost a year earlier was valid and binding upon both D1 and D2. D1 was ordered to pay costs and an interim payment of £10,000 on account of costs which was paid in October 2019, followed by the remaining balance in December 2019 which brough this robustly defended case to a successful conclusion.