The importance of a smile has never been stronger, especially during a year when it’s often been the only form of human connection we’ve been able to have. But while 2020 has also seen a rise in people searching for ways to improve their smile, many have been many have been happy with the dental treatment (or lack of) they have received, according to research by Healthwatch. Dental negligence is nothing to smile about.

Due to Covid, there has been 19 million fewer routine check-ups this year at NHS registered dental practices. Most practices are operating at a third of last year’s levels because of extra Covid sanitising precautions they must undertake between patients. Appointment waiting times have doubled, with some patients facing delays of up to two years for dental surgery. Some practices are prioritising private patients over those who receive treatment on the NHS.

So, with people unable to access these basic dental appointments, are we heading for an oral health crisis and a rise in dental negligence claims?

Typically, dental negligence claims cover any type of injury that has been directly caused, made worse or overlooked by your dental health professional. This may include problems such as failed fillings or root canals, wrong teeth being extracted, or healthy teeth being damaged during treatment. However, more people are being affected by delayed diagnosis of gum disease – a preventable condition which most adults experience, but which, if left untreated, can be catastrophic.

Early signs of gum disease are:

  • Bad breath
  • Bleeding gums
  • Pain and inflammation of the gums
  • A pink tinged toothbrush after brushing
  • Painful chewing

A regular examination, or ‘pocket testing’, undertaken by a dentist every 12 months enables your oral health to be monitored. Failure to spot and treat issues such as gum disease could result in bone damage, loose teeth and teeth subsequently falling out, especially if treatment is delayed. In the long term, oral health problems may also affect blood vessels, potentially leading to heart disease, diabetes, rheumatoid arthritis, stroke and dementia. Gum disease negligence claims resulting from delays to treatment can be worth between £10,000 and £40,000 depending on the lasting effects.

Covid has only exacerbated dental problems. The latest report by health and social care watchdog, Healthwatch England, states they have received a 452 percent rise in calls for complaints about dental experiences from July to September 2020. Access to routine and emergency dental care, limited NHS appointments, and affordability are just a few issues highlighted. This comes at a time when NHS dental fees are set to rise by the annual five percent on 14 December, meaning yet more barriers for people already struggling to get the adequate dental care they need or want.

New NHS dental fees (as of 14 December 2020)

Band 1 £23.80 (up £1.10)

Treatment covers:

  • an examination, diagnosis and care to prevent problems
  • if necessary, X-rays, scale and polish and planning for more treatment

Band 2 £65.20 (up £3.10)

Treatment covers:

  • all necessary treatment covered by band 1
  • treatment such as fillings, root-canal treatments or extractions (having teeth taken out)

Band 3 £282.80 (up £13.50)

Treatment covers:

  • all necessary treatment covered by band 1 and 2
  • more complicated procedures such as crowns, dentures or bridges

With NHS treatments, you a charged a contribution towards the cost of dental work. Some people are entitled to free NHS treatment or help with the costs of NHS dental treatment, such as those in receipt of certain benefits. However, NHS treatment is only for dental work you clinically need and does cover cosmetic or aesthetic work. This is where private dental clinics have seen an increase in patients; yet more people are being offered private appointments for routine or emergency work and feeling under-pressure to pay the increased fees.

If something goes wrong with NHS dental treatment within 12 months, such as a filling that falls out or crowns that come loose, it may be re-done or replaced for free under the NHS Dental Treatment Guarantee. Surprisingly, gum disease and dentures are exempt from this.

The impact of Covid on oral health

Even though many dentists are now open, the backlog and ongoing restrictions continue to cause problems and is having a dramatic impact on the public’s oral health. In particular, the lack of NHS dental appointments omits the opportunity to act on early symptoms of dental problems. Dentists generally spot around 22 cases of mouth cancer each day as a collective; this year, referrals for oral cancer fell by a third.

The pandemic is also affecting the oral health of our children. Once milk teeth burst through those swollen gums, we’re told to brush twice daily and floss regularly to stop teeth from decaying or falling out. Education is key to good oral health, but so too are regular check-ups. A scale and polish not only removes surface stains, but also plaque and tartar build-up which could help reduce the likelihood of gum disease developing. A quarter of children now have tooth decay, sometimes in three or four teeth, and there has been an increase in root canals in under 16s.

People who struggled to access dental treatments during the pandemic often experienced inconvenience, anxiety, worsening problems requiring further treatment or worse. Some people were left in debilitating pain, while others feared that they would lose their teeth when they couldn’t access care. People with ill-fitting dentures or broken fillings had developed ulcers, bleeding gums and infections, leaving them struggling to eat and speak. Healthwatch was contacted by people who had taken extreme steps, such as someone from Portsmouth pulling out their own teeth with pliers, after being denied specialist treatment.

When urgent dental treatment is delayed, this allows conditions to worsen and, inevitably, there will be some cases where people lose teeth or need extractions. Tooth loss can affect a person’s quality of life, impacting their confidence, ability to eat and drink, or sleep comfortably. Facial shape can also be affected by tooth or bone loss. Corrective work to fill the gaps of missing teeth, such as dental implants, is expensive and generally only offered via private clinics.

Patient with failed implants receives five-figure dental negligence compensation

Restorative work can also have its drawbacks if the foundations of gum disease are not monitored before undergoing treatment. Our senior solicitor, Christine Brown, recently won £75,000 damages for a 66-year-old woman who had failed dental implants over ten years ago and which have consequently affected her quality of life.

In 2009, the claimant, then 57, was advised by a private dentist to have multiple upper teeth removed and replaced by dental implants and implant-supported bridges which are supposed to be permanent solutions to missing teeth. This cost over £5,000 and was guaranteed for ten years.

However, within months she noticed sloping which was dismissed as a drooping lip. By 2014, three of the implants had come loose and a bridge could be easily removed. A second opinion confirmed this was due to severe bone loss and poor bone quality – the implants were the wrong type and had been overloaded into insufficient gum space.

Implantology is already an invasive procedure, but our client then had to have further restorative dentistry including a bone graft and subsequently had to wear partial dentures. This left her with severe pain, social anxiety, a limited diet of soft foods, and lasting psychological distress.

The compensation awarded included £35,000 for pain and suffering, plus £40,000 special damages which encompassed past and future dental treatment costs, psychotherapy treatment and travel costs.

The hidden costs of cosmetic dentistry

People pursue dental treatment for aesthetic purposes, as well as for medical reasons. Dentists have seen increased enquiries in 2020 for cosmetic dental work. Whether it be to straighten, lighten, reshape or repair teeth, people have become more conscious of their smiles and have sought ways to improve them. But the pursuit of perfect pearly whites to rival stars of the silver screen could end up more like a horror story with devastating effects.

With a rise reality TV stars and influencers, flawless selfie filters, and social media platforms giving way to so-called ‘Instagram tooth fairies’, more young people are desperate to have that Hollywood (or Turkish) smile. Yet many are not aware of the consequences of cosmetic dental work, such as crowns, which could permanently ruin your smile.

People seeking to change the appearance of their teeth might instantly think veneers are what they need. This is where thin tooth-coloured shells are attached to the front of teeth. However, many actually undergo crowns which are more invasive, quicker, and require less skill. Before crowns are fitted, existing teeth need grinding down to stumps – this is irreversible. Shaving teeth to this extreme also leaves them more prone to nerve damage, root canals and extractions. Crowns also need replacing every 10 to 15 years which can be a financial or biological burden; you cannot re prepare (or grind) teeth every time they need replacing, so people who have veneers in their early 20s may end up with dentures by the time they’re 40.

While cosmetic dentistry isn’t undertaken on the NHS, that doesn’t mean it is immune to errors or negligent practice. Implants can become infected or fall out. Natural teeth can shift because implants or implant-supported bridges were incorrectly positioned. Substandard assessments could mean you are advised of the wrong type of dental treatment. Invisible braces may be fitted incorrectly. Veneers may be more like piano keys that are too big for your mouth, resulting in you not being able to close your mouth properly, or causing jaw pain.

Protect yourself from dental negligence

As with any type of medical procedure, people should be fully aware and informed of what the benefits and risks there are to treatment, along with alternatives. Consent is much more than a signature. If you are considering any form of restorative dental treatment – whether for cosmetic or medical reasons – always check the GDC register to ensure your dentist is reputable. Price often reflects skill, so cheap ‘Miles for Smiles’ airline package deals may leave you more at risk of negligent dental treatment.

If you have undergone substandard dental work and think you may have a claim, speak to our specialist team free of charge. We offer a ‘no win, no fee’ service with free expert legal advice on whether or not you have the basis for a legal claim. Call 0114 250 7100 or email help@medical-solicitors.com.

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We’ve handled many different types of medical negligence cases and provided expert advice for over 20 years.

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Our surgery claims expert:

Caroline Moore

Solicitor/Managing Director