Reduced treatment time

BACKGROUND

Mr V books an emergency appointment at the dental surgery on a Friday morning before a bank holiday. He is 10 minutes late for a 15-minute slot and complains of extreme sensitivity in an upper right molar.

Mr V reports pain of short duration and made worse by cold and sweet things. Dr S does not find any teeth TTP (tender to percussion), nor swelling or gum problems but does note a small crack in the tooth. He applies desensitising varnish to ease the discomfort and asks Mr V to make an appointment with his regular dentist.

That Monday Mr V attends A&E with extreme pain in the upper right jaw and is referred to the dental hospital. Following a clinical examination and taking of appropriate radiographs, a diagnosis of irreversible pulpitis is made. Treatment options are discussed and Mr V elects to have the tooth extracted. This is completed uneventfully.

A few days later the practice receives a letter of complaint from Mr V. He questions why Dr S did not take a radiograph and diagnose pulpitis on the Friday, thus sparing him an “agonising weekend”. Treatment could have been offered then or at least a referral to the dental hospital.

ANALYSIS/OUTCOME

Dr S contacts MDDUS for advice. A dental adviser reviews the draft text of a response letter. First the dentist apologises for the inconvenience and distress the situation has caused and states that it is practice policy to investigate patient concerns and use that learning to improve services.

Dr S offers his view of the events based on the patient records. He points out that it was unfortunate that Mr V was 10 minutes late for a 15-minute appointment slot, leaving only five minutes for assessment and treatment. Nothing in the consultation suggested irreversible pulpitis and Dr S applied desensitising varnish for the discomfort until further treatment (if necessary) could be undertaken.

Dr S states that the complaint has given him cause to reflect on his clinical practice and how in future he will deal with similar dental emergencies. Mr V is invited to contact the practice if he wants to discuss the matter further – and is also provided contact details for the ombudsman if he is dissatisfied with this response.

Nothing further is heard from Mr V in regard to the matter and he remains a patient at the practice.

KEY POINTS

• Remind patients of the importance of attending appointments on time via the website, notices or other means.
• Ensure patients are offered advice on how to deal with unresolved or worsening symptoms.
• A sincere apology or expression of regret will often prevent complaints escalating into a claim or GDC referral.