Missed periodontal disease leads to claim

Dawn Wood, Claims Negotiator at Dental Protection reports on a case that highlights the importance of conducting regular Basic Periodontal Examinations (BPE).

Miss S made a claim against her dental practice after becoming aware she had ‘gum disease’ and required remedial treatment costing £1,530. She stated she had attended the practice for many years on a regular basis and was unaware of her periodontal situation.

A Basic Periodontal Examination (BPE) of 3*33/4*34 was noted by the subsequent dentist. Miss S had experienced several serious medical problems in recent years, most notably an intracerebral haemorrhage followed by a stroke a month later.

How Dental Protection assisted

The Dental Protection legal team reviewed the allegations brought by Miss S and ascertained that an independent dental expert would be required to review the allegations in full.

A breach and causation report was obtained from an independent GDP and a condition and prognosis report was obtained from a GDP with a special interest in periodontics. With the breach and condition report we were able to work through the allegations individually and decide which could be defended and which could not. With the condition and prognosis report we were able to tell which teeth had a good or a hopeless prognosis.

With the combination of both reports we were able to quantify the claim and also establish a patient contribution percentage, which allowed us to negotiate successfully with Miss S’s legal team.

Outcome

The claim was settled in full but we were able to negotiate Miss S’s legal team down to a modest sum, citing relevant case law and arguing for a patient contribution.

Learning points

It is important to take BPE scores at regular intervals in accordance with professional guidance. It is also important to act upon the BPE scores in accordance with the same guidance and develop a properly targeted approach to the management of the patient’s periodontal condition. 

The patient needs to take responsibility for the outcome, and this can only happen through effective communication between the clinician and the patient. Where a patient does not respond to the care provided then it may be necessary to refer the patient for further specialist management of their periodontal condition. 

It is vital that the treatment records show that appropriate investigations have been carried out and acted upon. The records also need to evidence the nature of the discussions that took place so you can show that the patient understood their role in managing the disease process, and also that they accepted the risk of a poor outcome where they were unable to maintain satisfactory standards of home care and address any contributing factors, such as smoking cessation.