Branded Invisible Braces – inadequate assessment for same — Dentist’s failure to seek expert advice when on-going symptoms warranted it – failure to keep proper and adequate notes – failure to obtain adequately informed consent – constant pain and itching caused by invisible braces – receding gums – physical and physiological damage – permanent damage to gums requiring intermittent gum grafting in the future.
Our Client attended a Dentist who advertises himself as a leader in the field of Advanced Aesthetic Dentistry. The Dentist’s advertising was comforting and indicated a high level of training in branded invisible braces and aesthetic dentistry.
Treatment was unusually painful and persisted for too long. On attending a local Dental Hygienist the Patient was told to go immediately to the Accident & Emergency Department of the Dublin Dental Hospital whereupon she was advised that she had considerable damage to her gums.
Investigations revealed that records kept by the Dentist did not show whether or not certain medical/dental investigations had been carried out prior to treatment. In particular, there was no record of independent orthodontic assessment, no measure of the degree of cross bite or overcrowding and there was apparently a failure to intervene when the Patient’s gums started to recede as a result of the treatment with invisible braces.
An Expert Opinion was sought from a Consultant Orthodontist at a leading English Dental Hospital.
Expert Opinion advised that the Dentist carrying out the invisible braces treatment was in breach of his Professional Duty in failing to provide a full diagnosis and treatment plan. It found that he failed to take appropriate action when our Client was having discomfort with her teeth and that her gum recession was readily apparent. Expert advice was that the Dentist ought to have sought advice from an Expert in Orthodontics on how the difficulties might be resolved and to discover that on-going treatment was likely to result in additional gum recession but instead, persisted with the negligent treatment.
In the Expert’s opinion, the use of the invisible braces resulted in significant recession of our Client’s gums in the upper and lower arches. It resulted in instability in the dentition, discomfort of the teeth and a worsened occlusion. The Expert discovered that the Patient now had an unstable occlusion, residual gum recession, particularly in places where the gum grafting, had not been successful.
It was discovered at this point that the Patient had permanent recession of her gums on a number of her teeth and that this was not recoverable even with a further operation. It was found that crowding is likely to recur. Unfortunately, because of the level of damage caused by the Dentist further orthodontic intervention is not now advised.
In conclusion, the Expert found that our Client had an unsatisfactory diagnosis of the problem, a failure to recognise the limitations of the appliance that was being used. A total failure to respond to the damage caused by the invisible braces during the course of treatment.
The investigation also found that the Dentist had breached his Duty of Care to our Client in that he did not have sufficient training on the use of invisible braces in the absence of the required diagnostic skills.
THE COURT CASE
Initial correspondence between this firm and the Dentist was ignored. Ultimately, we received communication from a Solicitor on his behalf. An initial offer was made in settlement of the case which was very small. It was rejected and the court proceedings were pursued aggressively. Prior to the trial of the case a realistic offer of settlement was made and accepted which included the following: –
- A refund of all costs of treatment to date
- Payment for likely future costs of remedial treatment
- Substantial damages
There is increasing press attention to medical negligence. In our experience the increase in aesthetic or cosmetic dentistry has led to an increase in the incidence of dental negligence. Furthermore, we have found on a number of occasions that there has been difficulty with insurance cover for Dentists. Always follow the advice of your existing, trusted, Dentist or follow a reliable recommendation before you engage someone you know little about.