The scene

A patient attended a DDU GDP member for placement of a restoration of a lower molar. At the appointment, the member warned the patient that there was a risk of future root canal treatment or extraction.

The patient later returned, complaining of pain at the lower molar on biting. The member noted that the lower molar was tender to percussion, and there was a lingering response to ethyl chloride testing. A subsequent periapical radiograph also showed apical pathology.

The patient was offered a root canal treatment or extraction, and they chose to have the tooth extracted.

The claim

The patient instructed solicitors to pursue a claim against the member. The claim alleged that the lower molar had been extracted prematurely/unnecessarily, and that the member had failed to discuss whether some or all of the symptoms could have been caused by the restoration having a high spot, which was alleged could have been relieved by smoothing it down.

It was further alleged that following the extraction of the lower molar, the patient suffered a dry socket and a cut to the lip.

How we helped

The member turned to the DDU for help addressing the claim. In order to assess whether it could be successfully defended, we consulted an independent expert to give an opinion on the treatment the member had provided.

In this case, the independent expert was supportive of the member's treatment. The expert considered that based on the patient's symptoms and clinical presentation, the most likely diagnosis was irreversible pulpitis, and therefore that extraction was reasonable.

The expert also noted that the member had recorded that the occlusion has been checked after the restoration was placed and did not consider the filling was high.

The expert confirmed that there is always a risk of a dry socket after extraction, and that it was a recognised complication of treatment rather than a result of any breach of duty.

Finally, there was no evidence that the patient's lip was cut when the lower molar was extracted.

The outcome

The DDU set out the supportive evidence from the independent expert in a formal letter of response, but the patient's solicitors did not accept this and made an offer to settle the claim.

However, we rejected this offer and maintained our position in denying liability on behalf of the member. Shortly afterwards, the claim was discontinued and the case was closed.