Let’s call the whole thing off: a case study

patient perceptionsLouise Eggleton considers what happens when a patient and dentist have very different perceptions of a treatment journey hindered due to practice closures, resulting in a regulatory complaint. 

A single-handed dentist was forced to close her dental clinic on two occasions during the COVID-19 pandemic.

On the first occasion, the dentist was unable to source some items of essential personal protective equipment for aerosol-generating procedures. This resulted in the suspension of appointments for many types of clinical interventions. The dentist was only able to offer a telephone triage service.

During this triage service, patients were given clinical advice and prescriptions for antibiotics when appropriate. Or, they were given referral to another clinic if necessary.

The second unavoidable closure arose after the dentist had contact with a family member who had tested positive for COVID-19. The dentist was forced to self-isolate for the recommended period of time. This was in accordance with the government guidelines in place at the time.

Unfortunately, a suitable locum dentist could not be found to cover the treatment appointments at such short notice. Patients were therefore contacted to reschedule or were offered emergency appointments at a nearby dentist who had agreed to provide additional support to the practice.

Most patients were very understanding of the dentist’s position. However, one patient, who had also been impacted by the first closure of the practice, was unhappy because their follow-up appointment had to be rearranged.

As the patient was experiencing discomfort, he accepted an alternative emergency appointment at a nearby practice.

The patient was advised their tooth was unrestorable and required extraction. The extraction procedure was completed uneventfully. However, the patient immediately complained to the regulator, alleging the six-week delay in treatment by the first dentist had caused the loss of his tooth.

Support and guidance

The dentist was understandably shocked and upset when she received notification of the complaint. She immediately contacted her defence organisation, Dental Protection, for assistance and support. Dental Protection then submitted a response to the regulator on the dentist’s behalf.

It was explained that both situations were beyond the dentist’s control and could not have been predicted. The response stated that her actions were reasonable and proportionate and that she had acted in a highly responsible and professional manner by complying with the government and dental association guidelines during that time.

After consideration, the regulator accepted the dentist’s explanation and the case was closed with no further action. The dentist, who had been under a considerable amount of stress while trying to single-handedly manage her dental clinic in addition to the regulatory investigation, was unsurprisingly very relieved to have the matter resolved.

Following further discussions with her case manager at Dental Protection and taking into account the extreme stress and pressure of the situation, the dentist accepted the offer of confidential counselling.

Access to these services is included as part of the dentist’s membership benefits. The dentist went on to receive additional guidance and support following this difficult period.

Learning points

Patient expectations of events do not always reflect the true picture. It is important to spend a little time explaining the reasons why appointments and treatment is delayed. It is suggested that the clinical record includes details of these conversations.

Dental Protection recognises the significant additional pressures many dentists are facing during the pandemic. The team understands how changes to the way care is delivered will have an impact on patient perception.

We understand that dentists are making every effort to continue providing the best possible service to patients during this time. At the same time we are adhering to the guidance set by the government and dental associations. Unfortunately, it is very difficult to predict how a patient may react to events that can often be outside the dentist’s control.

Here to help

If Dental Protection members are on the receiving end of any complaints, claims or regulatory challenges, including those that may have been triggered by the additional pressure of providing dental care during the COVID-19 pandemic, contact us at the earliest opportunity to ensure we can help and offer support.

You are not alone – we know that the serious pressures dental professionals have faced cannot be underestimated, with their effects likely to be felt for months and years to come. Please remember that Dental Protection offers confidential counselling services as part of its membership benefits. This is delivered by ICAS’ independent, qualified counsellors who are available 24/7.


For more information about the Dental Protection confidential counselling service, visit www.dentalprotection.org/uk/dentolegal-advice/counselling-service.

This article was first published in Dentistry magazine. Read the latest issue of Dentistry magazine here.

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