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Failure to provide treatment options for tooth replacement (12HDC00550)
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(12HDC00550, 26 June
General dentist ~ Dental practice ~ Maryland bridge ~
Information ~ Standard of care ~ Dental care ~ Vicarious liability
~ Rights 6(1)(b), 7(1), 4(1), 4(2)
A woman attended a general dentist for treatment of a broken
crown. The patient also wanted to have a gap between her teeth
closed at the same time. The dentist discussed replacement options
with the patient, which included either a Maryland bridge or a
3-unit bridge. The patient chose to have a Maryland bridge because
she believed that it would not alter any of her other teeth.
The dentist inserted the bridge but the patient was dissatisfied
with the look and feel of the bridge. The patient asked the dentist
about the possibility of an implant, but the dentist told the
patient that this was not a suitable option for her because of the
difficulty in its upkeep. The dentist agreed to redo the Maryland
During the process of removing the bridge and preparing the
teeth to be widened to close the gap, one of the teeth was chipped.
The dentist then inserted the second permanent Maryland bridge
which was noted to be a slightly lighter colour shade which, as a
result, made the patient's teeth look more yellow. The dentist
considered that this could be addressed by performing a custom
whitening of her teeth.
The patient complained of pain in one of her teeth. The dentist
took X-rays which revealed nothing. The dentist prescribed the
patient with an analgesic and an antibiotic "for infection in case
a near-mechanical exposure" was causing the pain.
The patient then decided to seek a second opinion from another
dentist. The second dentist told the patient that a Maryland bridge
was the wrong choice in her circumstances, and recommended an
implant. The patient was also told that during the preparation for
the insertion of the Maryland bridge, the dentist had removed more
tooth structure than was necessary.
The dentist breached Right 6(1)(b) for failing to provide the
patient with information that a reasonable consumer would require
in her situation,. The dentist also breached Right 7(1) for failing
to obtain the patient's informed consent for the proposed
The dentist did not exercise reasonable care and skill by
inserting the first Maryland bridge when he was unhappy with its
finish, and by damaging tooth 11 during the preparation for the
second Maryland bridge, was accordingly found to have breached
Right 4(1). For failing to maintain adequate documentation the
dentist failed to comply with relevant professional standards and
also breached Right 4(2).
The dental practice was vicariously liable for the dentist's
breaches of the Code.