The Dental Defence Union (DDU), which indemnifies dental professionals and pays compensation on their behalf, issued the warning as it revealed it had paid out £2.8m in compensation and a similar amount in legal fees to settle 126 claims over the five years 2008-2012.
The DDU said the average cost of a compensation claim had also risen over the period from around £21k in 2008 to £31k in 2012, an increase of nearly 50 per cent. The largest damages payment made was £170k for failing to diagnose and treat periodontal disease, which was a common allegation among the settled cases. In this case a significant portion of the compensation was for loss of earnings as the patient was unable to pursue their chosen career.
The figures were published in an analysis by DDU dento-legal adviser, Leo Briggs, in the latest edition of the DDU Journal. Leo commented:
“Periodontal disease is widespread and as much a threat to patients’ oral health as tooth decay. Around 45 per cent of adults with teeth in England, Wales and Northern Ireland show signs of gum disease and if untreated, it can eventually lead to tooth loss.
“Dental professionals have a critical role to play in monitoring their patient’s gum health at each check-up, diagnosing periodontal disease and advising patients at risk. In the minority of cases where this doesn’t happen, the dental professional is increasingly vulnerable to a negligence claim and even a General Dental Council (GDC) investigation.”
“It is important that dental professionals carry out a periodontal assessment during examinations and record this in the patient’s notes. Patients who are at risk of gum disease will need to be told of the importance of good oral hygiene, about quitting smoking and the need for regular dental visits. This advice should also be recorded in the notes. If necessary, the patient may need to be referred to a specialist.
“Claims in this area can be quite costly to settle as patients may need implants, crowns and specialist periodontal treatment. As well as the costs of remedial treatment, compensation can also encompass damages for pain and suffering and, in the case of the larger payouts, loss of earnings.”
In total, 170 claims were analysed. Of these, 126 were settled and 44 were discontinued by the patient. In 25 cases, the dental professional also faced a formal complaint and in five cases, their fitness to practise was investigated by the GDC.
The DDU’s advice to help reduce the risk of a claim for missing periodontal disease includes:
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Follow national guidance when making a treatment plan eg. the British Society of Periodontology’s guidance on the Basic Periodontal Examination (BPE).
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Record all your examination findings in the patient’s notes including BPE scores and factors which may mean closer monitoring is needed, such as gingival bleeding.
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Explain to patients who are at risk how to protect themselves and make a note of this conversation.
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When getting consent for periodontal treatment, ensure patients understand the risks, benefits and alternatives. Make a note of what was discussed and the patient’s agreement.
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Be prepared to refer the patient to a specialist if the patient’s condition doesn’t improve, despite treatment.