A woman was left in agony by her wisdom tooth removal but her dentist ignored her as she “struggled” in pain.
The operation caused her nerve damage that will take months to heal and the dentist agreed she had “a horrible experience”.
The dentist also described the operation as “an extremely difficult extraction for a nervous patient” and a struggle for both him and her.
Now the Health and Disability Commissioner has found the dentist breached the woman’s health consumer rights by not discussing the force required in the procedure and not explaining the potential risks, including nerve damage.
The dentist argued he did explain the procedure but did not record it in his notes.
In a decision released today, Deputy Health and Disability Commissioner Vanessa Caldwell said the dentist’s skills fell below the expected standard, which was another breach.
The dentist had been a subcontractor for the dental practice but has now retired and asked to be removed from the Dental Council’s register.
In her complaint to HDC, the patient said she usually gets treated at University Dentistry, where she had previously been seen for an impacted wisdom tooth infection.
She was given antibiotics and told she needed to have the tooth removed. She then went to another clinic for an emergency appointment to have her lower right wisdom tooth removed because of the pain and distress.
The woman said she emailed University Dentistry her dental X-rays, but she received no information about the procedure and was not asked to sign any consent forms before the extraction.
Caldwell said there were no discussions of side effects or potential risks. The dentist said he usually evaluates patients for tooth extractions, but he felt pressured to relieve the woman’s pain and distress.
The woman said in her complaint that the procedure was extremely painful despite receiving three injections of anesthesia. She said she “struggled in pain multiple times,” but the dentist ignored her and continued with the procedure.
He later said he needed to remove more bone than expected and that the extraction required “greater force on the tooth and jaw than he anticipated.”
She was not given any follow-up care or safety net advice, but soon experienced ongoing pain, tongue numbness and inflammation at the extraction site.
When she first raised her concerns with the clinic, she was given painkillers and, when the pain persisted, antibiotics, without being told what they were for.
She was also treated for a “dry socket”, but was not told how to use it or what effect it would have.
The HDC describes dry socket as a painful symptom that occurs after a tooth is extracted, when the blood clot covering the wound is dislodged or not fully formed.
She then asked for a copy of her dental records, and the owner of the clinic told her that she had nerve damage that would take months to heal.
After further examination at her regular dental clinic, she was diagnosed with possible lingual nerve damage and had a “debridement” (removal of bone fragments) of the tooth wound.
The woman was then referred to an oral and maxillofacial surgeon for further analysis and treatment.
The dentist who extracted the tooth submitted a claim for nerve damage to ACC, refunded the woman’s fees and sent her a written apology.
Caldwell was pleased to note that the dental practice accepted the findings of the independent consultant’s report and endorsed the recommendations made therein, which included continuing to educate all dental practice staff on the importance of adequate consultation, informed consent and thorough documentation.
Caldwell also recommended that if the dentist returns to practice, he should be familiar with the clinical technique for removing wisdom teeth, the complications of altered nerve sensation following extraction, and appropriate postoperative care.
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