A lacerated cheek

A dentist received a letter of complaint from an elderly patient who had sustained a soft tissue injury to the lining of the left cheek during the restoration of a lower left third molar three months earlier.

At the time the dentist had secured haemostasis with sutures, recorded the incident in the clinical notes and offered his sincere apology to the patient.

In his letter of complaint the patient stated that he wanted recompense for negligence and his unpleasant experience. When the letter of complaint was received, as a gesture of goodwill, the dentist decided to refund the cost of the restoration and to waive the charge for his next routine dental examination. The patient was not satisfied with this and stated in his letter that he was considering taking further action with his complaint. The dentist sought assistance from Dental Protection.

Dental Protection advised the dentist that despite accidents like this occasionally happening during dental procedures, it might be considered that the cheek was insufficiently retracted and therefore there was a breach of duty of care to the patient. However, it was recognised that the injury was transient, probably no worse than could have been sustained by cheek biting and the patient would have likely recovered. In complaining three months after the incident,the patient was very likely seeking some compensation for what he considered was negligence on the part of the dentist leading to an unpleasant experience.

Dental Protection advised the dentist to write a further letter to the patient, offering an apology and explaining that despite endeavouring to provide treatment in a caring and considerate manner, treatment of the molars at the back of the mouth requires the retraction of the soft tissues (tongue and cheek) which can be difficult, and occasionally these soft tissues may be accidentally damaged despite the best efforts of the dentist.

As with cheek biting, any small injuries in the mouth heal very quickly and there is rarely any long-term damage. The dentist mentioned that if the patient had contacted him in the days or weeks immediately following the incident, he would have been pleased to have provided all necessary care.The dentist then went on to say that he hoped that the patient would be happy with the explanation, reimbursement of the costs of the restoration and, if not, then could he write again outlining what he would consider a suitable response. No further correspondence was received from the patient.

Learning Points

• If an unexpected outcome arises whilst treating a patient, keep them informed.
• There is no automatic admission of liability in sharing a suboptimal outcome with a patient.