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An immediate denture

08 April 2019
A dentist contacted Dental Protection for advice, after receiving a letter of complaint from a patient regarding the fit of his lower partial cobalt-chrome denture, which had been provided 18 months earlier. The patient had requested a full refund, stating that the denture was not “fit for purpose”.

From the clinical records, it transpired that a lower molar tooth had been extracted, and a chrome lower partial denture had been provided two months later. This had then been relined at a later date, after the socket had fully healed, but the patient had struggled to use it.

Although the risks of post-extraction shrinkage were discussed with the patient and recorded at the denture fit appointment, there was nothing documented in the records reflecting that this issue had been discussed with the patient at the examination and treatment planning stage before treatment began and consent was given.

Equally, there was nothing recorded about the discussions had with the patient, outlining the choices available and their associated risks and benefits. An alternative approach would have been to extract the tooth, and then allow the space to heal completely before making a partial denture. The provision of what might be considered an ’immediate’ chrome denture was high risk.

After taking advice from Dental Protection, the offer of a full refund was made to the patient. Such business decisions can avoid the complaint escalating, which would lead to more anguish for the clinician.

Learning points
  • This case highlights how important it is for the patient to be given all the treatment options at the earliest stage, and if the provision of an immediate denture is the patient’s preferred treatment of choice, they need to be made aware of the consequences of the associated post-extraction shrinkage.
  • The future need for relining the immediate denture or the provision of a new replacement denture, at the patients’ cost, needs also to be discussed and documented.
  • An advice sheet handed to the patient at the start of treatment can help improve communication and the fact should be recorded in the notes together with the title or number of the advice sheet given.

These case studies are based on real events and provided here as guidance. They do not constitute legal advice but are published to help members better understand how they might deal with certain situations. This is just one of the many benefits dental members enjoy as part of their subscription. 
For more detailed advice on any issues, contact us

© 2019 The Medical Protection Society Limited

DPL Australia Pty Ltd (“DPLA”) is registered in Australia with ABN 24 092 695 933. Dental Protection Limited (“DPL”) is registered in England (No. 2374160) and along with DPLA is part of the Medical Protection Society Limited (“MPS”) group of companies. MPS is registered in England (No. 00036142). Both DPL and MPS have their registered office at Level 19, The Shard, 32 London Bridge Street, London, SE1 9SG. DPL serves and supports the dental members of MPS. All the benefits of MPS membership are discretionary, as set out in MPS’s Memorandum and Articles of Association. “Dental Protection member” in Australia means a non-indemnity dental member of MPS. Dental Protection members may hold membership independently or in conjunction with membership of the Australian Dental Association (W.A. Branch) Inc. (“ADA WA”).

Dental Protection members who hold membership independently need to apply for, and where applicable maintain, an individual Dental Indemnity Policy underwritten by MDA National Insurance Pty Ltd (“MDA”), ABN 56 058 271 417, AFS Licence No. 238073. DPLA is a Corporate Authorised Representative of MDA with CAR No. 326134. For such Dental Protection members, by agreement with MDA, DPLA provides point-of-contact member services, case management and colleague-to-colleague support.

Dental Protection members who are also ADA WA members need to apply for, and where applicable maintain, an individual Dental Indemnity Policy underwritten by MDA, which is available in accordance with the provisions of ADA WA membership.

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