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Regulating the effects of COVID-19

17 June 2021

By Dr Louise Eggleton, Dentolegal Consultant

A dentist closed her dental practice on two occasions during the ongoing COVID-19 pandemic. The first time was due to a combination of the nationwide lockdown and the restriction of dental practice, along with being unable to source some items of essential personal protective equipment. This limited the dentist for some weeks to providing triage advice to patients over the telephone, prescriptions when appropriate or referral to another clinic if it was possible for the patient to travel. 

The second unavoidable closure was shortly after the surgery reopened, following the dentist having had contact with a family member who was then confirmed to have tested positive for COVID-19.  The dentist was forced to self-isolate for the recommended period of time in accordance with government guidelines. Unfortunately, a suitable locum dentist could not be found to cover the treatment appointments at such short notice and therefore patients were contacted to reschedule, or were offered emergency appointments at a nearby dentist who had agreed to provide additional support to the practice.  

The majority of patients were very understanding of the dentist’s position. However, one patient, who had been unfortunately affected by the first closure of the practice, became unhappy that it was now necessary for their follow up appointment to also be rearranged. As the patient was experiencing discomfort, they accepted the alternative emergency appointment offered by the nearby practice. The patient was advised their tooth was unrestorable and required extraction. The extraction procedure was completed uneventfully; however, the patient shortly afterwards sent a letter of complaint to the original dentist claiming that the six-week delay in treatment had caused the loss of his tooth, and was threatening legal action.

The dentist was understandably upset on receiving the complaint and immediately contacted Dental Protection who assisted in responding to the patient. A reply was prepared to clearly explain that the factors leading to the delay in treatment could not have been predicted and were beyond the control of the dentist. The patient’s disappointment was acknowledged but assurance was provided that the steps taken to make alternative arrangements for the care of patients were appropriate. Although the dentist regretted not being able to personally care for patients, it was clarified that her actions were entirely reasonable and in compliance with the relevant national guidance on measures to limit the transmission of the virus. It was further explained to the patient that the reason for the extraction was the condition of the tooth rather than any fault on the part of the dentist. The appointment with the second dentist had been arranged as soon as it had become known that the original dentist would need to self-isolate, so the patient had been seen quickly.

The patient did not reply directly to the dentist’s response but did request a copy of his records to give to his new dentist. These included previous radiographs, which showed that the tooth in question was heavily filled and that the patient had been warned that the tooth would need further attention and perhaps require extraction in due course. The patient had in fact already been given advice on replacement options some 18 months previously and this was clearly evident from the notes.  

The dentist did not hear anything further from the patient after this and understood that he had started attending the practice who had assisted with his emergency care. There was no further complaint.

The dentist had been under considerable stress whilst trying to manage her practice during the pandemic as well as dealing with this complaint, and she was grateful for the offer of access to the confidential counselling service available to members of Dental Protection as a benefit of membership.

Learning points

  • Dental Protection recognises the significant additional pressures many dentists are facing during the pandemic and how changes to the way we deliver care will have an impact on patient perception. We understand dentists continue to try their best to provide a good level of service to patients during this time, while adhering to the relevant guidance. Unfortunately, it can be very difficult to predict how a patient may react to events that can often be outside the dentist’s control.

  • Contact Dental Protection at the earliest opportunity to ensure we can support and guide you through any complaints, claims or regulatory challenges that may have been triggered by the additional pressure of providing dental care during the COVID-19 pandemic.

  • You are not alone – Dental Protection understands the serious pressures dental professionals have faced during this time. We offer confidential counselling services from independent professional providers at no additional cost, as part of your membership benefits. Please contact us for more information.

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 Protection members enjoy as part of their subscription. 
For more detailed advice on any issues, contact us