If a patient complains of a painful swelling, failing to investigate its cause could lead to a devastating result, as this case demonstrates...
An irregular patient attended for examination, complaining of pain and swelling in the upper right premolar area. A treatment plan was agreed, which involved scaling and filling, but no specific investigation of the swollen area was undertaken.
Three months into treatment, the patient complained of loose teeth in the same quadrant. A radiograph was taken and a diffuse apical lesion noted. A referral was made to a specialist in maxillofacial surgery.
A large carcinoma of the palate was diagnosed, necessitating a complete maxillotomy. While the patient obviously had the lesion when she first attended, the late referral had delayed the diagnosis, resulting in the need for a complete maxillectomy as opposed to a hemi-maxillectomy resulting in greater trauma, distress and incapacity for the patient.
Not surprisingly, this resulted in a sizeable claim, which had to be settled on behalf of the member concerned, who was already devastated by the events of the case.
Referral for treatment of a suspected carcinoma is only possible when suspicion is aroused. Even a vigilant dentist may find themselves vulnerable in circumstances where everything appears normal.