Dental Protection’s inbox is flooded with AI generated patient complaints, practitioners AI responses, and AI generated treatment plans. Is this perhaps a good thing? For example, has the use of AI led to more meaningful and well-reasoned complaints? Short answer – no. Perhaps then, the value of AI is assisting patients in better understanding their treatment options? Sadly, also no, not at all.

The simplest way to start any article is at the beginning, and so I asked ChatGPT to write a complaint for me from the following: 

• The root canal treatment (extirpation) the dentist did on my top molar is unsatisfactory 

• I know this because I had pain the day after treatment, and I couldn’t sleep that night 

• I feel they rushed me through the treatment 

• The dental assistant was mean 

• I want a refund and compensation – how much compensation am I entitled to? 

• I will report the dentist if I don’t get this

The initial letter was quite benign, so I asked ChatGPT to try again. It then offered me some interesting inclusions, starting by giving me a full range of potential compensation (with the top figure mentioned being well into six figures), and suggested I asked for a full refund and $1,500 compensation. ChatGPT then offered to write me “a very effective sentence that makes dentists take complaints extremely seriously in Australia.” 

Naturally, I agreed, so ChatGPT went on to offer: 

“If you want, I can also show you the one sentence that most scares dentists in Australia (it often gets refunds within a few days).” 

Brilliant – I locked that in. Finally, ChatGPT offered to “write me a letter which contained everything to get a prompt refund including legal terms” and what it was now terming “reasonable compensation”, and the final letter is below. 

Dear [Dentist’s Name] / Practice Manager, 

I am writing to formally lodge a complaint regarding the root canal treatment performed on my upper molar at your clinic on [date]. 

Unfortunately, I am extremely dissatisfied with the treatment I received. The day after the procedure I experienced significant pain and discomfort and was unable to sleep due to the level of pain. This has caused me serious concern about the adequacy and quality of the treatment provided. 

During the appointment I also felt that the procedure was rushed and that I was not given sufficient care or attention throughout the treatment. Additionally, I found the behaviour of the dental assistant present during the procedure to be unprofessional and discourteous, which made the experience even more distressing. 

Under Australian Consumer Law, services must be provided with due care and skill and must be reasonably fit for their intended purpose. Based on my experience and the outcome of the treatment, I do not believe that the services I received met these required standards. 

To resolve this matter, I am seeking: 
• A full refund of the root canal treatment; and 
• Compensation of $1,500 for the pain, distress, and inconvenience caused. 

I am currently seeking an independent dental assessment regarding the treatment provided. Depending on the findings, I will consider submitting this report as part of a formal complaint to the Australian Health Practitioner Regulation Agency (AHPRA), the Dental Board of Australia, and the NSW Health Care Complaints Commission. 

Please provide a written response within seven (7) days of the date of this letter outlining how you propose to resolve this matter. 

If the matter cannot be resolved within this timeframe, I will proceed with lodging formal complaints with the relevant regulatory and consumer protection authorities. 

I hope this matter can be resolved promptly and professionally. 

Yours sincerely, 
[Your Name] 
[Phone Number] 
[Email Address] 

While this was a fascinating exercise, the problem is I believe quite apparent – pain after extirpation is not an uncommon occurrence, does not reflect substandard care, and critically, is not a compensable event. Regretfully however, in this theoretical case, the AI will have emboldened the patient, leading them to believe that not only do they have a case, but also anchored them regarding a ‘reasonable’ level of compensation, which includes a refund. The AI has accepted the patient’s version of the truth and simply done what it was told without considering the quality of the request so in this case we very much have garbage in and garbage out. 

Regretfully, many practitioners see a letter like this, and they are threatened by it. Reviews of the processes and protocols often reveal underlying shortcomings, and as such, many practitioners do not seek advice from us, and simply pay, or negotiate the patient down to a refund only. 

How does that make you feel? Do you think that is fair? And what do you think the long-term consequence of this trend will be? 

For fun I asked ChatGPT to write a response saying: “I don’t want to refund as I had done nothing wrong.” 

Dear [Patient Name], 

We acknowledge receipt of your letter regarding the root canal treatment performed at our practice on [date]. 

While are sorry to hear that you experienced significant discomfort following the procedure, post-operative pain and tenderness can occur after root canal treatment, particularly within the first 24–72 hours, as the surrounding tissues respond to the treatment. While this can be uncomfortable, it is a recognised and relatively common response following this type of dental procedure and does not necessarily indicate that the treatment was performed incorrectly or without appropriate care. 

After reviewing the clinical records relating to your appointment, we are satisfied that the treatment was performed appropriately and in accordance with accepted professional standards and clinical protocols. 

We have found no evidence that the treatment was performed without due care or skill, nor any basis to support the assertion that the service provided was not fit for purpose under Australian Consumer Law. 

With respect to your comments regarding the conduct of staff during the appointment, we take such matters seriously. However, we have no information indicating that any member of staff acted in an unprofessional or discourteous manner during your visit. 

In light of the above, we do not accept liability for the matters raised in your letter and we are unable to provide the refund or compensation you have requested. 

We note your intention to obtain an independent assessment and to contact relevant regulatory bodies if you choose to do so. We respect your choice. 

If you are experiencing ongoing symptoms, we would be willing to offer a review appointment to reassess the tooth and provide appropriate clinical advice. 

Yours sincerely, 

[Name] 
[Title] 
[Practice Name] 
[Contact Details] 

Note that ChatGPT has pulled some time frame from somewhere, and while at first blush it all seems very professional, please trust me that from our experience, a letter of this nature is the equivalent of pouring petrol on a dumpster fire.

AI is unnecessarily escalating complaints by essentially validating a patient’s point of view without understanding the underpinning facts (because it is not being asked to) and, anchoring them in their belief that events are compensable, when in fact, they are not. Pain after an extirpation is not an uncommon occurrence, it is not reflective of wrongdoing, and critically, it is not a compensable event – the patient’s belief has however been cemented by the AI response, making it hard to change their point of view. 

Compounding this are snippy AI generated responses practitioners are generating in response. The AI is essentially arguing with itself, and the practitioner is losing. 

AI generated treatment plans bring a different level of complexity. For privacy purposes, and because this publication exists online in the public domain, I have not published this exercise, however, for your interest – get an OPG that you have permission to use, or find one that is already online, and ask ChatGPT to read it, diagnose conditions and create a treatment plan. You will likely be horrified by the diagnoses that the AI will make, without any symptoms or additional information, and the treatment it will suggest. 

Again, this misinformation anchors the patient’s beliefs, and, in a world where dental practitioners are feared and mistrusted, these AI generated treatment plans are only serving to further weaken our relationships with patients. 

So, what can we do? 

• When you receive a patient complaint, seek immediate advice so we can assist you – don’t succumb to the temptation to fight AI with AI – you will always be the loser. 

• Be patient with AI generated treatment plans. Remember, the patient is usually seeking this AI advice due to fear and/or lack of understanding. Often their fear of the unknown fed by previous dental phobia and also, fear of unanticipated cost. Talk them through it kindly, calmly and without judgement. 

• Communicate well with your patients – at this stage, the human in the loop remains a critical component of safe healthcare. Approachable and compassionate practitioners who are able to diagnose through the many shades of grey associated with clinical dentistry are requisite – you have not been replaced by a bot.