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The perfect smile gone wrong

15 July 2014
Where aesthetics is all about the final result, making sure you and your patient are on the same page is the key to a happy ending...

A young male patient in his early twenties requested a dentist to close his midline diastema. He was getting married the following month and wanted this done before the wedding day. It was quite a large gap of some 4mm between the upper central incisors but the dentist confidently assured the young man that he could close the gap and produce ‘a perfect smile’ ready for the wedding photos.

At the next visit the patient returned, asking the dentist to prepare the two lateral incisors as well as the centrals. This was duly done and an impression was taken before the patient re-booked to return in two weeks’ time.

At the fit appointment the two central veneers were tried in and the patient agreed they looked fine. However, the dentist had not shown him all four veneers in place and had not tried them in using the try-in paste that came with the bonding kit.

The dentist went ahead anyway and cemented them in. When he looked in the mirror, the patient was surprised at the result and not at all happy with the size of the central incisors. He also felt the veneers were quite bulky under his lip. The dentist reassured him and asked him to return in a couple of weeks. 


The patient phoned the next day, having shown the veneers to his fiancée. Both were very upset with the result as they felt the front teeth were far too prominent and dominated his smile too much. With the wedding taking place in less than a fortnight, the dentist agreed to replace them at his own cost. The patient had lost confidence in the dentist by now and instead went to another who replaced the veneers for a considerably higher fee.

To resolve the case, the first dentist reimbursed the patient’s costs and Dental Protection paid for the remedial treatment and a small amount for pain and suffering and the inconvenience of having the work re-done.

Learning point:
Whenever aesthetics are involved in dentistry, it is wise to get the patient’s consent to the final appearance before completing the case, particularly if it will be difficult or expensive to redo the treatment once it has been cemented or bonded in place.
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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. 
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