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Be careful with multiple crown replacement

15 July 2014
When three opinions clash in the settlement of a difference in clinical opinion, something is clearly amiss...

A dentist had treated a patient for some years under a private capitation scheme. On his retirement, the patient went to a new practitioner who informed him that a considerable amount of treatment was now required including multiple crowns at a substantial cost.

The patient consulted a lawyer on the basis of the new practitioner’s plan and a claim for negligence was initiated against the previous dentist. It was clear from the radiographs that some work was required which should have been the responsibility of the recently retired dentist, but he was adamant that there was no large-scale neglect necessitating multiple crowns.

A joint expert was appointed to see the patient and to settle the disagreement. He was supplied with both sets of records and the proposed plan for crown and bridgework. He was critical of the original dentist’s standard of care but even more so of the second dentist, and was quite explicit that had that treatment been carried out, it would have been a gross overtreatment of the patient.

The patient accepted this report and a small settlement was agreed to cover the treatment deemed necessary. A third dentist carried this out as the patient did not want to return to the second dentist.

Learning point:

Many practitioners enjoy crown and bridgework but there is an overriding duty of care to a patient that should temper their enthusiasm for change.

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