A patient had attended a practice on three previous occasions, seeing a different dentist at each appointment. He had originally seen a dentist due to a fractured filling at the LL6, which had been placed many years earlier at another practice. The dentist placed a temporary dressing and advised that the patient return for a check-up and filling appointment.
At this second appointment, the patient saw the practice principal, who carried out an examination and placed an amalgam DO filling at the LL6. The dentist also identified early stages of periodontal disease and recommended a course of periodontal treatment. Root scale debridement was completed over two visits and it was advised that the patient return for a three-month follow-up appointment.
The patient did not attend for the follow-up but returned one year later, requesting a scale and polish to remove stains that had built up on the teeth as he had a family function that he would be attending the following week. The patient was advised on the phone by the receptionist that he was due for a check-up, and asked whether he would like to book for this and a scale and polish at the same time, or alternatively he could book for a private hygiene visit.
The patient booked in for an examination and scale and polish. At the appointment he mentioned that he had experienced some food packing in the region of the LL6, where the previous filling had been placed. A clinical examination identified that the filling was stable, but the patient was given the options of either smoothing the filling interproximally or replacing it to see if the contact point could be improved. As the filling had been placed more than one year earlier, a new charge would apply for a replacement filling.
The scale and polish was completed, but the patient expressed dissatisfaction at the time as not all of the stains had been removed. It was explained that if he wanted a full stain removal for cosmetic reasons, a separate hygiene appointment would be necessary and there would be a cost of €50, as this was a cosmetic treatment request.
The patient left and the following week a complaint email was received. The patient was unhappy that not all of the stains had been removed and explained that this was the prime reason for the appointment. He was also not happy that he was going to be charged for a replacement filling when the dentist had identified that there was a problem with it.
Both dentists involved were members of Dental Protection, and they sought our advice. An explanatory letter was sent and the patient was offered a refund of the charge that he had paid for the examination and for the scale and polish. The patient responded requesting a refund of the filling placed one year earlier at the LL6, and asked for compensation of €50 towards a hygiene appointment.
A decision was made to offer the patient a refund of the fees for the filling, as a gesture of goodwill and as an attempt to resolve the complaint swiftly and amicably. It was however decided that the offer of €50 towards a hygiene appointment in addition to the refund would have been considered to be betterment, and so this was not offered.
The patient accepted the refund and the complaint was satisfactorily resolved.
Learning points
This case raises the question of what to do when a patient asks for compensation, and whether it means it should be automatically considered a claim. Situations like this often arise when a patient writes a letter of complaint to a dentist and mentions that they would like financial compensation. Dental Protection can advise on whether to manage the matter as a formal claim or through the practice complaints procedure.