Dentist numbed wrong tooth- do I complain?

Of course not. It's no big deal so don't make it one.

“A big shout out to dentists reading this – the incident brought to my attention how stressful your job is; being bounced from patient to patient and needing intense concentration throughout the day. Being one mistake away from a complaint must take its toll”

I so agree, and for doctors too. The stress must be nearly intolerable.

Something similar happened to me where the wrong side of my mouth was numbed. I was booked for a filling in a tooth on my right lower quadrant. I was numbed on the left lower quadrant. An important detail, is that at the prior appointment, an x-ray flagged up a potential problem on a molar on the left side. I declined to investigate this further, preferring to simply monitor it. My instructions were to fix the chipped tooth on the right side only.

The appointment – the left lower quadrant was numbed, not the right. I was impressed with the dentist’s swift apology and genuine remorse.
My response – I did not complain. My dentist acknowledged his mistake. I did not inform the practice. A dental nurse was present who witnessed everything so I’m guessing the practice found out anyway.

Other considerations – I cannot separate a potential complaint from the feelings of the person at the other end. Furthermore, complaining, (especially a habitual response to any adversity,) can have effects on our own health, encouraging negative mind-sets and pessimism. So, if I was going to complain, it would be in a situation where not complaining would be more harmful to me, if that makes sense.

A big shout out to dentists reading this – the incident brought to my attention how stressful your job is; being bounced from patient to patient and needing intense concentration throughout the day. Being one mistake away from a complaint must take its toll. I have reflected on my attitude as a patient, (i.e. being visibly unhappy to see ‘The Dentist,’) and will try to be better. Ultimately, my dentist’s job is correcting mistakes and omissions I made with my oral hygiene when younger. A little bit of grace and gratitude is owed.

So, to all dentists, dental nurses and hygienists - thank you for all you do.

There are various anaesthetics and techniques used to numb a lower molar. The most common one is an IDB or an inferior dental block. The lower jaw is thick and a single infiltration near the tooth isn't strong enough to effectively numb the molar. The block goes in a the very back of the mouth behind the wisdom teeth in a position that is neither upper or lower region.
Occasionally, for various reasons such as poor technique. Inflammation, unusual anatomy, trauma etc it doesn't work the first time. Very frustrating for dentists, especially if you're running late!!!

Sometimes it feels like the upper teeth are numb instead of the lower. It's a reasonably common complication.

I'm not saying that this necessarily happened in the OPs case. Especially as they said the dentist apologised and offered a discount, which sounds like a mistake was made, but just wanted to make everyone aware that this can happen and it's not necessarily that a mistake was made.

Dentistry can be stressful and complicated. As can the people attached to both the drill and the teeth!

How informative this thread is.

@FixTheBone **

Good to know dentists get carte blanche to do whatever the fuck they want with no come back.

You couldn't be more wrong. See my post below regarding practice complaints procedure and GDC.
There are many levels of safe guarding and protection in place. Dentists and dental practices are heavily regulated. This includes ( but not limited to)

1. Dental reference reports- where patients are selected randomly and examined by regulators to ensure that treatment performed matches up to what's claimed/written in notes. And is to a satisfactory standard. Sanctions are put in place if any concerns
2. Three yearly health board inspections. This includes checks on radiation, pressure vessels, patient notes, decontamination procedures and policies and procedures
3. GDC declarations and checks such as meeting minimum CPD requirements especially including topics such as radiology, legal/ethics and professionalism/equality and diversity.
4. Checks on indemnity cover, practice insurances such as employers liability
5. In early years, practitioners are continually assessed in practice to determine whether they can practice independently
6. HMRC checks
7. Prior approval- large cases must be assessed by NHS regulators before permission to start treatment
8. Duty of candour requirements. Healthcare professionals must be open and honest about adverse incidents and must report to health board and authorities if required.
9. Duty to refer to secondary care, if something hasn't gone to plan or they need help from specialists with difficult cases.

I'd say we were one of the most heavily regulated professions and very much have to behave in a professional manner at all times.

Well not really. Just because something isn't a Never Event doesn't mean it isn't serious. Wrong tooth removal would definitely be classed as an SUI in our Trust. There are lots of incidents that would trigger an investigation, and depending on the outcome, potentially have serious implications for the staff involved which are not on the list of Never Events.

No they don’t, if you look at my post quoting the Royal College of Dentistry
ScrollingLeaves · Today 01:04

and then a following post from a knowledgeable dentist confirming that OP should complain, but to the practice ( and why that is).

Ive just checked, and you're spot on.

Good to know dentists get carte blanche to do whatever the fuck they want with no come back.

In that case you go complain It it didn’t happen so I wouldn’t complain

not being prefect myself I’m not adverse to making the odd blunder myself so just think no harm done and move on

Thank you, I was thinking of ‘telling the practice’ as being a complaint. For me, as an ordinary type of patient who hates to complain, telling the practice would feel like a complaint.

@ScrollingLeaves
* Does that GDC web page clearly state that people should first approach their dental practice?

It does say it on the GDC website, but not that clearly. I had to click a few buttons first to find the page I've posted below.

It is a regulatory requirement in Scotland that we have a practice complaints policy on display at reception.

Nope. Should the practice review their safety protocols? Yes. Is the OP owed any compensation? Absolutely not.

The first requires telling the practice. Only the second requires complaint.

@decemberknows
Speak to the practice first and let them follow through the process first please.

That is dreadful about the cases of dentists who have taken their own lives because of the stress of a complaint.

Your advice to take a complaint up with the practice in the first instance seems crucial in avoiding this.

Does that GDC web page clearly state that people should first approach their dental practice? So many affected patients would be shy of saying anything to the dental practice but instead go home and ‘google’, find that page, and fill it in.

Looking at the Royal College of Dentists in England page,
Some risk factors for wrong tooth extraction
I did think there but for the grace of God … could go anyone of us, and that a person needs to be brave to be a dentist or doctor and face the responsibilities and dangers.

Dentist here.
I think it is important that this issue is addressed. In my health board this would be a Duty of Candour report and a significant event. We would document this in patient notes, our practice manager would meet with the patient. We would do our best to resolve it locally, do a significant event analysis, learn from the mistake, and report the event to the health board.

We would take it seriously to ensure that it didn't happen again.

However I would urge that any complaint of this nature, especially one that was acknowledged and dealt with at the time, that hasn't resulted in lasting issues, firstly be taken up with the practice for local resolution first. I noted that someone up thread posted the GDC complaints page.

The GDC are robust in their approach and can put a dentist through the absolute worst time. Even a simple complaint as this ( would would ultimately be thrown out) can take several years of waiting around, investigations and scrutiny. It can and has resulted in many dentists suffering from mental health concerns, quitting the profession or just generally losing their reputation and livelihood.

Here is Scotland we are currently working with the Canmore trust charity after a couple of local dentists committed suicide after GDC investigation

So whilst the GDC protects the public and does a vital job, the impact that every individual complaint can be very serious and upsetting.

Speak to the practice first and let them follow through the process first please

Whilst I agree there’s probably no point in raising a a formal complaint, the clinical issue remains. Safety critical industries have stringent processes and procedures in place, including using check lists. Perhaps one check the dentist could incorporate is confirming the procedure with the patient (and which tooth) prior to any commencing.

It's a near miss and needs reporting or would do in NHS. Surprised people don't think it needs taking further. I wouldn't want you go to that dentist again.

Nowhere did I say that they shouldn’t be taken seriously- it was stated that in a hospital these would be never events. I was just being factual by saying they aren’t classed as a never event anymore?!

All events should be learned from and changes made to ensure a reduction of future occurrence.

It’s not a non event. What if this is someone practicing dentistry drunk? That’s a big error

Removing these dental mistakes from never events has nothing to do with not taking them seriously.

AI Overview about why wrong extractions were removed as a never event

“The NHS removed wrong tooth extractions from the list of Never Events on April 1, 2021 because the barriers to prevent them were not strong enough: Lack of standardization in tooth site marking.”

Never Events are serious patient safety incidents that can be prevented with strong systemic barriers. However, the NHS determined that the barriers to prevent wrong tooth extractions were not sufficient.

“While wrong tooth extractions are no longer considered Never Events, they are still classified as Patient Safety Incidents and should be reported and managed accordingly.”

Some risk factors for wrong tooth extractions include:

• Human error
• Miscommunication
• Inadequate referral
• Being overworked and rushed
• Lack of focus or experience
• Being distracted

From The Royal College of Surgeons of England

Wrong site tooth extraction: no longer a never event

Implications for dental professionals
Although wrong site tooth extraction has been removed from the never events list, it still remains an incident with significant and potentially harmful consequences. As well as any physical and psychological impact on the patient’s welfare, wrong site tooth extractions can also be costly, and cause fundamental long-term stress for the clinician and organisation involved.

Between 2004 and 2014, 51 claims for wrong tooth extractions were recorded by NHS trusts in England, with the successful claims costing the NHS over £340,000.

Data from the Dental Defence Union revealed that between 2006 and 2011, each settled claim cost on average £7,300 plus legal fees.

There could potentially be an increase in wrong site tooth events if clinicians are now less concerned about the consequences as these events are no longer identified or labelled as a never event. Dental professionals should be aware of the potential risk factors, which include differences in dental notation, multiple carious teeth, orthodontic extractions, only two molar teeth being present in a quadrant, extractions in the mixed dentition, time lag between treatment plan and extraction date, and human errors such as miscommunication, distraction, complacency, stress, fatigue and teamwork as well as lack of resources, awareness, knowledge and assertiveness.

It is important to recognise that it is rare for only one of these risk factors to be involved in the incident. The Swiss cheese model illustrates how hazards are prevented by a number of barriers or defences.12 Each barrier has a ‘hole’ or weakness such as one of the risk factors described. An adverse incident is very likely to occur if all the holes are aligned, showing how there is usually a combination of risk factors that results in a wrong site tooth extraction.

Recommendations
It is clear that despite having LocSSIPs and safety protocols, wrong site tooth extractions still occur. However, best practice should still be followed to minimise risk, as suggested in the Faculty of Dental Surgery toolkit. Additionally, methods to reduce human error should be introduced and implemented in organisations, including in primary dental care. Strategies proposed by Pemberton include:13
……..

(there follows a table of protocols )

https://publishing.rcseng.ac.uk/doi/full/10.1308/rcsfdj.2021.42

Who knows why the never event framework excludes wrong tooth extraction given what could happen to the dentist if he/she did extract the wrong tooth. It is not something for a dentist to be blasé about:

£40,000 Compensation For Wrong Tooth Extraction

https://www.legalexpert.co.uk/compensation-amounts/40k-compensation-for-wrong-tooth-extraction/

That was in response to the previous poster

The updated never event framework of 2021 excludes wrong tooth extraction and dental anaesthetic blocks.

OP - You were able to correct the dentist, he has apologised and provided a discount. I wouldn’t complain- but you could ask to understand what lessons or processes have changed following the consultation.

I think you are unaware of the issue.