To sue the orthodontist?

[HerbertPootle]

No win no fee? How do you do it? What do I need? I have email trails and some notes from earlier appointment. This is long as I’m trying to include all relevant details.

DS first seen Feb 2024 age 11, Orthodontist says he has multiple crowding problems but to wait a year and see if anything changes as he’s small for age and still growing. Confirms DS qualifies for NHS braces. Our local Dentist referred mainly to get baby tooth removed that’s blocking some teeth, they don’t arrange this.

Never got any correspondence and neither did my dentist. Dentist receptionist spent months emailing orthodontist for copy of report. Eventually orthodontist sent transcribed notes from appointment but no report.

No follow up sent Feb 2025 so I chased up. DS had private and then NHS diagnosis summer 2024 for metabolic bone disease which can also affect teeth so I made orthodontist aware in same message chasing appt. Got appointment that weekend (early March).

DH took DS. Different male orthodontist says teeth much, much worse after waiting a year and DS now needs urgent dental surgery. Upper canine in roof of mouth heading in direction of upper incisor roots. He will do referral to specialist/hospital, we will hear direct from them. Probably bit of delay as NHS. DH asked if he should book a further appt with orthodontist but told no need, would hear from specialist direct and see them going forwards.

Phoned orthodontist a few times to chase for a copy of referral letter but they never answer phone. DS also having other bone surgeries during this time so decided to take him to a different private dentist once he’s recovered for second opinion.

Saw private dentist last week, upper canine now hitting roots of upper front teeth. Real possibility he’ll lose all his upper teeth due to delays from orthodontist. New dentist suggests going private with them and doing asap, she’s horrified original orthodontist didn’t remove baby tooth in 2024 as this could have given enough space for canine and incisor to come through normally. Should all have been dealt with in 2024 as was visible on original X-rays (I took photo of xray in appt and showed her). She says this was urgent in Feb 2024, no reason to delay a year. Going back tomorrow to meet with her and new orthodontist with results from CT and find out costs.

Got an email from original orthodontist receptionist today that has given me the rage (and made me want to sue them). She says we were told in appointment in March that we need to make an appointment with an orthodontist to get the referral letters written. Which is a complete lie!!! Why would the orthodontist say make another appointment with an orthodontist? Complete nonsense. And even if he had said that we would have made an appointment straight away!!

So there is no referral letter. I was chasing a copy so I could contact specialist direct thinking it was done 4 months ago with new x-rays to see if we could get a cancellation on NHS before he loses all his adult front teeth. But it doesn’t exist. She’s booked me an appointment for next week to do the letters. Am so incredibly angry 😡

Would you sue original orthodontist??

She was very angry at his appointment last week, I’ll ask her what she thinks when we’re back there tomorrow. I doubt she would either.

Your comment is very balanced. I think probably we would have had to go private but I wish they had flagged it up in Feb 24 as I would have taken him to see someone privately then. By saying it might improve if we wait a year, we waited a year. Which delayed the treatment to the point it’s now impacting his upper front teeth, which is where he’s now worse off. It wasn’t impacting his upper front teeth before (early 2024). Surgery should have been arranged straight away to give enough time for waiting list etc. and if not we would have gone private. No one ever said his upper front teeth were being impacted until we saw the private dentist last week. Will know more when we see the CT results tomorrow. I’ve attached his xray of roof of mouth. You can see it looks like the root of one incisor has already been impacted but hopefully not.

Sorry above message with photo as a reply.

Thing is, if the ortho finds one other ortho to say that they also would have advised to wait for a year, he won’t be judged to have fallen below the standard of required care

I had a photo of the X-ray from 2024 which I showed her. The baby canine tooth has a retained root which is why my dentist was saying it was urgent, but who knows. The orthodontist did include this in the notes they wrote Feb 2024 but no sense of urgency.

Unfortunately, his X-ray last week it looks like the canine is already past the root of the first incisor but waiting for CT results as obviously not a 3D image. I’ve added image, what do u think? I wish I’d taken him private 18months ago.

OP, this sounds a very stressful situation for you and your son.

FWIW, my DD first saw the ortho aged 11 but had to wait for a baby tooth to either fall out or be removed. During this time we had regular dental check-ups and xrays at her dental practice, who called the shots on removal of the tooth. She eventually got braces aged 14. It's not at all unusual to have to wait.

Why did your ordinary dentist not step in and make a referral to get the tooth out? I'm confused as to their part in all this - as a pp said, orthodontists do not remove teeth.

@Hecatoncheires I think our dentist were waiting for the orthodontist to refer the baby tooth to the specialist / hospital for extraction. It has a retained root so it’s very long and dentist didn’t want to remove himself. They were then happy to wait for orthodontist although at every check up they did ask if we’d heard anything. We never had any correspondence and neither did the dentist which I think delayed things.

Looking at the X Ray you have provided, it doesn’t look like the canine has had much effect on the incisors. Yes it’s overlapping, but it’s an image which will show this. The roots of the incisors look intact. The canine, I guess is palatal to them. I need a little more information.
Your original dentist should easily/ confidently have extracted the deciduous canine, without waiting for an orthodontic opinion. There’s no way of knowing this would have resulted in a different outcome. The canine may still have not come down. And you could be in exactly the same position as you are in now

This is 2024 x-ray from front of mouth, 18months ago, can already see (upper left) canine moving sideways. They didn’t do a roof of mouth x-ray but decided to leave it 12 months. Anyone else have similar X-rays at this point told to wait? Baby canine unusual in that it has a retained root (which is still retained now).

I don’t think you’re going to win , you’re also unlikely to find a no win no fee solicitor who will take you on for this ,
they usually recognise the cases that they’re going to get a kick back from , from their years of experience .
I would have paid privately from the off assuming you had the means to do so , it’s not news that the NHS is ( unfortunately ) on the bones of its arse .

@bugalugs45 I would have paid 18m ago if they’d said it could impact his upper front teeth. They said he will need braces but to wait in case it improved over 12m growing. Then this year it’s suddenly an emergency but they haven’t done a referral 4m later despite saying they would. It’s just been a massive waste of time.

From the 2024 opg, the canine is already off line!

It’s all a matter of opinion though, not unusual in the medical world , also waiting a year is often advised , especially regarding baby/ adult teeth , although I’m not a dental expert but have had braces myself ( & 2 teeth removed )
I do get your frustration but I don’t think su-ing is the answer . Notoriously difficult to prove medical negligence , as other PPs have stated

@littlemissprosseco thats good to know, thank you, I’m really worried about his upper front incisors being affected. The dentist I think wanted the orthodontist to refer to specialist/hospital for extraction. They wouldn’t do it themselves when they saw the X-ray. It does also have a retained root which I think meant they wanted a specialist to do it.

I’m not convinced it would have made a difference to the path of the canine (would have helped incisor which is through the front of the gum). I just can’t see the logic of waiting so long when waiting lists are long anyway.

@bugalugs45 yes, that’s why I didn’t question it when they said wait a year as others had been told the same. But the X-ray from 2024 already shows the canine heading sideways. According to everyone it’s now too late to wait for NHS treatment as it’s only going to do more damage.

Which tbh is my experience of NHS last few years, we just paid for private knee surgeries as NHS waited too long to refer and he was at risk of losing his mobility/never doing sports again, can’t afford private surgery again plus braces without borrowing money now.

A deciduous canine is easily extracted. It doesn’t matter who does it, an orthodontist won’t, would refer it back to the general dentist anyway.
Im going to assume that on your next scan it will show that the incisors aren’t affected and that you need to make a decision,

1. to leave the canine where it is,

2.remove the deciduous canine and wait ( your child is still young, and some positive growth may happen. No way of predicting that!) 3.go for active treatment

DS is 13 now. I feel the need to go private now as private orthodontist is saying this is going to impact his upper incisors if we wait any longer. She’s looking at doing the surgery in weeks not months. I wish I had opted for it before but the local orthodontist said it wasn’t that bad. I believed them when they said it might improve if we wait a year. Also, in the meantime, he’s had a diagnosis of a metabolic bone condition which affects teeth and bones so with this underlying condition it’s an even worse prognosis for possibly losing front adult teeth.

@LIZS also turns out orthodontist hasn’t actually done the referral they said they would in March so he’s not even been referred for NHS yet.

@littlemissprosseco thank you, fingers crossed. I’m hoping it’s not as bad as it sounded last week. Bearing in mind my son has a metabolic bone condition, areas of bone loss in jaw, spontaneous dental abscess (from age 2-7, none recent) do you think they’ll want to wait? Dentist seemed to want to arrange surgery ASAP and would decide depending on CT.

It’s not definitely going to impact his upper incisors. It could lie there in the palate for the rest of his life, doing nothing. The main question to ask,after your next scan, is, “is the root closed?” If it is…. It won’t move any more/ cause any further problems

You’ll still have orthodontic issues to address, the crowding, the deciduous canine….
But I’ve seen canines lying in patients palates with no problems at all. Deciduous canines, they can last for decades, well into the patients 30s before they fail. If the other teeth/ crowding have already been addressed, then what tends to happen is that the deciduous canine fails( its only meant to last into teenage years, but if they can, and do, last much longer), people have implants put in. It’s not an uncommon situation

why do you now need to pay privately? If it is that urgent he should be seen on the NHS asap. My kids were originally told upto 5 years wait on the NHS. DD got seen within 6 months as she had already had treatment from the orthodontist when younger due to an accident to was classed as continuing treatment rather then a new patient and DS had an adult tooth that was completely horizontal so he was classed as an emergency and seen within a couple months. (having had some scans and tooth extraction in thoses couple of months).
I would be asking the NHS why if it is so bad that he may lose his teetht that he is not being classed as an emergency?

Id be wary of what the private dentist is telling you, it is very unprofessional of them to be ‘horrified’ if thats the phrase they used, for starters they don't know how the situation looked clinically a year ago

this.

we saw a private orthodontist. We also got the spiel about this and that hadn’t been done and if they’d have seen them earlier they could have done x or y, and now the only fix would be surgery etc.

they were excellent in the end but the difference was their end point was “perfect” cosmetic jaw alignment, very straight teeth etc. both dc had a slight overbite, which was not an issue and cosmetically fine, just not absolutely “perfect”. The fix would have been jaw surgery to break and realign the jaw, which was just not appropriate for such a relatively minor cosmetic issue.

bear in mind they are a business and they want to get you signed up to their product. Their competition is free treatment on the NHS, so they need to do something to persuade you to part with your ££££££.

@littlemissprosseco

Thank you I’ll ask if the root is closed. He has had a number of spontaneous dental abscess in between baby/adult teeth in the jaw so I don’t know if new dentist was thinking this could potentially be a problem with it left in place. Will ask her tomorrow.

Unfortunately, I don’t think he can have implants due to the metabolic bone condition as bone loss visible in jaw. He is now receiving treatment for this though so who knows, bone might improve in future. Trying to remember why local dentist didn’t remove baby tooth and as well as all previous things I’ve mentioned the upper right incisor is coming out of the front of the gum just above it, so I think they’ll wanted orthodontist to see it then refer as they said would need braces at same time to align the incisor when it’s removed. Or something like that.

Get a third and fourth opinion.