Do I have grounds to make a claim against my dentist

[Moveonward]

So I am an NHS patient at my local dentist since last summer. At the first consultation the dentist x-rayed my teeth and examined me and said all fine and back in 12 months.

in March this year I noticed an area of swelling behind my teeth on my palate as well as a small bony area at the front. I went to see my dentist straight away as I know they look for oral cancers.

She examined me again and another x ray and found no issues but sent a routine referral to my local max fax dept ‘to check im not missing anything’

fast forward to august- still no appt from max fax team but had my usual annual check up at the dentists again and I mentioned the lump which was still there. Different dentist this time basically shrugged and said ‘well the referrals been made and it might be an abscess’

a few weeks later I was really starting to get worried as our local max fax secretaries informed me that the appointment was likely to be early next year!

i called the dental receptionist and asked them to expedite the referral as I’m concerned this could be something significant. She spoke to the dentist and then called me back to say that the dentist won’t expedite the referral and if I’m concerned to cal my GP! I asked does she think it’s nothing to worry about then and she said that she could she couldn’t comment.

i actually work in a large London teaching hospital and because I was so concerned I approached the max fax team there directly so kindly saw me.

After more x-rays, a CT scan and a biopsy I essentially have a rare cystic mass which was bulging I to lay palate and eroding it away. The mass has also caused bone loss in my jaw and now involves 3 of my teeth which may need to be extracted.

i am devastated as these are healthy teeth and the lump has been there since March. I went back to my dental surgery this week as I need an urgent dental assessment before the surgery can take place and I saw the dentist I saw the second time.

she was extremely sheepish and seemed quite shaken and basically said I need to see a private Endodontics as beyond her capabilities. Tellingly they didn’t charge me for this consultation

I am now left with bone loss in my jaw and teeth which need extracting potentially because the dentist didn’t recognise this was a potentially serious issue back in March and didn’t refer me in urgently. I have been beating myself up that I didn’t push more at the time but as my DH pointed out- I went as soon as I found something and I trusted their judgement.

im now left with potentially costly surgery and a potentially disfiguring mass in my face and not sure how to proceed- any ideas?

@Angrymum22 thats reassuring in regards to the patient you saw re delay in diagnosis. Mine has also started to progress into my palate

out of interest did he have all the teeth involved extracted? I understand in a way that the max fax team want to preserve my teeth but the cyst is so large and causing symptoms I’d like to just get on with it and maybe just get the teeth extracted. Losing healthy teeth would be awful as they are healthy and it’s three of them but the waiting for treatment and the feeling that I am having to do all the coordinating between the max fax team and Endodontics is really having an impact on my mental health

Extracting the teeth may not be an option, depending on how large the cyst is , as the bone can be quite “crumbly “ and taking teeth out may lead to quite a bit of damage if it is three molar teeth. It may not be just a case of keeping the teeth but also keeping as much bone as possible in the area.

@Lollygaggle the Endodontist felt despite quite a bit of bone loss my teeth were still quite firmly in place and his feeling was to proceed to decompression and then removal of the cyst and then he would keep a really close eye on my teeth and if any die off he could either extract or perform root canal at that point.

But as he said he has not come across this pathology before and so had to just give his opinion to the max fax team and see what they say. Hopefully I’ll get some movement next week. The lead head and neck nurse specialist has been on AL for the past 2 weeks so I haven’t had her support but she has said she will call me on Monday.
I’m hoping she can help push things forward too

My understanding is , depending on where exactly the cyst is , the max fac team may also place a solution in the cavity after the cyst has been removed that will kill off any stray cells that formed the cyst . Again if it is close to roots of the teeth then that may also cause the nerves to die off.
The main thing is the endodontist is liasing with the surgical team and between the two will come to a conclusion as to the best way to move forward.

Have you access to mindfulness courses via work? They are very useful when dealing with the stress of health problems .

I would agree. Teeth whether vital or non vital will preserve bone and help post op to encourage reformation of the bone in the area. I think your endodontist has the right approach. Certainly the two cases I was involved with have not involved extraction although I recent case in the practice is in the lower jaw so treatment may be different. I haven’t seen the plan so wouldn’t be able to comment.
Extraction would not be recommended to solve the problem since the tooth isn’t the causative structure. With the more common radicular cysts they are the source of infection so are removed to solve the problem.
The patient who delayed treatment had a drain placed after enucleation ( removal of cyst lining) to prevent formation of further cyst. It was complicated. But as I said he delayed treatment by 5-6 yrs.

@Angrymum22 thats quite reassuring that you agree with the Endodontist I saw. He is very experienced and I trust his judgment and it helps that you think this approach sounds sensible too.

I think I need to wait for his letter to reach my Consultant and then push for another consultation to get things moving and explore the possibility of just leaving the teeth for now and see how they are post cyst removal