Failure to communicate

In this case, which occurred in the east of the country, a woman was fitted with a metal-based crown. However, her dentist did not tell her in advance that the crown would be metal-based. The patient was due to be fitted with a second crown by the same dentist, but was very reluctant to do so.

She attended the dentist to have an impression taken for the second crown, but before he began to take the impression, the patient explained her reluctance to him, and her disappointment at having not been told that the original crown would be metal-based. The patient said she would like a full refund for the original crown, as she would have to attend another dentist to have this crown made. Her dentist said this was not an option, and questioned if she was threatening him by requesting a refund.

The dentist said he had spent a lot of time doing the crown preparation and he would just about break even if he charged her €100 for the new porcelain-only crown.

The patient informed the dentist that she would make a complaint about him, which led to a heated exchange. The dentist said that her complaint would not stand, as she had said at the time that she was happy with the crown. The patient denied this, and pointed out that her gums had been very inflamed after the crown prep, which had never happened to her with any other dentist.

The dentist then took the impression and demanded that the patient pay the extra €100 up-front, which she refused to do, as she did not want to pay until she could confirm she was happy with the new crown. The dentist then said she could pay the sum on the day of her appointment, before it was cemented. This patient’s main issue with the metal-based crown was that these types of crowns are unsuitable for people with receding gums, as she has. Her dentist was aware of this, and she believed he should have taken this into consideration before proceeding with the crown-prep.

The patient decided to contact the Dental Complaints Resolution Service, as she felt that she had been treated very poorly. She requested that she be refunded the full amount of €500 that she had paid for the crown.

Michael Kilcoyne wrote to the dentist, enclosing a copy of the complaint. Although he was very reluctant at first, taking the line that there was no problem with the metal-based crown, the dentist eventually agreed to pay the patient a €500 refund.

Mr Kilcoyne believes that this case shows that you need to be mindful of the patient’s stated preferences, and discuss and receive their consent for the most appropriate treatment plan. The dentist should not just decide on a course of action, without any agreement from a patient. In most cases, people will take the dentist’s advice if they are told in advance and everything is explained to them clearly. Mr Kilcoyne also believes that the presence of rudeness in this particular case was a recipe for disaster. This case could have been avoided if there had been clearer communication between the dentist and his patient.