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Extraction of all lower teeth instead of four as planned (02HDC18228)

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(02HDC18228, 11 June 2004)

Dentist ~ Standard of care ~ Informed consent ~ Rights 4(1), 7(1), 7(6)(d)

A 67-year-old woman complained that a dentist removed 14 of her teeth, rather than four as planned. A treatment plan to remove four lower incisors and fit a partial plate had been agreed during an initial consultation with the dentist and a clinical dental technician. A full clearance of the lower teeth was discussed, although there is no record of this. It is also unclear whether an X-ray was suggested at this consultation; in the event none was taken, and X-rays from approximately two years previously were viewed.

The treatment plan was entered onto the practice computer and impressions were taken for the partial plate. When the woman attended for the extractions, the dentist reviewed her records on the computer, but did not view the partial plate before commencing the procedure (which is his normal practice), and formed the mistaken view that a full lower clearance had been decided upon. After a brief conversation with the woman to check consent, he carried out the full lower clearance.

The dentist was found in breach of Right 4(1), as he had not made adequate checks prior to commencing treatment. He also failed to take adequate steps to confirm that both he and the woman understood the procedure to be carried out, thus failing to obtain her consent to removal of all her lower teeth, in breach of Right 7(1). In addition, he breached Right 7(6)(d), as he did not obtain consent in writing for a procedure that carried a significant risk of adverse effects on the consumer.

It was noted that the dentist quickly admitted his error and made efforts to remedy it. He also reviewed his procedures and record-keeping to ensure that a similar error does not occur again.