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Orthodontics is a complex area of dentistry that has a number of risks and potential complications. Whilst the majority of orthodontic treatment provides good aesthetic and functional outcome to the patient, sometimes treatment can go wrong and be classified as negligent.
If you are unhappy with the aesthetics of your teeth after treatment then this may suggest that something has gone wrong.
The basic principle of orthodontic treatment is to fit an appliance that manipulates your teeth in a controlled way into a different, straighter position. If it is clear to you that the orthodontic treatment has caused your teeth to move into a position you didn’t expect, and which may be detrimental, this may indicate that your orthodontic treatment has not been managed correctly.
For example, you may now have noticed that one or more of your teeth have rotated or that the spacing between your teeth is unequal.
These tooth movements are not only disheartening when you have paid a lot of money for orthodontic treatment but it can also lead to permanent damage to your teeth. In the right hands orthodontic treatment is completely safe and undertaken every day, but if you are worried about the position of your teeth then something may have gone wrong.
Unfortunately, we have acted for numerous clients where there was a failure to refer them to an orthodontist to see whether they should receive orthodontic treatment.
In each of these cases, we were able to say (with medical evidence), that a referral to an orthodontist should have happened when they were under the age of 18 and given the orthodontic condition of their teeth, they would have qualified for free NHS treatment. As a result of the failure to refer our clients to an orthodontist, they now have to pay privately for costly orthodontic treatment, as it is no longer free to them on the NHS.
If you have suffered problems with orthodontic treatment or you feel that you should have had orthodontic treatment as a child, please contact us to see whether we are able to assist.
“Thank you so much to Sophie Angwin-Thornes at Withy king for wining my dental negligence case. Sophie has been great always kept me informed about my case and was always very positive. I would definitely recommend Sophie Angwin-Thornes for any case of negligence.”
Tania Achadinha on TrustPilot
The Claimant was born without her upper left and upper right lateral incisors (UL2 and UR2). By the time she was 11, her upper left and right canines (UL3 and UR3) had started to move into these spaces. She was therefore referred to an Orthodontist (the Defendant) in June 2003 with the aim of reopening these spaces so prosthetic teeth could be placed.
The Claimant was discharged from orthodontic treatment in July 2005 and referred to her local Dental Hospital for implant placement. She was examined by a Consultant in Restorative Dentistry in February 2007, and advised that the orthodontic treatment had not been successful in opening a large enough gap to facilitate implant treatment. The Claimant was told that she required further orthodontic treatment before implant treatment could be commenced.
The Claimant was reluctant to undergo further orthodontic treatment, but attended an appointment with a Consultant Orthodontist in the same hospital in May 2007 to discuss this. During this appointment, she was told that her upper left and right central incisors (UL1 and UR1) had suffered root resorption as a result of the previous orthodontic treatment, meaning that they could be damaged if the Claimant underwent further orthodontic treatment.
Sophie Angwin successfully claimed £9,000 for the Claimant, for the failure to create sufficient spaces for the prosthetic teeth, which left the Claimant with a poor aesthetic outcome.
Katie Parr acted for a Claimant who received £25,000 in compensation for substandard orthodontic treatment.
The Claimant attended for orthodontic treatment in 2012. Upon examining him, the Defendant Orthodontist advised the Claimant that his lower first premolars (LL4 and LR4) should be extracted and upper and lower lingual braces fitted.
Six months later, the Claimant attended with a different dentist at another practice. She advised the Claimant that the treatment he was receiving was inappropriate and would not correct his issues. The Claimant then attended an appointment with a Consultant Oral Maxillofacial Surgeon, who confirmed the same and also that his LL4 and LR4 had been extracted unnecessarily. The Consultant Oral Maxillofacial Surgeon advised the Claimant that he required surgery to correct the issues he had with his skeletal development.
The Claimant elected to undergo surgery, as he was advised that the space created by the extractions could not be closed orthodontically. He later attended a consultation to discuss the option of implant placement to replace his LL4 and LR4.
Katie Parr successfully recovered damages for substandard treatment planning, the unnecessary extractions and the failure to discuss the need for surgery which resulted in unnecessary orthodontic treatment.
The Claimant underwent three separate courses of orthodontic treatment from the Defendant dentist, the first course taking place in 2000.
In 2006, the Defendant noted that the Claimant’s dentition had relapsed, and advised her to undergo a second course. These braces were removed in July 2007. In December 2008, the Defendant advised the Claimant that she was experiencing recession of the gums around her lower right central incisor (LR1). The LR1 eventually required extraction in November 2009.
Following this, the Claimant was advised that she required a third course of orthodontic treatment. She attended her local Dental Hospital after these braces were removed, and was advised that the gum recession at her LR1 had been caused by the orthodontic treatment. The Claimant was also advised that her LL1 (lower left central incisor) would be also be lost due to root resorption.
Katie Parr successfully recovered £6,000 for the Claimant for the substandard orthodontic treatment.
If you have undergone negligent orthodontics, you may have experienced some of the following issues. Find out more about them by clicking below:
If orthodontic treatment has taken longer than expected, does this mean something has gone wrong?
There are many different orthodontic systems available to straighten and align teeth. Options include:
Given the various treatment options available, with each patient having unique treatment needs, there is no simple answer as to how long orthodontic treatment will take. However, this should always be an important consideration for any dentist when compiling a treatment plan and they should inform you of how long the treatment will take before any orthodontic treatment starts.
In some cases, orthodontic treatment can take longer than expected. However, it can be dangerous to have braces fitted for a long time as it can put unnecessary forces onto your teeth and lead to complications. Therefore it is important that, if orthodontic treatment is taking longer than predicted, your dentist helps you understand why and that they are assessing your risk of complications.
In some of the cases we are involved in, treatment takes longer than expected; all because the desired outcome will never happen the treatment plan put together by the dentist.
If you are suffering from root resorption following orthodontic treatment, has this been caused by negligence?
Root resorption is one of the leading problems arising from orthodontic treatment. It is an uncommon condition in adults, but a normal process that causes deciduous (baby) teeth to be lost.
Root resorption can lead to the breakdown of the structure of teeth, and can cause, for example, root shortening eventually. This can be dangerous and ultimately leads to teeth becoming mobile (essentially, being able to move them in your mouth) and requiring extraction.
Root resorption can occur during orthodontic treatment, as often there is added pressure onto the root surface of the tooth from the orthodontic appliance itself. Given the potential consequences of root resorption, it is important that your dentist monitors the length of your roots by taking regular radiographs.
Root resorption can occur as a recognised complication of orthodontic treatment but it is important that your personal risk of developing this condition is considered before treatment is carried out. For example, you may be more susceptible if you have short roots.
Whilst a small amount of shortening in the root is acceptable and expected during orthodontic treatment, sometimes severe changes can occur which are unacceptable.
If your orthodontic treatment has taken longer than expected, this can leave you at increased risk of root resorption. If you suffer from severe root resorption after prolonged orthodontic treatment, you may have a dental negligence claim.
Gum problems following treatment: are they normal?
It is widely accepted by dental professionals that having an orthodontic brace fitted can lead to plaque related gingivitis.
When orthodontic appliances bond to teeth, they become harder to clean. Quite often, despite tooth brushing, food debris is left on or around the orthodontic appliance that can cause gingivitis.
It is important that you get the right oral hygiene advice from your dentist during orthodontic treatment. Regular appointments with the hygienist may be recommended to help remove any plaque that may have built up on your teeth.
If gingivitis is not treated, the surrounding tissues and bone that support teeth can be affected. This is known as periodontal disease.
Given that orthodontic braces can cause problems with the gum, it is important that your gums are in a good condition before a brace is fitted. Unfortunately, if an orthodontic appliance is fitted to someone that has periodontal disease, it can accelerate its progression and lead to permanent damages to the teeth, bone and gums.
Unfortunately, we often see cases where a dentist has failed to diagnose the presence of periodontal disease before fitting an orthodontic brace. As a result, patients are left with permanent damage.
If you feel your dentist has not considered and treated the condition of your gums prior or during your orthodontic treatment then you may have a claim for dental negligence.
Teeth misaligned following dental treatment; has this been caused by negligence?
Malocclusion of the teeth is a misalignment problem that can lead to serious oral health complications. It can include issues such as:
It is critical that teeth are correctly aligned otherwise it will affect the basic and vital functions of the teeth such as biting and chewing. If your bite becomes mal-aligned it can also cause pressure points between opposing teeth when chewing or even talking which then causes pain, sensitivity and/or teeth to chip each other. Equally, your jaw may be misaligned as a result and this can cause discomfort around the jaw line.
When orthodontic treatment is planned, the dentist will need to consider whether there is any malocclusion that needs to be corrected or whether the anticipated orthodontic treatment will affect this in any way.
When orthodontic treatment begins, an appropriate assessment of the space in the mouth must be undertaken. There are lots of things that can go wrong when considering malocclusion, so fine adjustments need to be made to ensure that the teeth are still able to function.
When issues concerning malocclusion occur alongside orthodontic treatment, it is possible that something has gone wrong.
As a general rule, cases should conclude between 18-24 months after the first time you contact us. However, each case is different and this may vary dependent on the facts.
Any compensation you receive will vary depending on what injury you sustain.
Compensation received following a successful claim for dental negligence will be comprised of:
You can sue a retired dentist, as long as your claim is not statute barred.
By law, all dentists must be registered with the General Dental Council (GDC), and must have appropriate indemnity and insurance arrangements in place; this allows patients to seek any compensation they may be entitled to.
Therefore, even after a dentist retires they will still be responsible for the treatment which was carried out when they were practising as a dentist.
You have three years to bring a claim of dental negligence, from the date of negligence or knowledge of it, under the laws concerning ‘limitation’ in England and Wales. These laws state that a Claimant must issue court proceedings within this time period, or else their claim would be statute barred.
Generally, we would advise you to contact us at least 6 months before the limitation period in your case is due to end. However, this can be reviewed on a case by case basis; if you believe that your limitation period may expire soon, we encourage you to contact us as soon as possible.