Undiagnosed Periodontal Disease

Periodontal (gum) disease is an infection of the structures around the teeth caused by bacteria in dental plaque.

The earliest stage of periodontal disease is referred to as gingivitis with symptoms often being swollen, bleeding gums. If left untreated, this can develop into chronic adult periodontitis, characterised by a breakdown of the tooth’s attachment to the gum and bone. It leads to loss of bone, mobility of the teeth, and ultimately loss of teeth entirely.

Unfortunately, one of the most common types of claim we see is undiagnosed periodontal disease. We understand the impact such a painful and chronic disease has on a patient, and know it can be especially frustrating if it has been undiagnosed over a long period and allowed to progress unchecked.

How should a dentist monitor the health of your gums?

Dentists should carry out regular monitoring of the health of their patients’ gums, both by taking a history from the patient, and also by “pocket testing” – a basic periodontal examination (BPE).

With BPE scoring, a small probe is gently used to measure the depth of the gum line and to identify any gum loss (recession) on each and every tooth. Special attention should also be paid to whether the probing causes any bleeding as this can indicate the extent of inflammation in the gums. If your dentist fails to do these tests, they may well be treating you negligently.

Some people will have increased susceptibility to periodontal disease, particularly those with poor oral hygiene, diabetes and those who smoke. So, if you are at high risk of contracting the disease, it is particularly important that your dentist monitors the health of your gums regularly.

What you need to know about periodontal, or gum, disease

Below we explain different situations you might find yourself in with periodontal disease, when you might have experienced negligence, and what you can do:

YOU HAVE BEEN DIAGNOSED WITH GUM DISEASE

You have been diagnosed with periodontal disease. How should a dentist be treating this?

If you have been diagnosed with periodontal disease, then you should be fully informed of the nature of the disease, the risks, and methods of self-prevention. These self-prevention methods will include oral hygiene advice and advice about quitting smoking, as well as dietary advice.

Following this advice, periodontal treatment (such as scaling, root planning and antibiotic therapy) should be commenced. If there is no significant improvement a referral should be made to a periodontal specialist.

There is no cure for periodontal disease, but early intervention can prevent the disease from developing further.

PERIODONTAL DISEASE NOT TREATED

A dentist failed to diagnose you with periodontal disease or failed to provide any treatment. Have they acted negligently?

When diagnosed early, periodontal disease can be treated conservatively with high prospects of success. However, if left untreated the condition can have serious consequences, including the loss of multiple teeth and damage to the supporting bone.

Where patients have neither been treated nor referred, and their condition has deteriorated significantly as a result, there may well be a claim for undiagnosed periodontal disease. We would therefore advise you to contact us as soon as possible.

YOU THINK YOU HAVE PERIODONTAL DISEASE

You’re concerned that you may have periodontal disease. What should you do?

The symptoms of periodontal disease include:

red and swollen gums that may be highly painful and bleed when cleaning.
bad breath that won’t go away – this is because periodontal disease causes ‘pockets’ in the teeth and gums which trap food and bacteria, which can then omit an odour.
painful abscesses that discharge pus, which is released when your gums try and fight the bacterial infection.
receding gums and sensitivity – which is a sign that the supporting tissues around your teeth are damaged.
loose teeth.

If you are concerned that you may be suffering from periodontal disease, you should speak to your dentist about this. If, upon speaking to them, you are still concerned that they are failing to diagnose the disease, you should seek a second opinion as soon as possible.

In addition, you should ensure that you adopt good oral hygiene practices. Regular brushing, as well as use of dental floss or interdental brushes will help to maintain a healthy mouth. Your dentist will be able to provide you with oral hygiene advice and show you how to use interdental brushes.

Recent cases

£70,000 Undiagnosed Periodontal Disease

Associate, Katie Parr, acted for a 49 year old man, who received £70,000 for the failure to diagnose and treat aggressive periodontal disease from 1985 until 2012.

The client was a regular attender and during his treatment with the Defendant lost 16 teeth. In August 2012, the client attended an implant specialist to consider implant replacement for his lost teeth. During this appointment the client’s periodontal condition was diagnosed and he was referred to a periodontal specialist. The client was advised that he would not have lost his teeth, had his aggressive periodontal disease been diagnosed and treated by the Defendant.

£70,000 Undiagnosed Periodontal Disease

Chartered Legal Executive, Samantha Swaby, acted for a 76 year-old woman who received £70,000 for the failure of her dentist to diagnose and treat periodontal disease. The Claimant had been a patient under the Defendant’s care from 1978 until 2014. When she attended an appointment with a different dentist in January 2015, she was told that she had advanced chronic periodontal disease. Nine of the Claimant’s teeth required extraction, and there was a 50% risk that she would lose a further 13 teeth in the next 5-10 yeas.

Samantha successfully recovered compensation to fund the Claimant’s remedial treatment, and to compensate her for her pain and suffering

£30,000 Mismanagement of periodontal health

Sophie Angwin acted for a 50 year-old woman, who received £30,000 in compensation for the mismanagement of her periodontal health between 1978 and 2013. The Claimant had been a patient under the Defendant’s care since she was 13 years old, and it was not until she joined a new dental practice in 2013 that she was told she had advanced chronic periodontal disease.

This was a devastating diagnosis for the Claimant, as she needed to have 9 teeth extracted. Since the extraction of these teeth, the Claimant has had 8 dental implants fitted at the costs of £11,000 in order to restore her dentition. Sophie Angwin was successful in securing the Claimant the cost of this treatment back from the Defendant, together with additional funds to compensate the Claimant for her pain and suffering.

Should you stop seeing your NHS dentist if you make a claim?

Whilst the dentist you are claiming against has the right to refuse to continue treatment, this does not mean that you cannot be treated by a different dentist at the same practice.

However, if you would prefer to continue your treatment elsewhere, you are entitled to do so and it will not have any impact on your claim.

If you need treatment whilst your claim is ongoing, for example; periodontal surgery, implants or bone grafts; it is important that you continue with this treatment. If the treatment is required due to negligence, this will be factored into your claim.

The fact you are making a claim will not affect your eligibility to join another NHS practice.

How long will it take to make a claim?

As a general rule, cases concerning undiagnosed periodontal disease should conclude between 18-30 months after the first time you contact us. However, each case is different and this may vary dependent on the facts.

How much compensation might you receive? How is it calculated?

The compensation you may receive will vary depending on what injury you sustain. For example, if you lose several teeth as a result of undiagnosed periodontal disease, you will receive more compensation than if you only require periodontal treatment and scaling.

Compensation received following a successful claim for dental negligence will be comprised of:

an award for pain and suffering – this will compensate you for any pain you have endured, and also things like inconvenience, social effects (such as embarrassment) and any changes in your eating or sleeping habits.
an award for future treatment costs – for example, if you require an implant to replace a tooth lost as a result of undiagnosed periodontal disease. We will also take into account the future maintenance costs for any treatment you may require, including future specialist appointments.
past loss – this may include past prescription costs, travel or dental treatment. For instance, if you had to repeatedly travel to a specialist appointment as a result of dental negligence, the cost of this will likely be recoverable.

A dentist failed to diagnose periodontal disease, but they have since retired. Can you sue a retired dentist?

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.

How long do you have to make a claim?

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.

Find out more about limitations and the process of making a claim right here: