The high cost of dental treatment is fuelling a consumer backlash with soaring claims for damages and a doubling of disciplinary cases against dentists.
Victims of dishonest, incompetent or outdated dental practice have won millions of pounds in compensation as patients have become increasingly aware of their rights, legal experts say.
Dentistry is unlike medicine in that money changes hands across the counter, even for NHS treatment, and patients are increasingly questioning whether they are getting value for money.
The Dental Law Partnership, the biggest legal firm handling dental claims in England, said it had won £10.4m in damages for 1,411 dental patients in the seven years since it was founded, in 2000. Since 2001, the number of claims had increased almost fourfold to 228 in 2006 and the average payout rose to £7,980.
Christopher Dean, the senior partner, said: "It is the cost of treatment that is driving patients to seek redress when treatment fails, and the high cost of putting things right. The drift to private practice has seen costs rise significantly in recent years."
Typical cases included a woman who had a crown badly fitted which led to an infection resulting in the loss of the tooth. She had an implant to replace the missing tooth and the case was settled out of court in November for £6,000.
A man who had extensive treatment that went wrong leading to the loss of "multiple" teeth received £85,000 and a patient who had symptoms of head and neck cancer that were missed by the dentist was paid "hundreds of thousands" of pounds compensation.
Mr Dean said: "Patients have unquestionably become more aware of their rights and less diffident about exercising them. Those dentists working in the NHS are doing more and more private dentistry and more patients are having more complex work done."
The General Dental Council (GDC) said it dealt with 2,399 complaints against dentists last year, of which 797 were deemed to be about their fitness to practice. Most complaints are settled but full disciplinary hearings have doubled in three years, from 31 in 2004 to 64 in 2006. The number of dentists struck off trebled over the same period from five to 16.
A spokeswoman for the GDC said poor treatment, fraud and unjust claims for payment were the commonest findings against dentists.
Kevin Lewis, the director of Dental Protection, which insures 70 per cent of dentists in England against malpractice claims, said: "Hearings before the GDC have gone through the roof. A decade ago there were 10 days of hearings a year. Now there are 350 days a year and the disciplinary panels are sitting at weekends to get through the cases."
Mr Lewis said Dental Protection paid out £3m in damages in 2006, a 40 per cent rise since 2000. The commonest claims were for root treatments that didn't work or crowns and bridges that broke, accounting for 40 per cent of the total.
More than twice as many claims are made against dentists as against doctors he said. "Money changes hands in dentistry, but it doesn't in medicine. When I qualified as a dentist the most you could pay on the NHS was £1. Today, when you have parted with hundreds of pounds, you are going to be less forgiving."
The rise in damages claims had been driven by firms such as the Dental Law Partnership, which operates on a no-win, no-fee basis. "The amount paid out to lawyers now exceeds what is paid to the patients," Mr Lewis said. Dentistry in Britain is the most expensive in Europe, according to a nine-country survey for the European Commission.
'The compensation is not enough' - Maria Pulgar
Maria Pulgar was born with damaged teeth caused by antibiotics her mother took in pregnancy. Her front set were discoloured and the enamel riddled with tiny holes, but they were strengthened 10 years ago with veneers.
When her NHS dentist suggested the veneers needed replacing, she was thrilled. "I was over the moon. I have a deep complex about my teeth and all my life I have been covering my mouth when I smiled. It is very difficult."
But the procedure went disastrously wrong when the dentist drilled through to the dentine underneath the enamel, leaving her teeth acutely sensitive.
She contacted the Dental Law Partnership and won £5,000 compensation in December. Now she is looking for a dentist to repair her six upper front teeth.
"I am definitely going private this time – but the prices are unbelievable. I can't have veneers again – it will have to be crowns and £5,000 may not be enough."
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