Commission criticises dentist after woman suffers tooth infection for eight months
Deputy Health and Disability Commissioner Vanessa Caldwell says from the time of the initial procedure on 4 December 2019, Ms A had concerns.
Photo:
123rf
A woman whose dental implant and bone-graft failed and who suffered an undiagnosed infection for eight months says she still has pain, headaches and brain fog four years on, and ended up losing her job as a result.
In a report released on Monday, the Health and Disability Commission has criticised the dentist for failing to adequately explain the risks of the procedure, and for poor record-keeping and medication management.
The complainant, known as "Ms A", had an implant supported crown placed in her upper left central incisor by a specialist periodontist in 2009.
However, after two years of problems with the implant starting in 2017, she consulted the dentist in July of 2019.
He suggested a treatment plan involving a bone graft to support a new implant and crown, which was approved by her insurance provider.
Ms A told HDC that in discussing risks, the dentist "mentioned only that infection was a possibility, but he said that he had performed the procedure many times and only one other person had had an infection, which had healed well".
She said he made the procedure sound very low risk and "all very fixable", and never mentioned anything about the possibility of it failing.
"I really didn't think I was going to have a problem and I trusted [the dentist]."
However, in the days following the procedure, she began feeling unwell and had "a burning sensation".
Between 4 and 19 December, the dentist saw Ms A four times to assess the healing.
He could see no sign of infection but prescribed antibiotics.
On 16 December, he reported there was slight puffiness at the site of the graft, but no pus or other evidence of infection.
At 6.55am on 19 December, Ms A texted the dentist asking him to call her.
He ended up seeing her after hours and removing the "membrane" (a special wound dressing made from the patient's own blood), at her request.
"He stated that he discussed the possible complications of re-opening the site, but she was very insistent that the membrane be removed. Dr B stated: 'In the end I abided by her wishes'.
"In response to the provisional opinion, Ms A told HDC: 'This is not correct … It was his only suggestion he gave me to remedy the issue.'."
On 20 December, Ms A went to a public hospital Emergency Department with swelling to her upper lip and left cheek, but an X-ray was normal and there was no sign of infection.
She went back to the dentist on 23 December, who reassured her the site was healing well.
He gave her a medical certificate.
The patient told the HDC she asked him to write out an insurance claim but he declined, saying she was "Okay [and there was] no need to do that."
"She said that she told him that she had no more sick leave and had started to use up her annual leave, but he did not seem to care and shrugged everything off, seemingly ignoring her.
"Dr B said that the process was that she should have downloaded and completed the relevant form, which he would then have countersigned."
She phoned the clinic again on Christmas Eve, and reception staff advised her to either go to the hospital or she could see another dentist at the practice on the following Friday.
On Boxing Day, she went to the ED again with pain in her face, and was given painkillers and discharged.
She texted the dentist, asking him to call her urgently.
He called her that afternoon and she said blood tests were normal but clinicians suspected inflammation as the probable cause.
On 27 December Ms A was seen by the dentist, who extended her medical certificate to 3 January 2020 and recorded that her gum looked "ok".
The sutures were removed on 13 January by another dentist, who noted there were no signs of infection.
On 20 January and again on 18 February, she was seen again by the dentist, who assured while the site looked normal and was healing well. Ms A was upset and worried that the infection was back.
On 15 May Ms A's general practitioner (GP) referred her to an oral and maxillofacial surgeon at a public hospital, querying whether Ms A had an infected dental cyst.
Meanwhile, she had several more appointments over 2020 with the dentist , who uncovered the implant and put a temporary crown in place.
"I felt like he wasn't listening, [and I was] at a loss to know what was happening to my body.'"
On 17 August 2020 Ms A was seen by the maxillofacial service at the public hospital. The specialist noted the presence of a soft tissue pocket, peri-implantitis and bone loss, and that there was "large force put on [the] implant due to incorrect crown/implant ratio".
She was referred to oral and maxillofacial surgeon, who removed both the implant and crown on 13 October 2020.
Ms A told HDC that when the infected implant and surrounding bone in her jaw was removed, it left her with gum and bone shrinkage and stained teeth.
She said the bacterial infection had been left undiagnosed for over eight months, and it had taken a toll on her health.
"Today I still have burning, swelling and discomfort around the area where the implant use to be. I suffer from headaches, brain fog and concentration issues. Coupled with very bad fatigue. I also couldn't go back to work and I ended up losing my employment.
"Four years on from then my life has never been the same."
In response to the HDC provisional opinion, the dentist said it was "unfortunate Ms A has had to go through this".
"No one likes to see a patient struggle and their treatment not go to plan."
Two other dentists, two hospital visits and two X-rays had not found any evidence of infection either, he said.
"It seems there was a low grade bone infection… We are all disappointed and sorry for [Ms A] that she got an infection and did not get the desired outcome."
Deputy Health and Disability Commissioner Vanessa Caldwell said from the time of the initial procedure on 4 December 2019, Ms A had "concerns".
She said while the dentist pointed out the infection was only detected in December 2020 - when the hospital specialist conducted a CBCT (cone beam CT scan) - Ms A's GP had been "sufficiently concerned in May 2020 to refer her to a maxillofacial specialist".
"And when Ms A was seen at the public hospital on 17 August the maxillofacial service identified a soft tissue pocket, peri-implantitis and bone loss.
"Further, on 19 December 2019, the dentist had recorded 'infection tissue removed'."
A dental expert who reviewed the clinical record for the HDC found the dentist "demonstrated considerable skill".
"Although the procedure failed, the treatment was within his scope."
Caldwell said however, the dentist failed to provide Ms A with the information she needed to make informed choices about her treatment, and his records were "incomplete in several respects".
Dr B stopped practising dentistry in June 2021 due to a medical condition, but he said after receiving the complaint, he and the dental practice reviewed all clinicians' note-taking, and consent forms were being reviewed and updated.
The HDC has recommended that the dentist apologise to Ms A for the criticisms in the report, and before returning to practice he undertake additional education on record-keeping, informed consent, person-centred care and effective communication with health consumers.
Sign up for Ngā Pitopito Kōrero
,
a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
Hashtags

Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles

RNZ News
4 hours ago
- RNZ News
Potential insurance costs cast shadow over parent visa
Christchurch resident Xiuyun Liu (top left) with her parents, husband and children. Photo: Supplied Insurance experts have raised concerns about potential costs for the long-awaited Parent Boost Visa that was announced by the government last weekend. Immigration Minister Erica Stanford said Sunday the visa would allow parents of citizens and residents to stay in New Zealand for up to five years, with an opportunity for the visa to be extended another five years. Included in the health and income conditions of the visa was a requirement for the parents to obtain sufficient health insurance to cover the first 12 months of their stay. Anyone staying longer than a year would need to renew their health insurance policies for the duration of their stay. Christchurch resident Xiuyun Liu questioned whether the insurance conditions could make it harder for her parents to take advantage of the new visa. Her parents, 70 and 73, had been on visitor and study visas to stay in New Zealand, helping her to look after her young children. "I think it's good that the policy is out now. At least we have hope for the next five years," Liu said. "But what if I can't get insurance for my parents? Even if they can get insurance [now], there will be a day they won't be able to. "For example, my father has high blood pressure and some other issues. ... I think getting insurance will be a problem." The government requires applicants to hold at least one year of health insurance that covers emergency healthcare (minimum $250,000 a year), medical repatriation, return of remains and cancer treatment (minimum $100,000). Paula Lorgelly says many existing health insurance policies have upper age limits. Photo: Supplied Paula Lorgelly, a professor of health economics at the University of Auckland, said she was unaware of any matching insurance products currently on the market, but she expected providers to start work on delivering them. "Currently a number of insurers have a visiting New Zealand policy to provide cover for a range of travel and medical related claims," Lorgelly said. "These do have considerable exclusions with respect to pre-existing conditions, which means they are somewhat affordable, about $2200 a year [for a couple who are both 60 years old]." Lorgelly said many existing policies had upper age limits of 65 or 75, and they would also include exclusions for pre-existing conditions. "If you have such conditions, which often come with age, then the policy holder will need to pay more to cover them," she said. The $2200 figure was likely to be on the low side of what a new policy would offer, if cancer treatment was included, Lorgelly said. Insurance consultant Amy Tao believed any new insurance products would effectively be like existing travel insurance policies. "It will just be upgraded to include the $100,000 cancer treatment cover, for example," Tao said. She said insurance companies might cover some low-risk pre-existing conditions with extra premiums. "But underwriting is definitely required," she said. "If they think the risk is too high, they may not be able to provide insurance even if you pay more." Her estimation of existing travel insurance policies for an elderly couple was similar to the figure Lorgelly shared, citing $1840 for a couple of 65-year-olds and $2514 for two 70-year-olds, with both policies carrying an excess of $100. Tao said any new product would be more expensive, adding extra cover for cancer and pre-existing conditions. "Insurance is for sure going to cost a bit," she said. "Currently, some insurance companies only allow travel insurance to be purchased for a maximum of one year or two years," she said. "It can be renewed after the expiration date but cannot be purchased directly for five years." Speaking to Morning Report on Monday, Prime Minister Christopher Luxon said people needed to hold health insurance for the duration of their stay. "We're striking the balance of making sure that ... these folks who are not taxpayers, haven't contributed to our publicly funded healthcare system, won't be eligible for those services." Immigration minister Erica Stanford Photo: RNZ / Samuel Rillstone Rob Hennin, New Zealand chief executive of health insurance provider NIB, said the company had begun work in line with the government's announcement. "We are already working on a product that aligns with the requirements for this visa, and aim to launch it in September," Hennin said. "While all of the details are yet to be determined, the product would be available to purchase for at least one year to align with government requirements, and cover clients for the entirety of their stay while residing in New Zealand." When asked about the costing, Hennin said it was too soon to say. "We will be working through the product design and details and aim to have this ready by the deadline," he said. Financial Services Council chief executive Kirk Hope said the government had consulted with the industry before the decision was made, and the requirements were reasonable. "I think it's reasonable given what the costs of the taxpayer would be if someone didn't have insurance and had to rely on the taxpayers," Hope said. "So, it's important that people are insured when they're here on visitor visits." Hope said it was important for the types of insurance to be provided by the visitors' home market. Despite the visa's hefty application fee and additional insurance requirements, immigration lawyer Sonny Lam believed the visa would still be popular at face value. "It is not excessively high - flying every six months back and forth is going to cost more than $3000," Lam said. "But the insurance requirement may be harder than it looks," he said. "I had a look at Southern Cross and travel insurance for people over 75 is not so easy." Immigration lawyer Arran Hunt also said the cost of insurance would be "the biggest factor for many". "We expect we'll see more competition in the market, with insurance policies being created to solely meet the criteria of this visa," Hunt said. "The requirements for the visa, as in the pay levels required for sponsors, should mean it is open to almost all couples where both are working," he said. "However, some may struggle to cover the insurance costs, especially for older applicants."

RNZ News
8 hours ago
- RNZ News
No single approach to migraine prevention is effective
science health about 1 hour ago Around half of people with migraine disease turn to non-medication treatments to ease their symptoms, new research has revealed. The Migraine in Aotearoa New Zealand survey from University of Otago researchers asked participants about supplements and treatments they've used including magnesium and vitamin B2 or meditation, yoga and massage. Dr Fiona Imlach is an epidemiologist at the Department of Public Health at the University of Otago and founder of charity Migraine Foundation Aotearoa New Zealand. She says there is no one-size-fits-all approach to migraine treatment and that while there are some treatments out there that are not recommended, many non-pharmacological approaches can actually help - they just aren't available here.

RNZ News
8 hours ago
- RNZ News
Midday Report Essentials for Tuesday 10 June 2025
health transport 27 minutes ago In today's episode, Hillmorton patient Elliot Cameron has been sentenced to life imprisonment for the murder of 83-year-old Frances Anne Phelps, locals in the Northland town of Moerewa are taking it upon themselves to clean up burnt out cars and scorched rubber left behind from street racers, there has been a 25 percent decrease in the number of 16 to 25-year-olds who have donated blood at least once in a two-year period since 2020, and a severe thunderstorm watch has been issued for Northland, Auckland, Great Barrier Island, Coromandel Peninsula, Waikato, Waitomo, and Taranaki.