In terms of breaches of duty, the DDU expert identified the following:

the member failed to show an awareness of the patient's established periodontal condition
the DDU member under-estimated the patient's periodontal condition when completing the BPEs
bite-wing radiographs showed clear evidence of vertical bony defects around the patient's posterior teeth, which on the balance of probabilities would not correspond to the recorded BPE score.

The DDU expert concluded that the member should have been aware that such bone loss in a young adult is very unusual and indicative of a diagnosis of aggressive periodontitis.

The expert also stated there were breaches of duty in relation to the management of the patient's periodontal condition; their aggressive periodontitis should have been recognised when they first saw the member, and they should have been referred to a specialist.

Conclusions and outcome

After concluding its investigations and consulting with the member about how to proceed, the DDU started negotiations in order to reach an amicable settlement of the patient's claim.

Based on the expert evidence, the DDU argued that despite the vulnerabilities that were identified in relation to breach of duty, future periodontal maintenance treatment would have been required in any event due to the chronic and progressive nature of periodontal disease.

The DDU's expert had stated that the ongoing periodontal maintenance therapy required by the patient would have been needed regardless. This was based on a diagnosis of localised aggressive periodontitis and the patient's high susceptibility to periodontal breakdown.

The DDU also argued that even if the patient had received adequate treatment from the member, they would still have required ongoing periodontal therapy because of their inherent susceptibility to periodontal disease. The main issues were that early intervention could have stabilised the condition.

The patient also claimed damages for future losses, but the DDU argued successfully that based on the treatment duration and the chronic and progressive nature of the disease, there was no evidence that there would be any future loss of teeth due to the identified breaches of duty.

The claim was eventually settled for over £5,000 in damages. The patient was compensated for the general worsening of their periodontal condition but not for any future losses, as there was no evidence to support a claim for this.

Diagnosis of aggressive periodontitis

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Diagnosis of aggressive periodontitis