More than 2,000 complaints have been made against dentists over the past four years, the majority relating to a single practitioner, new figures show.
The Dental Council says it routinely receives up to 150 contacts from patients each year, and in 2022-2023 it received more than 1,500 phone calls and emails about one dentist.
This dentist, Anne Hahessy of Oranmore, Co Galway, has given an undertaking to the High Court not to engage in the practice of dentistry while the council investigates concerns raised after hundreds of patients were left stranded without critical orthodontic treatment.
The vast majority of contacts received by the council each year are complaints from patients about the treatment they received, its registrar, David O’Flynn, said.
Despite the flow of complaints, long-sought reforms to the regulation of dentistry have not been advanced.
Dentistry is unique among Irish health professions in that fitness-to-practise hearings are held in private. Only the most serious allegations against dentists are investigated. These involve professional misconduct, defined as a serious falling-short of standards, with allegations having to be proven beyond reasonable doubt, as in criminal cases.
Dentists comprise a majority on the Dental Council – 12 out of 19 members. The council has not published an annual report since 2018 due, Mr O’Flynn said, to resourcing issues.
In a submission to the Minister for Health in 2021, the council warned of a “significant risk to public safety” from gaps in legislation.
“Patient safety cannot be assured and patients have been harmed because of this failure to regulate,” it said.
Pleading for more powers to intervene, it highlighted problems such as a dentist opening a practice in Ireland despite being struck off in other countries; unregistered dentists working here; and evidence of “significant failures” in patient safety standards.
Since 2020, there have been 38 applications for an inquiry into a dentist; 26 made by patients, nine by the council and three by the profession.
The council made a decision to hold an inquiry into 22 of these cases, and decided there was no prima facie evidence of professional misconduct in 15 instances, with one application still open.
In five cases, involving three dentists, inquiries have been held and resolved in the High Court. The other 17 are still pending. The resolved cases resulted in one dentist giving an undertaking to resign from the register; another case is to go to the council for sanction; and no action was taken in relation to the third dentist.
Mr O’Flynn said there have been “constructive discussions” with the Department of Health on future legislative change. Amendments under consideration would require dentists to produce a certification of registration when asked and to undergo mandatory professional competence schemes.
The council does not have the power to check a dentist’s registration under current legislation, or to insist on continuing professional development, he added. “There’s an ethical obligation there, but not a statutory one.”
Asked about delays in hearing inquiries, he said it takes the council up to nine months to properly investigate allegations. In many cases, he said, there is a “health dimension” which can add to the time needed to ensure fair procedures are followed.
The department, which has employed a chief dental officer since 2017, said it was committed to reviewing the Dentists Act, 1985.
“The Minister met the council in January to discuss the regulatory powers available to them under the Act, and the potential advancement of interim amendments. A series of thematic engagements between the department and the council to discuss legislative matters in more depth have taken place, with further engagements planned,” it said.
“Consideration will be given to further aligning provisions for fitness to practise and other relevant components of the Act with those contained in the other health regulatory Acts.”
A patient’s story
The experience of Patricia* in seeking investigation of her adverse experience with a dentist has convinced her the profession is “effectively unregulated”.
In 2019, she attended a dentist for routine treatment after experiencing discomfort in a crown. Shortly after having root canal treatment she started to experience “horrendous pain, worse than childbirth”.
“I had a burning pain across the side of my face, down into the jaw, sinus problems and blurred vision. I was so sick I was almost passing out.”
She was prescribed antibiotics by the dentist on eight separate occasions, but the pain persisted. There followed a medical odyssey – visits to eight further dentists and dental surgeons, eight doctors, a two-week hospital stay, medication and two nerve blocks.
Her business came to a standstill due to the pain she was suffering.
“What was meant to be a routine dental procedure left me with a devastating permanent injury that will need treatment and pain medication for the rest of my life,” Patricia said.
She sued the dentist and settled out of court for a substantial sum, with no admission of liability by him.
Through her solicitors, she also complained to the Dental Council over the dentist’s failure to release her X-rays for more than a year. The dentist released records after the council intervened but Patricia claimed they were not complete. Nonetheless, the council closed its investigation and refused to reopen it.
Replying to Patricia, Dental Council registrar David O’Connor said it does not consider complaints “in the way that this phrase is commonly understood”.
“The Dental Council considers allegations of professional misconduct rather than complaints, and this is defined as a serious falling-short in the standards expected of a dentist,” he said.
The requirement to prove allegations beyond reasonable doubt “actually allows for there to be a falling-short in the standards of dental practice that will not amount to professional misconduct, and sometimes this shortfall in standards can be significant,” Mr O’Connor wrote, in correspondence seen by The Irish Times.
“When an allegation is received, the only question the council can consider is what can be proven. It has no role in answering patient questions.”
The dentist is facing other sets of legal proceedings, Patricia said. “It took my real-life experience of dental treatment that went very badly wrong to find out that the Act and the council are a cardboard mock-up of regulation – an outward appearance but with zero capacity,” she added.
“People assume the job of keeping dental patients safe is being done by the Dental Council. A good regulatory body supports its profession and patients equally. It can spot, and intervene early, where practitioners are falling short. It can help those practitioners to get back on track. It can carry out no-fault investigations into treatment failures, to learn lessons and improve practice. Where treatment goes wrong, it can help patients by connecting them to experts to repair or reverse the initial wrong treatment. Finally, it can provide a remedy for patients who have been harmed.
“The Dental Council does not do any of these things.”
The file on the dentist was closed after he said he had provided everything he could, Mr O’Connor told The Irish Times.
* Not her real name
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