A recent case relating to alleged negligence on the part of a dentist highlights the difficulties when a case boils down to a simple factual dispute – who is more convincing, the patient or the dentist? A judge must ultimately decide.

This situation arose in a recent case in the UK[1]. It related to the alleged negligent failure by a dentist, Mr Hughes, to refer for investigation a lesion in the lower left side of a patient’s mouth. It was alleged that Mrs Drabble, the patient, should have been urgently referred following an examination on 30 June 2008. Following investigations, the patient underwent surgery in July 2009 to remove a tumour on the left floor of her mouth, extending into the lymph nodes. She underwent radiotherapy and chemotherapy and fortunately made a good recovery.  

Factual Dispute

It was accepted by both parties that, had malignant changes been present in June 2008, then referral and treatment prior to November of that year would have meant less invasive and radical treatment. However, the case ultimately centred around the factual dispute between the patient and the dentist.

The patient stated that she began to notice changes to a white patch in the lower left side of her mouth, which had been under observation by the dentist since 2004. The patient stated that she brought this to the dentist’s attention on 30 June 2008, on which date he undertook a full examination of her mouth. However, it was the dentist’s evidence that he simply could not have failed to see the white patch when he examined the patient in June 2008. He insisted he would have recorded any concern expressed by her and would have referred her if the appearance of the white patch had been as she described it.  

The Outcome

The judge was of the view that if the patient was correct in her contentions, the dentist not only failed to observe the change in the appearance of the white patch but he also failed to record her complaints. These errors and omissions were then repeated to a greater or lesser extent on each of the four further occasions on which the dentist saw the patient throughout 2008 and 2009.

Having considered all of the evidence carefully, the judge found it improbable that this persistent failure occurred, and ultimately preferred the dentist’s account of events. The patient’s case was therefore dismissed.