The Silent Decline: Why "Perio" Claims Are Dominating Dental Negligence

In the world of dental negligence, there is a quiet but costly trend: the rise of the periodontal (gum disease) claim. Unlike a failed extraction or a botched crown, which are immediate and obvious, periodontal disease—or "perio"—is often a slow-motion disaster.

For many patients, the first sign that something is wrong isn't pain; it’s a loose tooth or a shocking diagnosis from a new dentist after years of being told everything was "fine."

The "Screening Gap"

At the heart of most perio claims is a failure to monitor. The Basic Periodontal Examination (BPE) is a mandatory screening tool used by UK dentists to assess gum health. When a dentist fails to record these scores, or fails to act on a high score (Codes 3 or 4) with detailed pocket charting and radiographs, the "breach of duty" is often clear-cut.

Under the GDC Standards for the Dental Team, practitioners must provide a standard of care that meets the expectations of a "reasonable body of practitioners." Failing to diagnose a condition that is visible on X-rays or detectable via simple probing is a difficult position to defend.

The True Cost of Neglect

Perio claims often attract higher damages than single-tooth injuries because they frequently involve "generalized" bone loss. This means multiple teeth—sometimes entire arches—are compromised.

When we calculate General Damages using the Judicial College Guidelines (17th Edition), the figures reflect the severity of this long-term deterioration:

• Significant, chronic tooth pain with general deterioration: Up to £46,540.

• Loss of or serious damage to several front teeth: £10,660 to £13,930.

• Loss of back teeth: Between £1,330 and £2,080 per tooth.

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Beyond the physical pain, the "Special Damages" (financial losses) for perio cases can be astronomical. If a patient loses ten teeth due to untreated gum disease, the cost of a full mouth of dental implants, including the necessary bone grafts and lifetime maintenance, can easily reach six figures.

Common Defence Arguments (And the Reality)

In our experience acting for claimants, defendants often rely on two main arguments to avoid liability:

1. "The patient had poor oral hygiene": While patient compliance is important, a dentist has a duty to provide Oral Hygiene Instruction (OHI) and warn the patient of the risks of bone loss. If the clinical notes don't show that these warnings were given, the "contributory negligence" argument often fails.

2. "The patient was a smoker": Smoking is a major risk factor, but it does not absolve a dentist of their duty to treat and refer. In fact, it arguably places a higher burden on the dentist to monitor the patient more closely.

   
   

The Path to Settlement

For those who have suffered from undiagnosed gum disease, the goal is rarely a day in court; it is the means to fund the extensive restorative work needed to eat and smile again.

Because the evidence in these cases is largely documented in the clinical records and X-rays, many perio claims are well-suited to the Pre-Action Protocol for the Resolution of Clinical Disputes. By presenting a robust case grounded in GDC standards and clear causation, we often reach settlements that allow patients to move forward without the stress of a trial.

Are you concerned that your gum disease was diagnosed too late? If you’ve recently seen a new dentist who has raised alarms about your bone levels or "perio" status, it may be worth reviewing your dental history.