Dentist

Primary Care Dentist 

A. Introduction

Primary Care Dentistry concerns the diagnosis, prevention and treatment of diseases affecting the teeth, supporting structures and oral tissues. In expert witness work, a general dental practitioner provides independent opinion on standard of care, clinical decision-making and outcomes in primary dental practice.

Experts typically hold a Bachelor of Dental Surgery (BDS) or equivalent, are registered with the General Dental Council, and often have postgraduate training in areas such as restorative dentistry, occlusion or aesthetic treatments. Many also have extensive experience across multidisciplinary care, including restorative, orthodontic and periodontal interfaces .

All expert evidence must comply with CPR Part 35. The expert’s overriding duty is to the court, requiring independence, objectivity and clarity. Opinions must remain within the expert’s competence and be supported by appropriate reasoning.

B. Typical Case Types (Civil Court)

General dentistry experts are most commonly instructed in clinical negligence claims, including:

• Failure to diagnose or monitor disease
• Dental caries, periodontal disease, periapical pathology
• Delayed recognition of oral cancer or suspicious lesions
• Consent disputes
• Whether risks, benefits and alternatives were adequately explained
• Issues arising from elective or cosmetic procedures
• Substandard treatment
• Poorly executed restorations (fillings, crowns, bridges, veneers)
• Inadequate endodontic treatment or extractions
• Treatment planning errors
• Inappropriate sequencing of care or failure to consider alternatives
• Complex aesthetic or restorative cases
• Failure to refer
• Delay in referral to specialists (periodontists, oral surgeons, orthodontists)
• Dental trauma and quantum
• Assessment of injury, prognosis and future treatment costs

C. Role of the Expert Witness

The expert’s role is to provide an independent clinical opinion addressing:

• Breach of duty – whether care fell below a reasonable standard
• Causation – whether any breach caused harm
• Condition and prognosis – current oral health and likely future outcomes

Experts analyse conditions such as caries, periodontal disease, tooth wear, occlusal dysfunction, and complications arising from restorative or aesthetic treatments.

Typical treatments considered include:

• Restorative work (fillings, crowns, bridges, dentures)
• Endodontics (root canal treatment)
• Periodontal therapy
• Extractions and minor oral surgery
• Cosmetic procedures (whitening, veneers)
• Orthodontic and aligner-based treatments

Experts may be asked questions such as:

• Were appropriate examinations and radiographs undertaken?
• Was valid consent obtained in line with professional standards?
• Should referral have occurred earlier?
• What remedial treatment is now required?

D. Evidence and Reporting

A dental expert report is structured, reasoned and compliant with CPR Part 35 and Practice Direction 35. It typically includes:

• Instructions received and issues to be addressed
• Documents reviewed
• Chronology of events
• Clinical findings and analysis
• Opinion on breach, causation and prognosis
• Statement of truth

Key records required:

• Full dental records (clinical notes, charting, medical history)
• Radiographs (bitewings, periapicals, panoramic imaging)
• Photographs, study models or digital scans
• Treatment plans and consent documentation
• Referral correspondence and laboratory prescriptions

The expert may also conduct an examination where appropriate. All findings must distinguish between factual observations and opinion. Any limitations in evidence must be clearly stated.