What counts as dental negligence in the UK?

A dental negligence claim succeeds only if two separate things are established. First, that the care fell below the standard of a reasonably competent practitioner — this is breach of duty. Second, that the breach caused harm which would not otherwise have occurred — this is causation. A claim fails if either is missing, which is why treatment that was plainly poor sometimes still cannot be claimed for: if the same outcome would have happened anyway, there is nothing to compensate.

The standard is not perfection, and it is not the best practitioner in the country. Under Bolam, a dentist is not negligent if they acted in accordance with a practice accepted as proper by a responsible body of practitioners skilled in that field. Dentistry frequently offers several legitimate approaches to the same problem, and choosing one that turned out badly is not in itself a breach.

Bolam alone would let any established habit defend itself. Bolitho added the requirement that the body of opinion relied on must be capable of withstanding logical analysis — a court can reject a practice as unreasonable even if others follow it. In dental cases this matters most where a practice is convenient rather than defensible: not taking radiographs because the machine was out of service, for example.

Causation is where more dental claims fail than anywhere else. The test is usually whether, on the balance of probabilities, the harm would have been avoided but for the breach. If a tooth was already unsalvageable when the dentist failed to act, the failure caused no loss. In delayed-diagnosis cases the question becomes what the outcome would have been had diagnosis occurred when it should have — which is why these claims turn almost entirely on expert evidence about staging and prognosis.

Since Montgomery, consent is judged by what a reasonable patient would want to know rather than what a reasonable dentist would choose to disclose. This creates a route to a claim that does not depend on the treatment being badly done at all: competently executed work can still be negligent if the material risks and reasonable alternatives were never explained. For elective cosmetic treatment, where doing nothing is always an option, this duty is at its strongest.