Dentist suspended over treatment that left patient worse off

A general dentist who practised beyond his ability and left the patient worse off than before treatment has been suspended for three months, fined $15,000 and prohibited from offering orthodontic services for two years.

He also has to pay the cost of the disciplinary hearing.

The patient now needs to extract an affected tooth, as well as a few other teeth, and might even require jaw surgery.

The Singapore Dental Council (SDC) said in its grounds of decision released yesterday that Dr Simon Jude Chua Chew Kiat, who practises at Advanced Dental Surgery in Tampines, had offered the patient three treatment plans to choose from.

The plan that the patient opted for to straighten his crooked teeth should never have been offered, said the SDC's disciplinary committee, because of its "high risk of gum recession".

The treatment plan would also result in the patient's upper teeth protruding more than before.

The charge against Dr Chua was that he knew or ought to have known that he did not possess the appropriate knowledge, skill or required knowledge and should have referred the patient to a dentist with the necessary expertise.

Though he had taken courses in orthodontic treatments before, this was a complex case better handled by a specialist.

As a result of the orthodontic treatment over a one-year period, the committee said the patient will now need to have an affected tooth extracted.

It said in its grounds of decision: "This is necessary since the tooth was moved out of the bone. Furthermore, it is now necessary to remove a few other teeth to provide a reasonable treatment outcome.

"There is also a possibility that the patient may require jaw surgery."

The committee did not agree with the dentist's lawyers, who argued that the harm to the patient "was limited and that it was capable of being rectified".

The committee said: "The patient is left worse off than before his treatment started. He has now lost the bone support for the canine and his arch asymmetry has worsened."

Dr Chua, who was a senior dentist at a polyclinic before he left for private practice in 2012, admitted that it was the first time he had attempted the procedure.

The disciplinary committee said there was "obvious lack of expertise" in this case, and Dr Chua should have referred the patient to an orthodontic specialist. But this option was not offered to the patient.

The committee felt that the penalty should be heavy enough "to deter like-minded persons" from carrying out treatment beyond their competency. As Dr Chua had gained financially, a fine was also appropriate.

The disciplinary committee said it would have suspended Dr Chua for six months if not for the delay in hearing his case.

Taking a cue from the High Court, which halved the suspension for cancer doctor Ang Peng Tiam in June because of the length of time - four years - for the case to be concluded, the disciplinary committee halved the suspension for Dr Chua to reflect the two years in this case.

Salma Khalik

A version of this article appeared in the print edition of The Straits Times on October 20, 2017, with the headline 'Dentist suspended over treatment that left patient worse off'. Print Edition | Subscribe