A 14-year-old boy lost five front teeth after a collision with a car. Despite the teeth being preserved in milk after the accident, a staff member at the Oral and Maxillofacial Surgery (OMS) department failed to consider the matter an emergency, leading to a delay in treatment.
A report released today by the Office of the Health and Disability Commissioner (HDC) concluded that this delay “significantly jeopardized” the boy’s long-term prognosis and violated regulations protecting health consumer rights.
The incident reportedly occurred in May 2021. The boy underwent an initial evaluation and CT scan at a local hospital and was subsequently transferred to another hospital for overnight neurological monitoring.
On the day of the incident, several hospitals contacted the dental health department for evaluation and reimplantation recommendations but were told the situation was not an emergency.
Clinical records from the first public hospital indicate that the dental resident did not recommend immediate reimplantation, stating that it was at most a temporary measure and recommended alternative treatment with a private dentist the following day. The second hospital made similar recommendations.
In its response to the HDC, the Ministry of Health stated that if the patient’s condition warranted transfer, it would be willing to replant and splint the patient that same day. It also suggested referring the patient to a third hospital and provided a contact number. However, the report stated that no follow-up call was received, and the handwritten phone record had been destroyed.
HDC Deputy Commissioner Vanessa Caldwell noted that standards require same-day emergency replantation of “lost teeth.” She stated, “I strongly urge that this not be done.”
The complainant, the teenager’s father, appealed the delay in treatment and the OMS resident’s decision that urgent care was not necessary.
Twenty-four hours later, a private surgeon scheduled a follow-up visit and contacted two dental specialists, who stated that the delay “almost certainly” resulted in the tooth‘s loss due to root resorption.
The specialists also noted that, because the tooth was preserved in milk, a relatively favorable medium, the delay was not irreversible.
Two specialists subsequently reimplanted the teenager’s teeth, an orthodontist installed a splint to stabilize the upper teeth, and another orthodontist sutured the large upper gum laceration. Follow-up endodontic care was arranged.
The HDC report also stated that while awaiting reimplantation, measures were taken to protect the surrounding jawbone for possible future dental implants or other restorations.
In his statement to the HDC, the teenager expressed “surprise and disappointment” that the OMS resident did not recommend reimplantation or schedule a follow-up appointment that same day.
The HDC investigation concluded that healthcare systems should adhere to established emergency and reimplantation guidelines to avoid misjudgment or communication that could compromise patients’ long-term oral health.
