Dentist loses permission to treat kids

19:36, Jun 27 2014

A Nelson dentist has had his right to treat children under a government contract revoked, after concerns about the standard of care he was providing.

The Nelson Marlborough District Health Board has suspended its contract with Dr Nicholas Smith of Stoke Dental Centre, which allowed him to provide oral health services to children and adolescents.

New Zealanders aged under 18 are eligible for free dental treatment, which is provided by private dentists contracted by their local DHB under government-funded dental benefits.

"We have suspended this contract because we have concerns that this dentist has not been providing the best possible care to children and adolescents," NMDHB chief executive Chris Fleming said.

Smith said it was a "combined decision" between him and the DHB, made in early May.

"We had an audit earlier in the year, and they had a look and decided that I hadn't been taking enough X-rays to be sure I was covering all the treatment."


Smith said he had decided that the contract was not worth keeping, as he was not seeing many children, so he "gave it away".

His practice would be subject to a review, and the Dental Council would decide whether it was going to do anything about the DHB's concerns, he said.

Fleming said parents of adolescents and children attending the Stoke Dental Centre under the DHB contract had been given a list of alternative dental practices.

The DHB's issues with the practice were being dealt with by the Dental Council, he said.

Council chief executive Marie Warner said Smith would be electronically monitored until he proved himself competent to treat patients unsupervised.

She said that as part of the individual recertification programme, the council saw all clinical records before each patient was treated and reviewed any procedures performed.

"We see everything that comes in, and our dentist here is supervising his work.

"While [Smith] is being remediated, that is the safety mechanism that has gone in - through electronic supervision, until such time as he is back up to standard."

Separate to this, there was an educational programme Smith would go through at the same time he was being monitored, Warner said.

"Basically, if there is a gap identified in knowledge, we effectively identify what the gap is, and require an educational programme to bring the practitioner back up to a required standard."

Smith's current practising certificate already has a condition on it, imposed in August 2013, preventing him from undertaking endodontic work - root canal treatment of the pulp in the centre of a tooth.

The condition prevents him from doing the complex work. If a patient requires it, he has to refer them to another dentist.

Warner said the condition would have been imposed as a result of concerns about Smith's endodontic work being referred to the Dental Council.

Orders restricting a dentist's scope of practice were imposed if a risk to the public was identified, she said.

Smith would also complete a supervised educational programme behind the scenes to bring him back up to the necessary standard in endodontic care, Warner said.

The Dentists Disciplinary Tribunal suspended Smith's registration for six months in 2002 after he was convicted on charges of fraudulently claiming $40,000 as part of the government-funded dental benefits scheme.

Smith was sentenced to home detention by a court, and repaid the money.

The circumstances of the offences reflected adversely on his fitness to practise dentistry, the tribunal said.

The Nelson Mail