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Italian dentists found guilty
7th Jul 2005
Two dentists who caused distress to a significant number of young patients, in some cases making their teeth worse and not better, have been found guilty by the General Dental Council (GDC) of gross negligence and struck off the register. Over the course of five years, Silverio Di Rocca and Alicia Caffarena, who both had a dental qualification from Turin University, notched up a devastating number of abuses of patients teeth, and of the NHS system of remuneration for dentists. Their catalogue of wrongdoing began in 1999, when they started work at centres in Cambridge and in Palmers Green, North London. They continued working in both places until July last year, when the GDC ordered an immediate interim suspension pending an investigation. Between 2000 and July 2004 they worked in a third location, near Kingston-upon-Thames. Neither of them had a recognised specialist qualification but they both limited their practice to orthodontics. Among the problems they caused some patients were: • Root resorption • Decalcification • Prolonged and inappropriate treatment • Impacted teeth left undiagnosed. In the case of one patient, they deliberately created a false record card, in order to frustrate a complaint. Many patients have had to go on and have remedial treatment for up to two further years. One of the most disturbing anecdotes heard by the committee was an attempt Alicia Caffarena made to demonstrate the strength of the brackets she had just fixed to a patient’s upper teeth. She took hold of the bracket and forcibly shook the patient’s head, ignoring the requests of both the patient’s mother and the dentist to stop what she was doing. They were both found to have breached nine sections of the General Dental Council’s ethical guide, Maintaining Standards, in respect of: personal behaviour, acting in the best interests of patients, providing high standard of care, explaining treatment and costs, consent, handling complaints, contemporaneous records, misleading claims and dental records and radiographs. Alicia Caffarena was found to have breached two additional sections, which were: treating difficult patients and children, and complaints of rudeness and discourtesy. It’s thought that DiRocca and Caffarena, who lived and worked as a couple and whose address in the UK was in Richmond, Surrey, returned to Italy when they were suspended. At the GDC hearing in May, an application for an adjournment was made on their behalf. However, the chairman said that the committee was satisfied that they had ‘deliberately absented’ themselves. He ruled that, exceptionally, because of their conduct, the case would proceed in their absence. In summing up, the chairman said in both cases there were multiple failures, sub-standard practice, gross negligence and abuse of patient trust. He added that the committee recognised that there might well be cultural and philosophical differences in their practices compared to the practice of many dentists in the UK, but these differences could not justify sub-standard treatment. The conduct committee chairman also referred to their non-extraction philosophy. In the absence of proper diagnoses and treatment plans, it was clear that they both failed to take the individual patient’s problems and needs into account when applying the philosophy. He concluded that the gravity of the findings meant that no lesser direction than erasure would suffice.
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