South Tyneside and Sunderland NHS Trust Foundation v SA (By His Litigation Friend The Official Solicitor) [2022] EWCOP 23 (Fam)

Application by NHS Trust to carry out dental treatment on SA, a 22 year old who lives in 24 hour supported care.

SA has a diagnosis of Autistic Spectrum Disorder, Severe Learning Disabilities, Communication difficulties and Attention Deficit Hyperactivity Disorder and has lived in supported care for 10 years. The Trust was seeking orders enabling them to examines SA’s mouth after it was noticed that he was experiencing discomfort but a dental appointment failed because of SA’s agitation. In subsequent meetings by the medical team it was agreed that SA lacked capacity and there was also debate over whether he should have a frenectomy to correct a tongue-tie, as this may possibly improve SA’s communication.. SA’s mother objected to the treatment unless the frenectomy was also undertaken, a position the Trust did not support.

In this judgment, Theis J agrees SA clearly lacks capacity and that the evidence was that SA needed dental examination and treatment under general anaesthetic to overcome his agitation. However she finds that performing the frenectomy would not be in SA’s best interests as his oral hygiene was good, he eats well and the risks of post-operative problems while the wound healed outweighed any benefits. 

Read the judgment on the National Archives