A Greymouth dentist who bungled multiple procedures, leaving a string of shoddy dental work, is fighting to keep his registration, saying the West Coast community will suffer if he cannot practise.

Another dentist said he was “appalled” after seeing Dr Bharath Raja Subramani’s work, saying it was “likely to fail catastrophically”.

Subramani admitted misconduct with 11 patients, including doing dental work without consent, doing unnecessary extractions and fillings, and in one case doing $32,700 worth of work that all had to be redone by another dentist.

Subramani is pushing for a stay on a Health Practitioners Disciplinary Tribunal decision to cancel his registration. His lawyers appeared in the Court of Appeal in Wellington this morning to argue for his right to continue practising until a full appeal could be heard.

In the meantime, he has been practising under “intensive” supervision, said his lawyer, Harry Waalkens, KC.

According to the tribunal decision, Subramani admitted to a charge of professional misconduct relating to work he carried out over the course of a year between 2017 and 2018 when he was working for Lumino as the sole dentist in his Greymouth clinic.

One of his patients, who received multiple fillings despite not consenting to them, had four of the fillings fall out within a few months of them being placed.

Subramani told 10 of the patients they ground their teeth and prescribed mouth guards, but other dentists noted there was no evidence to show the patients ground their teeth.

Another patient who wanted dental implants ended up with infections after Subramani performed the procedure inadequately. The patient had paid Subramani more than $32,700 upfront for the work.

Another dentist, Dr Angelo Ioanides, who dealt with the patient after Subramani left the clinic, told the tribunal he was “appalled” by what he saw.

Ioanides said the man had a full mouth “restoration” delivered to an extremely poor standard.

The case was heard in the Court of Appeal on Tuesday. Photo / NZME

“In Dr Ioanides’ opinion, Dr Subramani should not have been placing costly and difficult-to-dismantle dental work on top of diseased foundations,” the tribunal decision said.

He also said Subramani’s notes were “grossly deficient and inaccurate”.

He told the Dental Council all of the treatment provided was “likely to fail catastrophically”.

Subramani replaced another patient’s tooth after it was knocked out, but did not tell him the tooth was broken, meaning it could not have successfully healed.

The patient said the wire keeping the tooth in came loose and was a hindrance until he cut it off with toenail clippers and filed the end down.

Subramani failed to give another patient reasonable care and monitoring after sedating him, and left a chunk of root fragment behind without telling him.

There were multiple issues with patients receiving unnecessary or excessive work, procedures being botched, and Subramani keeping poor records. Patients were often left in pain and needing further dental work.

There were also problems with patients being charged well over the quoted fee, or charged large amounts for unneeded work, with one patient telling the tribunal he felt “absolutely swindled”.

Subramani told the tribunal he was “devastated” to have been charged and that he now recognised he had been out of his depth.

The tribunal cancelled Subramani’s registration, censured him, and fined him $10,000, as well as ordering him to pay $150,000 in costs.

In court today, Waalkens said there was no real risk to the public for Subramani to continue practising pending the appeal, because he was under “intensive” supervision. He must send a treatment proposal to his supervisor before doing any work on a patient, and is only doing procedures that a junior dental assistant could do.

He said the West Coast was notoriously difficult to attract dentists to, and to deprive the community of Subramani would be “wrong”.

“He’s undertaking a valuable role for the community. He is a changed man,” Waalkens said.

“It would beggar belief to suggest the public is being protected in the West Coast by stopping this man from practising.”

Lawyer for the Professional Conduct Committee (PCC), Dr Jonathan Coates, said the PCC did not accept the supervision was adequate to protect the public, and that Subramani had been under supervision in the past without any lasting effect.

“For whatever reason Dr Subramani seemed to perform adequately when he was under supervision but then when he’s practising by himself without supervision the wheels come off.”

Co-counsel Andrea Lane said the community would be fine without Subramani working there, as other dentists on the West Coast had the capacity to pick up his caseload.

The full appeal against the tribunal’s decision will be held in September. The Court of Appeal today reserved its decision on the stay.

Melissa Nightingale is a Wellington-based reporter who covers crime, justice and news in the capital. She joined the Herald in 2016 and has worked as a journalist for 10 years.