This article discusses practice in England and Wales. Legal tests and procedural rules may differ elsewhere. For UK, Republic of Ireland and selective international enquiries, see how to instruct.
Dental expert evidence needs both clinical reasoning and a clear understanding of the questions the court must decide. Reviewing the records and explaining the clinical course are essential. The report must also show how those findings relate to the issues in the instruction, without assuming that an unsatisfactory outcome proves negligence.
Clear reasoning matters. Breach of duty is not just poor dentistry; it is a departure from the standard of a reasonably competent practitioner in the same circumstances. Causation is not just a bad outcome; it requires establishing that the breach, on the balance of probabilities, caused identifiable harm. An expert who conflates these, or who frames an opinion around what they personally would have done rather than what falls within the range of acceptable practice, produces a report that is vulnerable to challenge and of limited use to the instructing solicitor.
I hold an LLM in Legal Aspects of Medical Practice and a Diploma of Legal Medicine, both completed alongside clinical practice. That training informs how I read instructions, structure an opinion and recognise the limits of what I can properly address. For clinical diagnosis and treatment decisions, I consider the professional practice test in Bolam and the logical analysis required by Bolitho. Disclosure of material risks requires the distinct, patient-focused assessment in Montgomery. Identifying which treatment alternatives are reasonable also involves professional judgment, as clarified in McCulloch v Forth Valley Health Board [2023] UKSC 26, a Scottish appeal considering the professional practice test in both Scots and English law. These questions should be distinguished, with the court determining the legal issues.
CPR 35 and Practice Direction 35 are not formalities. They set out the expert's overriding duty to the court, the requirement for transparency of methodology, and the need to distinguish between fact, assumption and opinion. Reports that ignore this structure tend to generate unnecessary Part 35 questions, delay proceedings, and create problems at joint statement stage that could have been avoided.
Solicitors instructing a dental expert should expect a report that is clinically grounded and legally coherent. Clear structure and relevant procedural understanding help make the clinical reasoning useful to the court.