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Key Takeaways
A UK coroner’s inquest concluded in April 2025 with a finding that has drawn widespread attention across the dental community. Pawel Bukowski, a 48-year-old father of three from Watton, Norfolk, died by suicide after a dental procedure in Turkey left him without any teeth and no provisional restoration — an outcome his family says he was never prepared for.
The case has prompted difficult questions about informed consent, patient communication, and the duty of care owed to people undergoing full-arch tooth replacement.
What Happened
Bukowski had been living with serious periodontal disease — a chronic bacterial infection that erodes gum tissue and bone, and is one of the leading causes of tooth loss in adults. In January 2025, he travelled to a private clinic in Turkey to have his teeth replaced with dental implants.
He was told the procedure would follow a clear sequence: his remaining teeth would be extracted, temporary dentures would be fitted immediately, and he would return several months later for his permanent implants. That plan did not materialise.
After extracting all of his teeth, the clinic informed Bukowski that it could not proceed further with the treatment. He was sent home to the UK without any provisional teeth and told to return in six months.
His wife, Daria Bukowska, told the inquest that the experience was emotionally devastating. “He always took care of himself, his appearance and his health,” she said. “He was deeply broken emotionally. Losing his teeth had destroyed his self-confidence and sense of hope.”
In the weeks that followed, Bukowski struggled to eat properly, fell into heavy drinking, and experienced a severe deterioration in his mental health. Despite the involvement of mental health services, he was not admitted to psychiatric care. A psychiatrist’s scheduled home visit on April 28 arrived too late. Bukowski was found dead that afternoon.
Norfolk area coroner Johanna Thompson recorded a conclusion of suicide and noted that the subsequent NHS investigation identified several missed opportunities for intervention.
The Clinical Issue: Why Same-Day Provisionals Matter
For patients unfamiliar with implant dentistry, the detail that sits at the centre of this case — the absence of temporary teeth — may not immediately register as a clinical failure. It is.
In standard full-arch implant protocols, including the widely used All-on-4 approach, patients receive a provisional restoration on the day of surgery. This is not cosmetic. Provisional teeth serve multiple functions during the healing period: they protect the surgical site, allow for appropriate distribution of bite forces while the implants integrate with the bone, and enable the patient to eat, speak, and function while their permanent restoration is being prepared.
They also serve a purpose that clinical literature increasingly recognises as essential — psychological continuity. Patients who arrive for full-arch restoration have almost always spent years managing significant dental deterioration. The procedure represents the end of that chapter. Sending a patient home without teeth after extracting every tooth in their mouth does not simply delay the outcome. It removes the very thing the patient came in for, with no clear or credible path to recovery visible to them.
Informed Consent and the Communication Gap
Bukowska told the inquest that her husband had been assured of a specific treatment sequence before travelling. What he experienced bore no resemblance to that plan. The clinic’s decision to halt treatment mid-procedure — without apparent contingency, without provisional restoration, and without adequate support — left a vulnerable patient in a position he had not been prepared for.
Informed consent in implant dentistry is more than a signature on a form before surgery. It is an ongoing process that requires the provider to ensure the patient genuinely understands what will happen at every stage, what the realistic risks and variables are, and what support exists if things do not proceed as planned.
A patient who is surprised to find themselves toothless and without recourse at the end of a procedure has not been properly consented. That gap in communication is a clinical failure, regardless of where the treatment takes place.
A Broader Concern
Bukowski’s case is not simply a cautionary tale about overseas dental tourism, though it has been widely reported as such. The core failures here — inadequate communication, no provisional restoration, and no structured aftercare — are not failures unique to any geography. They are failures of process and of patient-centred care.
What the case does illustrate is the heightened risk that comes when patients travel far from home for complex procedures, with no local provider invested in their long-term outcome and no straightforward path to follow-up care if something goes wrong.
For patients considering full-arch implant treatment, the questions worth asking of any provider are the same regardless of location: Will I leave with teeth on the day of surgery? What does my aftercare schedule look like? What happens if a complication arises? Who is responsible for my care if the plan changes?
A provider who cannot answer those questions clearly and specifically before treatment begins is not a provider who has fully considered your welfare as a patient.
The Family’s Response
Bukowska has spoken publicly about her husband’s death in the hope that other families are spared a similar outcome. “Pawel was failed at crucial points,” she said following the inquest. “I hope that this is never repeated — that other families get to keep their dads, husbands, brothers and sons. Pawel deserved better.”
The coroner’s findings have been referred to the NHS trust involved in his subsequent mental health care, with lessons identified around psychiatric admission thresholds and continuity of follow-up.
If you or someone you know is struggling, please reach out to a crisis support service in your country. In the US, call or text 988. In the UK, Samaritans are available 24/7 on 116 123. International resources can be found at findahelpline.com.
