DENTAL MALPRACTICE: WHAT YOU NEED TO KNOW

Dentist and oral surgeons must follow the standard of care of a reasonably competent dentist. This standard is not what is “customary” but what is “competent.” Dental Malpractice occurs when a dentist or oral surgeon does not follow the standard of care and hurts or harms her patient.

• DENTAL MALPRACTICE EXAMPLES

• DENTAL NERVE DAMAGE

• TOOTH EXTRACTION

• IMPLANT INJURIES

• WHEN A BAD ROOT CANAL IS DENTAL MALPRACTICE

• FAILURE TO DIAGNOSE ORAL CANCER

DENTAL MALPRACTICE EXAMPLES

Malpractice occurs during many kinds of dental procedures, including, but not limited to:

• Root canals
• Implants
• Tooth removal (extractions)
• Deep cleaning
• Bridges
• Fillings
• Veneers

Further, Dental negligence includes some of the following examples:

• A failure to diagnose, thus leading to injury;
• An Injury to the lips, teeth, tongue or nerves of the patient;
• An Infection from dirty dental equipment;
• No informed consent prior to the dental task;
• Treating a patient with something the patient does not need, such as pulling a healthy tooth or going through a surgery that can be fixed without surgery;
• Failing to detect, or diagnose oral cancer;
• The wrong use of a dental instrument, resulting in cuts to the mouth
• cutting and severing a nerve in the tongue, jaw, lips, teeth, throat, face, and more;
• Leaving a foreign objects in the mouth;
• Using the wrong procedure on the patient and
• Using a procedure on the wrong patient.

INJURIES

Dental malpractice injuries can be serious. Many times the injuries occur while the patient is under anesthetics. Therefore, the dentist can cause nerve damage by drilling through nerves and other oral tissue. Furthermore, injuries may include infection, the need for implants, and/or the need for restorative work.

DENTAL NERVE DAMAGE

Dental nerve damage is often the result of dental malpractice. The most common dental nerve damage is to the lingual nerve and/or the inferior alvealor nerve.

THE LINGUAL NERVE

The lingual nerve refers to nerves in the tongue. Often, tongue nerve damage occurs only one side. Thus, a client has no taste or feeling on the right side of the tongue or the left side of the tongue. Many clients are self-conscious about how the loss of tongue use has impacted their life, including their personal relationships. When pressed, however, a client will admit to biting her tongue several times a week without noticing until blood is dripping down her face.

Do not hesitate to address a lingual dental nerve injury since the injury may require a surgical repair. Studies have shown that after 10-12 weeks, the likelihood of success decreases with each passing month so time is of the essence.[1] If you experience nerve pain after a extraction, do not simply “wait and see” if things get better. Call your doctor as soon as possible.

THE INFERIOR ALVEOLAR NERVE

The inferior alveolar nerve runs alongside the outside of the mouth. This nerve is often injured when there is overfilling or overinstrumentation during a root canal treatment, the removal of wisdom teeth, or the placement of dental implants. Inferior alveolar dental nerve damage requires immediate treatment. Tooth nerve damage symptoms include feeling a “shock sensation” that feels “electric” and both numbness and pain.

CONSORTIUM CLAIM

Nerve injuries may result in a lack of intimacy and a possible consortium claim should be considered.  Consortium concerns injuries that a spouse experiences when a dentist is negligent to his or her partner.

NO INFORMED CONSENT IS DENTAL MALPRACTICE

Often a patient will sign an informed consent before a procedure. A proper informed consent should accurately describe the dental procedure and outline the risk. Nerve damage in tooth treatment is a common risk during an extraction, a root canal, and sometimes during anesthesia. Signing an informed consent does not preclude you from filing a lawsuit. In our practice, we have seen nerve damage arise from unnecessary procedures. Consult with attorneys experienced in the field to weigh whether you can bring a successful dental nerve damage lawsuit.

TOOTH EXTRACTION

Tooth extraction occurs when a dentist removes a permanent tooth from its socket in the jawbone. Most tooth extractions have no issues, but sometimes mistakes happen.  If you have suffered from a mistake you may have a tooth extraction negligence claim.

Before tooth removal, Dentists must offer other treatment options after determining whether the tooth cannot be saved. The dentist then must conduct an oral examination before extracting a tooth. This includes an x-ray in order to establish the best way to complete the removal. The dentist must review your your dental and medical history before taking out a tooth.

The following are a few of the tooth extraction negligence claims we have seen in our law practice.

EXTRACTING THE WRONG TOOTH

This used to be a rare event, but is now an injury we are seeing more and more every year. Large Corporations buy out small dental offices and less people visit the same dentist who owns and runs his or her own office.  These dental chains focus on maximizing the speed of treatment and the number of patients treated in a day. In this high pressure environment, more dentists and their staff will pull the wrong tooth.

AFTER EXTRACTION

If an infected tooth still requires an extraction, the patient has a gap with two teeth instead of one. This makes implants more costly. Sometimes dentists will pull the correct tooth but damage a neighboring tooth during the procedure, which should not occur.

A common defense is that the pulled tooth would have needed to be removed anyway. Since there was an extraction already scheduled, none of the clients have a flawless mouth. The defense will use the flawed mouth to devalue the claim. A solid expert can often overcome this defense. We deploy many dental experts to assist in valuing claims.

TOOTH EXTRACTION WITHOUT CONSENT IS DENTAL MALPRACTICE

Dentists and oral surgeons should not remove teeth without the proper informed consent of the patient. Prior to surgery,  the patient has the legal right to have all the  risks of the treatment fully explained so they can decide if they still want the procedure and still want the dentist to remove the tooth. Failure to remove a tooth without telling the patient constitutes a medical battery and is an example of dental malpractice. We have seen these kinds of dental negligence cases most often in patients with dental insurance and/or Medicaid since these insurance plans pay by the tooth, rather than by the visit.

PAINFUL INJURY AFTER A TOOTH EXTRACTION

Most patients will not feel pain after an extraction, but if an extraction is not performed correctly, a permanent injury can occur. Examples of permanent injuries include a bone infection (osteomyelitis) or an infection in the gum. A dentist needs to treat these areas and is required to give advise on how to avoid the infection and prevent the infection from spreading.

While getting an infection doesn’t immediately give you a reason to file a claim, if your dentist hasn’t prescribed antibiotics, hasn’t given you advice about possible infections, or you haven’t been referred for further treatment, you may well have a claim. Other injuries include permanent nerve damage and sinus perforation following a dental extraction.  

COST OF TREATMENT

If you have suffered from dental malpractice, treatment may include an implant or implants, bone graft surgery or sinus membrane perforation repair. Each of these treatments are extremely expensive, costing thousands of dollar. Unlike surgeries to other areas of the bodies, many health insurance plans do not cover dental surgeries. The cost of repair can be harmful to one’s financial health. Hiring dental malpractice lawyers and filing a claim will help recover the money  needed to make the repairs that would not have been needed had there not been tooth extraction negligence.

IMPLANT INJURIES

Dental Implant Injuries include nerve damage, foreign objects, and infection. If an injury occurs, it may be due to dental malpractice. Implant injuries happen because dental implants have become the most favored method of tooth replacement. Though more expensive than a dental bridge, implants have a high success rate and avoid the need to remove healthy teeth. Implants are artificial teeth that look exactly like real teeth. Surgically embedded into the jawbone and gum tissue, the implants fuse with the living tissues of the mouth. This allows the implants to support a crown, bridge, or denture in the same way that natural teeth would support a crown, bridge, or denture.

Dental Implants are more complex than one might realize. Placed in the jaw, implants are close to a number of nerves and bones. These nerves and bones can be injured by the implant. Common implant injuries include:

• Infection of the jaw bone
• Nerve Damage
• Complete Loss of Teeth (edentulous)
• Implant loss
• Fractured jaw

TREATMENT

Dental implant injuries require many types of treatment. Treatment includes pain medications, removing the implant, starting over, and/or surgical repair of the nerve damaged by the implant. Oral steroid medications are often used in combination with these methods to ease pain and lessen inflammation.

BEWARE THE TYPE OF DENTIST

Implant injuries are more common with a regular dentists than with a specialist like a periodontist (a dental professional with more training). Regular dentists can install implants but are often not working with the same level of tools as a periodontist. Time is important when treating an implant injury. Nerve damage gets worse the longer it goes untreated. Broken implants move over time, causing more injury.

In addition to physical pain, Implant injuries cause other kinds of damage to one’s emotional state. If a patient is unable to have a new implant, the patient often suffers depression from having less teeth and feeling old and/or unattractive.

WHEN A BAD ROOT CANAL IS DENTAL MALPRACTICE

Dentists perform thousands of root canal procedures each year. Most procedures have no issues. However, if you experience a bad root canal, you can sue the dentist if the dentist fails to treat the problem in a timely manner. Bad root canals and a failure to diagnose the bad root canal is an example of dental malpractice

ROOT CANAL OVERVIEW

The “root” of the tooth, is approximately 2/3 the size of the tooth and rests below the gum. When the pulp inside of root  becomes infected with bacteria, the treatment to save the tooth is a known as a root canal.

First, the dentist takes an X-Ray. The X-Ray reveals the exact location of the damage and nerve pulp.  The root canal procedure involves removing the dead or dying material, then ‘filling in’ the root canals inside the teeth.  The dentist then fits a crown over the patient’s tooth to strengthen it and protect it from future infections. A final x-ray checks that the canals have been filled completely and to the correct length, not underfilled or overfilled. After a root canal, discomfort should disappear in a few days.  If you are still experiencing pain after more than a couple weeks, you have experienced a root canal complication.

SIGNS & SYMPROMS OF A BAD ROOT CANAL THAT IS DENTAL MALPRACTICE

You should not experience pain after a couple of weeks following surgery. If the tooth still is sensitive or still inflamed, you may have an issue. You may also see swelling or discoloration.  Sometimes, the tooth has a sensitivity to hot or cold. Finally, poor work can result in  numbness or an electric shock sensation that may be a sign you have experienced nerve damage.

WHY ROOT CANALS FAIL

The most common root canal dental malpractice involves overfilling or over-instrumentation of the tooth. Overfills are diagnosed with a CBCT (dental cone beam computed topography), a three dimensional x-ray. Lawyers use this 3D X-Ray as a perfect visual for a demonstrative exhibit at trial or mediation. The standard of care for treating an overfill (which may include an extraction) is to treat the overfill within 48 hours.[1]  

Overfills are a known risk and often a patient signs an informed consent. The negligence occurs by not treating the overfill or over-instrumentation since the dentist should be aware through a post-operative X-ray that the overfill has occurred. Many times the overfill is recognized almost immediately by the dentist without an x ray and the dentist should consider beginning either a flushing sequence and/or an extraction.

Other times root canals fail because of a lack of sanitation or because the infection re-established itself or wasn’t fully removed. If the infection isn’t fully removed or is still present, a dentist should detect this quickly following the root canal. Dentists are required to conduct a post-operative X-Ray which should reveal whether the infection has been removed. Oftentimes, malpractice occurs when a dentist fails to properly diagnose that the root canal was not successful in removing the entire infection.

CONCLUSION

Root canals have a reputation of being an unpleasant experience. The reality, however, is that with modern medicine, you should not have persistent pain several weeks after the procedure. If you are still experiencing pain, we advise that you call a different medical professional to evaluate your mouth. If you have been a victim of dental malpractice, you can sue the dentist and have expensive follow up treatment bills paid for by the offending dentist.

FAILURE TO DIAGNOSE ORAL CANCER

Oral Cancer is a cancer of the mouth or tongue. While oral cancer is rare, Kentucky has more cases per person than the broader United States. In Kentucky, doctors will diagnose an estimated 850 people with oral cancer. Among this group, 190 of these patients will die. With a high death rate, dentists and oral surgeons must screen their patients for signs and symptoms of oral cancer. A doctor failing to diagnose oral cancer is possibly an example of dental malpractice. A patient who has suffered failure to diagnose malpractice must Call a dental negligence lawyer. A dentist negligence lawyer will evaluate whether you can bring a successful lawsuit.

SIGNS & SYMPTOMS OF ORAL CANCER

Call your dentist and/ or your doctor if you notice the following list of symptoms:

A sore or lesion in the mouth that does not heal within two weeks.

A lump or thickening in the cheek.

A white or red patch on the gums, the tongue, tonsils , or lining of the mouth.

A sore throat or lump in the throat.

Difficulty chewing or swallowing.

Difficulty moving the jaw or tongue.

Numbness of the tongue or other area of the mouth.

Swelling of the jaw that causes implants to fit poorly or become uncomfortable.

Chronic hoarseness.

Having one of the above symptoms doesn’t mean you have oral cancer. Most likely you have a less serious problem. However, you must visit a medical professional for a diagnosis. Your dentists determines if a referral is needed for more screens.

FAILURE TO DIAGNOSE IS DENTAL MALPRACTICE

A dentist should properly screen oral cancer at each exam (every 6 months). The dentist asks questions about tobacco and alcohol use. The dentists looks for symptoms consistent with oral cancer. The dentist is responsible for taking appropriate action in preventing the worsening of the cancer if symptoms are discovered at this point. This includes follow-up examinations and referrals to other medical professionals for diagnosis.

Specifically, your dentist observe the symptom for about two weeks. If the symptom has not healed , the dentist refers to an oral surgeon. The oral surgeon evaluates and determines whether to conduct a biopsy. A biopsy, or the removal and examination of tissue, is the most effective method for detecting cancer. A pathologist examines the tissue under a microscope and ultimately diagnoses oral cancer.

Dental malpractice for failing to diagnose oral cancer occurs for several reasons. If the dentist fails to conduct screens, the cancer will not detected. Second, Dentists often misdiagnose a symptom as periodontal disease or as loose tissue. Further, an oral surgeon who delays a biopsy could result in a delayed in diagnosis. Finally, a doctor will improperly read a biopsy in addition to failing to double-check the initial diagnosis after a report has been made. Any of these failures delay the detection of oral cancer which can prove deadly.

EARLY DETECTION

Cancer has less time to spread when detected early on. Early detection makes treatment more effective. Further, the patient experiences more expensive treatment if detection occurs later. Early treatment includes a simple surgical extraction. Later treatment consists of surgical, radiation, or chemotherapy treatment. Chemotherapy results in hair loss, nausea, and vomiting. When Oral cancer worsens, symptoms include problems with swallowing, tooth decay, and fatigue.

These painful symptoms interfere with work and cause severe pain and suffering. Moreover, the later oral cancer is detected the more likely the cancer will result in death. When a patient dies from oral cancer that could have been prevented, the patient’s family can bring a wrongful death lawsuit against the doctors who failed to diagnose the oral cancer. 

FINDING AN EXPERT

Under Kentucky law, a successful dental negligence claim requires an expert. When choosing an expert, the choice is between a general dentist and a specialist. A general dentist may undertake any dentist procedure The specialist, (e.g. periodontist, orthodontist, oral surgeon etc.) is limited to her specialty. When general dentists undertake an orthodontic case, for example, they will generally be held to the same standard of care that a licensed orthodontist would be held to.  

CONCLUSION

When injured by a dental professional, call a dental  negligence lawyer. A dental negligence attorney will help you  get compensated. Compensation depends on a variety of factors,  including the nature of the incident, the actions of the dental professional, the severity and length of your injury, how the injury will impact your future, the severity and duration of your injury, and the amount of medical treatment and lost wages.

There is no guarantee that a dental lawsuit will succeed. Dental negligence can be difficult to prove and payouts are not the norm. However, dental negligence lawyers do win cases, at trial or by a dental malpractice settlement. 

CONTACT LAW HELP LOUISVILLE

If you, or someone you care about, has suffered a dental nerve injury, please email lawhelplouisville@gmail.com or call 502-771-0588. Under Kentucky law, any malpractice claim, including a claim against a dental professional must be brought within one year of when the injury occurred or reasonably should have been discovered. Under Indiana law, any malpractice claim must be brought within two years. Do not hesitate to call us.

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