Articles Posted in Dental Malpractice

According to recent news coverage and the Fulton County Deputy District Attorney, a dental “practitioner” in northeast Atlanta has been arrested and accused of, among other things, of practicing dentistry without a license. (WSB-TV, October 3, 2024).As the story unfolded, patients showed up expecting dental work, but were instead surprised to see district attorney investigators and local police who had raided the dental offices.

Dentistry in Georgia means “the evaluation, diagnosis, prevention, or treatment, or any combination thereof, whether using surgical or nonsurgical procedures, of diseases, disorders, or conditions, or any combination thereof, of the oral cavity, maxillofacial area, or the adjacent and associated structures, or any combination thereof, and their impact on the human body provided by a dentist, within the scope of his or her education, training, and experience, in accordance with the ethics of the profession and applicable law, including, but not limited to, the acts specified in Section 43-11-17 of the Georgia Code.” In order to practice dentistry in Georgia, one must be a graduate of an accredited dental school (a school or college or university with an education program accredited by the Commission on Dental Accreditation of the American Dental Association), and  be a dentist licensed and in good standing in this state pursuant to Chapter 11 of Title 43 of the Georgia Code. The Georgia Board of Dentistry is charged with examining dental applicants, issuing dental licenses and investigating dental complaints made by the public.

Under the Code, any person who performs any of the following procedures, operations, or services shall be regarded as practicing dentistry within the meaning of chapter 11:

You’ve been injured by a dentist and need a lawyer. Choosing which lawyer to represent you in a dental malpractice case is no small task, especially since the lawyer will be representing you through all phases of litigation. If the case does not settle pre-suit, the lawyer will be filing a dental malpractice complain on your behalf, usually in state court. So, choosing the right lawyer for you is critical in the proper resolution of your case. Asking co-workers, family members, or other professionals with whom you have a relationship for a referral to a lawyer can sometimes be helpful. However, Georgia Dental Malpractice litigation is such a specialized area that these resources may not be entirely helpful. However, asking the right questions and doing the proper research will put you in an excellent position to find the right dental malpractice lawyer for you. Here are some considerations to take into account and to ask any lawyer you are contemplating hiring to represent you in a Georgia dental malpractice case:

1. How long have you been practicing? In many professions, there simply is no substitute for experience and the law is no exception. This is especially true in dental malpractice litigation. You want a lawyer that has substantial experience practicing law, and (more importantly) regularly handles dental malpractice cases in Georgia. So, it would behoove you to ask any prospective dental malpractice attorney how long they have been practicing law and what percentage of their practice is devoted to dental malpractice.
2. Do you have trial experience?  While most dental malpractice cases do not go to trial, sometimes the only way to get the proper compensation in a dental malpractice case is to try it in a Georgia court before a jury of your peers. You want a lawyer who is ready, willing and able to go to bat for you in the courtroom. You owe it to yourself to hire a lawyer that you feel is comfortable in the courtroom and who will not shy away from taking your dental case to trial.

While three of the top dental injuries are toothache, jaw pain and broken teeth, the most prevalent injuries from dental procedures or dental malpractice in Georgia are quite different. Among the most common injuries from dental procedures are a numb tongue, numb chin, numb lip and teeth, and nerve injuries of the face, jaw and tongue. While this may be stating the obvious, to pursue a dental malpractice claim in Georgia, the plaintiff must prove: (1) that she sustained and injury from a dental procedure; and (2) that the injury was caused by negligence on the part of the dentist during the performance of a dental procedure such as a root canal or dental implant. In other words, it is not enough that there is an injury, but rather the plaintiff must prove that the injury was caused by malpractice.

Basic dental malpractrice law requires that the Plaintiff establish duty, breach and causition. Put another way, tin order to prove her case, the Plaintiff in Georgia must prove that there was a dentist/patient relationship, that the dentist had a duty of care to perfrom the procedure in a competent manner, the dentist breached that duty, and that the breach of the standard of care caused the injuries that the Plaintiff is complaining of in the lawsuit. Some of these necessary requirements are satisfied by expert testimony in the form of an affidavit that is attached to the complaint when it is filed with the court. That is why it is essential to retireve Plaintiff’s records from the defendant, as well as all subsequent treating providers such as dentists, doctors, hospitals and pain doctors.

Elements of damages can include, but are not limited to, past lost earnings, future lost earnings, a decreased ability to labor, disfugrement, physical or mental impairment pain and suffering, past medical bills, future medical bills and other damages. These types of damages are proven with documentary evidence, as well as testimony and opinions from dentists, doctors and lay witnesses in order to fill in the gaps and provide a complete picture to the jury.

Dental malpractice in Georgia can take many forms. Some of the most common reasons malpractice occurs is a lack of training by the dentist performing certain procedures (such as root canals, dental implants and oral cancer screenings); a lack of communication between two dentists (whether in the same office or in separate dental offices) who are involved in the care and treatment of a patient; a failure to properly document and observe important anatomical landmarks and measurements (thi is especially important when performing root canals and dental implant procedures); failing to review the patient’s chart and medical history prior to using or prescribing drugs that the patient may be alert to or which may interact with medications that the patient is current taking; and carelessly performing a procedure which results in injury to the patient.

The standard of care for dental malpractice in Georgia requires that all of the above situtions be handled in a fashion that a reasonable dentist would do in like or similar circumstances. Many of the standard of care violations that we uncover occur when general dentists perform dental procedures that should be referred out to a specialist. This occurs most often with complicated extractions, root canals and the installation of dental implants. One area that we have seen that results in a lot of dental malpractice claims is large corporate dental chains who advertise as providing affordeable dentures causing severe dental nerve injuries when the attempt an “all on 4” dental implant procedure. This procedure involves extracting all of the patient’s existing teeth (both top and bottom), placing 4 implants on the top and 4 on the bottom, and then attaching the implants to these implants. Unfortunately, the high volume of procedures preformed result in many serious dental nerve injuires that could be avoided with proper training, careful placement and other quality control processes that don’t happen in high volume dental implant offices that sometimes focus on quantity over quality.

Lawsuits in these situations will focus on duty (from the dentist to the patient), breach (of the standard of care, in other words the procedure is not done properly) and the resulting damages (often dental nerve injuries and other types of dental injuries that result from the procedure. These form the basis of the lawsuit and each of the elements are necessary to pursue a dental malpractice case in Georgia.

Most dental malpractice cases handled by our firm stem from root canals or dental implants that are performed below the standard of care and which result in serious dental nerve injuries. A recent case (that we did not handle) appears to have been filed by a woman who claims that her dentist performed over 30 dental procedures in a single sitting. This is hard to fathom, and, if the allegations are true, it would be hard to imagine how the patient could have stayed numbfor these dental procedures without exceeding the recommended maximum dose of anesthetic numbing agents (but withouth knowing more, I guess it is possible).

8 crowns, 4 root canals, and 20 fillings in a single visit is certainly a lot of dental procedures in one day. Without reviewing the patient’s dental records, it’s hard to comment further, other than to follow the case and learn more as facts develop in the case. According to news reports, the expert who reviewed the records noted that almost every tooth in the plaintiff’s mouth had some form of decay on it, but that the care provided was nonetheless, “wrong.” One of the specific acts of negligence cited in the news report was that the amount of anesthesia administered to the patient exceeded what the expert considered to be safe under the circumstances. It is not clear, what specific injuries this alleged violation of the standard of care caused. However, it is an interesting case to follow for a nunber of dental reasons and I am curios to see how the litigation develops.

Most dental malpractice cases in Georgia are reviewed by an expert dentist, endodontist, oral surgeon or similar expert prior to the lawsuit being filed. If there is malpractice identified by the expert and the malpractice has proximately caused a substaintial permanent injury, an affidavit is prepared to support the lawsuit, the lawsuit is drafted and the complaint is filed in the appropriate court. Most of these cases start out as root canals or dental implants which are not performed to the standard of care and which wind up injuring an adjacent structure in the mouth or jaw such as a dental nerve. This is similar to a medical malpractice case where a doctor or surgeon leaves the surgical field and injures the patient while they are not operating in the area in which they should be. This is usually when the most damage is caused by the dentist.

It’s all the rage these days. Clients are asking dentists to pull all of their teeth and install all-on-four dentures. Sometimes called teeth in a day or full mouth implants, these procedures are sometimes performed in the same day. While the billboard advertisements tout shiny smiles and happy patients, this may not always be the case.

All-on-four implants are offered by individual dentists and small dental practice groups. But, the vast majority of these procedures are performed by large dental chains. Some of the large dental chains that offer this type of procedure are ClearChoice, Affordable Dentures, Aspen Dental, Coast Dental, First Dent, DentChoice. This list is certainly not exhaustive and all-on-four dental implant procedures are performed by anyone from a general dentist, periodontist, prosthodontist, all the way up to an oral surgeon.

While the vast majority of these procedures are performed adequately, some complications due to dental malpractice can arise. These procedures require a great deal of expertise, proper planning and implementation, very precise radiographic tests such as the use of a Cone Beam CT Scan (CBCT) and a great deal of skill on the part of the dentist. Lack of proper planning, improper measurements, drilling to deeply when prepare the site for the implant and installing the implants too deeply into the jaw line or just some of the potential problems that can occur when these procedures are not performed correctly. This can happen when the dentist is not properly trained in the procedure, is careless, or lacks the skills to adequately plan and perform the procedure with the applicable standard of care.

The primary goal of root canal treatment is to eliminate and prevent re-infection of the root canal system anatomy. In necrotic teeth, microorganisms can colonize anatomical complexities, such as isthmuses, ramifications and dentinal tubules and this causes infection and abcesses that are partially the reason why a root canal is performed. Instrumentation (dental files) can reduce the bacterial load by approximately 80%. However, the microorganisms cannot be completely eliminated with dental files alone as the file are very small but not small enought to get into every crevice of the roots of the tooth. sometime, in order to try and achieve this or simply due to inexperience or a lack of skill or knowledge, dentists over-instrument the canals, which is below the standard of care and often leads to catastrophic nerve injury.

After the canals are obturated (or cleaned out) the endodontist (or the general dentist if the patient has not been referred out to a root canal specialist: for the rest of this article we will refer to the practitioner performing the root canal as the “dentist” as both general dentists and endodontists are dentists) places sodium hypochlorite (NaOCl) solution into the canals to clean and disinfect them. This is a strong solution which, due to its antimicrobial/antibiofilm activity, and organic tissue dissolution capacity is able to clean and disinfect the canals. It is placed into the canal by the dentist using a needle coupled to a syringe, a system known as conventional syringe irrigation (CSI). CSI has a rinsing effect, which is an important part of the irrigation process. Once again, due to inexperience, a lack of skill, or nelgigence, too much apical pressure by the dentist can lead to sodium hypochlorite extrusion outside of the tooth roots and, many times, into the dental nerve which lays just beyond the apex of the tooth being treated (if the tooth is a bottom molar).