Articles Posted in Dental Malpractice

As a recent article related to sub-standard dental care makes clear, the practice of dentistry is only as good as the dentist who is performing the dental care and treatment. Why on earth a dentist in a large dental practice would subject his patients to potential disease and infection by re-using dental instruments which were designed and sold for single-use is anyone’s guess. What is important to know though, is that the dental care and treatment must comply with the applicable standard of care, regardless of the circumstances.

Dental implants are especially susceptible to infection because they are, by definition, a foreign body placed in the mouth with the intent on it staying there for the life of the implant.

As a lawyer who regularly handles dental malpractice cases in Georgia, I have reviewed many malpractice cases that stem from the negligent installation of dental implants. Most of these cases are very fact intensive and require a thorough review to determine if there was malpractice and if the malpractice caused the injury which the patient is complaining of. In most cases, all of the dental and medical records must be obtained and a competent expert must be retained to review the records to determine this. This is a complex process that, in many cases, takes many months to complete. That is why time is of the essence if you have been injured by a dental procedure.

Dental nerve damage can often be caused by dental treatment. Many kinds of treatment have reportedly caused dental nerve damage such as root canals and placement of dental implants in the lower jaw. Despite many types of proposed treatment and many claims of success, many victims of dental malpractice in Georgia have exhibited poor recovery after surgery is attempted to correct dental nerve damage.

After undergoing microneurosurgery, an injured dental patient’s quality of daily life activities may improve because of the resolution of numbness or pain in the tongue, lip, chip or face during movement.  Other areas of sensory perception which may improve after this type of corrective surgery are thermal perception (ability to feel hot or cold) and taste sensation.  Improvements in taste can include recoveries of sweet and salty tastes or recovery of the injured patient’s ability to taste sour things again. It is interesting to note, that even when some semblance of taste is recovered, the taste buds on the side of the tongue that the nerve was injured on are sometimes smaller and less prominent, and this  almost always permanent. It is also common that the subjective taste perception does not mimic an apparent regeneration of the nerve under some of the radiographic tests that are available for this purpose, such as a cone beam CT scan (3D CT), x-rays, MRI or MRN.

I regularly handle cases that involved nerve injuries that were caused by dental procedures. It has been my experience that most of these injuries are traumatic and severe. Due to the nature of the injury, the effects on the injured patient are certainly seen in pain and numbness in the area of the injury. However, many times the patient has far more reaching pain and numbness that cannot be adequately addressed by corrective surgery, pain drugs or therapy. In these cases, the patient’s injuries become debilitating and permanent. In these cases, the injury become much more than simply a physical pain or numbness and it can affect almost every aspect of the patient’s daily life. This can include, but is certainly not limited to, pain while brushing teeth; pain while eating; drooling; unbearable pain in the jaw, face and ear; tremendous anxiety; difficulty sleeping; not being able to work; sexual dysfunction; fear of getting future dental work done; and many other types of problems.

General dentists must comply with the standard of care for dentists under like or similar circumstances in Georgia and nationwide. When a dentist fails to comply with this standard of care and a serious injury or death results, a lawsuit for dental malpractice can be filed. A national dental practice, which touts itself as general dentistry for kids has been sued by a mother of a child-patient who died as a result of complications from a dental procedure, and an infection which was alleged to have not been treated properly. According to reports, the infection spread after a follow-up visit to the dentist and sadly took the fear year-old girl’s life.

Infections secondary to dental procedures, while not uncommon, rarely cause death. This is because most patients report back to the dentist and receive the proper treatment to get the infection under control and to make sure that the patient does not become toxic and the infection does not spread. Ludwig’s Angina is one type of dental infection that can cause death if not properly diagnosed and treated by dentists.The majority of cases of Ludwig’s angina are odontogenic in etiology, primarily resulting from infections of the second and third molars (wisdom teeth). In this scenario, the dental infection spreads to the throat and compromises the patient’s ability to breath and can, if not treated cause severe suffering, lack of oxygen to the brain, and even death. With progressive swelling of the soft tissues and elevation and posterior displacement of the tongue, the most life-threatening complication of Ludwig’s angina is airway obstruction. Prior to the development of antibiotics, mortality for Ludwig’s angina exceeded 50%

Even if the original dental procedure that caused the infection was performed within the standard of care, the dentist and the dental practice may be liable for failing to timely diagnose and treat Ludwig’s Angina and/or failing to refer the patient to a specialist in a timely manner.

I have been practicing law since 1994. Over the years I have had, what I consider, some great trial victories in areas such as medical malpractice, civil litigation and personal injury. But, there is one area of law that I have gravitated to over the years and which has become somewhat of a specialty for me: dental malpractice. While I could not fully explain in this article all of the reasons why I have gravitated to specializing in dental malpractice, I can say that I am drawn to this area of law because it allows me to help clients who have been seriously hurt seemingly out of the blue. In other words, many of my clients went to the dentist of have a simple dental procedure performed (such as getting a dental implant or root canal) and within days they have suffered a lief-changing injury. This is very unsettling and I understand what these clients are going through. Consequently, I get a deep sense of satisfaction in being able to walk them through the legal and dental process, and ultimately I do everything I can to help them recover from the dental injury and move on with their life.

I consider myself to by very good at identifying dental negligence and being able to quickly and accurately identify which dental injuries are caused by malpractice and which cases have merit. This seemingly simple step goes a long way in helping those injured in the dental chair have a clearer understanding of how and why they were hurt and what their prospects of being adequately compensated for their dental injuries are.

While my dental malpractice clients vary in every respect (i.e, age, gender, income level, political affiliation, etc.), they all have one thing in common: they were seriously injured by no fault of their own, and many times this happens when they are under general anesthesia and not even cognizant of what is taking place. I understand how troubling this is and I do all I can to address this with my clients. Many of these injuries are debilitating and permanent such as trigeminal nerve injuries, mental nerve injuries, inferior alveolar nerve injuries, and lingual nerve injuries. Due to the nature of facial nerve injuries, there is a great deal of pain, numbness, and quite frankly disbelief. All of these reactions are real and normal and I do my best to address them with each client that I represent in this area of law.

This is the question many potential clients call to ask. And it’s a reasonable inquiry, to say the least. Whether one can sue for dental malpractice related to the placement of a dental implant depends on a number of factors including but not limited to: Whether the pre-implant planning process was properly followed; whether an implant surgical guide was used; whether the pre-implant planning measurements were followed in placing the implants; and whether the skills and technical proficiency of the dentist placing the implants meet the standard of care.

Of course, whether one can sue for dental malpractice related to the placement of dental implants will depend on the answers to the above questions. But, the result of the negligence must be a substantial injury from the dental implant placement. In other words, it is not enough that the dental implant procedure did not go well (or you are not happy with the procedure for one reason or another), in order for there to be the basis for a lawsuit, you must have suffered an injury from the dental procedure.

We have seen a proliferation of injuries to the facial nerves after the negligent placement of dental implants. Most of these are from implants placed in the lower jaw (or mandible) which are placed too deep into the jaw and affect the inferior alveolar nerve or the mental nerve, if the implant is placed closer to the front of the mouth. However, there are instances of nerve injuries after the negligent placement of dental implants in the maxillary (upper jaw) although these are much rarer and do not have a classical presentation. From the cases that I have evaluated, the trigeminal nerve most often injured by improperly placed maxillary dental implants is the infra-orbital nerve. This nerve runs out of the foramen (small opening in the skull) just below the eye and runs a course which stays well above the upper teeth. Of course, the improper placement of the dental implant must result in damages in order to support a dental malpractice lawsuit, which in many cases of dental negligence, are substantial. Whether the injury is to the nerves in the lower jaw (much more common) or upper jaw, timely action is needed in order to properly evaluate the cause of the injury and whether a malpractice lawsuit is justified.

As an Atlanta lawyer who specializes in the handling of dental malpractice cases, I have noticed a rise in the number of dental malpractice claims caused by negligent dental treatment during certain dental procedures. Many of the injuries that we have been seeing are catastrophic and permanent. The cases on the rise that I have seen involve dental nerve injuries sustained after the patient has undergone dental implant placement, root canal therapy and extraction of wisdom teeth and other molars.

Dental malpractice in this area often leads to serious injury due to the proximity of the nerves in the jaw and face to the tooth and mouth structures that are being worked on. For instance, dental implants can cause injury to the nerves in the mouth due to placement of the implant in the wrong position. This often leads to the implant crushing the nerve and the patient is often left with insurmountable pain and numbness. Similarly, if a root canal is not performed according to the applicable standard of care, this too, can lead to a serious dental nerve injury that, in many cases, is permanent and debilitating.

As a dentist licensed in the State of Georgia, a dentist and the acts performed in the dental  practice are governed by and subject to the Georgia Dental Practice Act, O.C.G.A. §§ 43-11-1, et seq. (the “Dental Act”) Under the Dental Act, “dentistry” 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 Code Section 43-11-17. When a dentist performs any of the procedures mentioned in the Dental Act, the procedures must be performed within the standard of care or liability attaches to the malpractice.

Recent studies confirm that almost 1/4 of Americans have been negatively impacted by medical errors. While this appears alarming on its face, the scary part, is that the actual number of Americans who have been victimized by medical negligence could be much higher due to unreported medical errors or situations in which medical errors have occurred and are the subject of a coverup by the doctor or hospital.

The recent survey which was conducted by the NORC at the University of Chicago, found that almost 25% of Americans reported having personally experienced a medical error and was careful to note that, when medical errors do occur, they “have a lasting impact on the patient’s physical health, emotional health, financial well-being, or family errors.

In addition to the 25% of Americans that the study uncovered as having personally experienced the results of medical malpractice, 31%, almost 1/3 of Americans, reported that someone who they knew well and whose medical care they were personally involved with experienced the ill-effects of medical malpractice.