Articles Posted in Dental Malpractice

As a lawyer in Atlanta, Georgia who specializes in Dental Malpractice Injuries, I receive lots of calls from Georgia patients who have been severely injured by Atlanta dentists. The calls are many, and at the outset, I must point out, that not every injury in the dental chair is caused by dental malpractice. In other words, some people are injured as a the result of a dental procedures and the injury is something that can happen absent malpractice. It is part of my job, as a lawyer evaluating dental injuries, to identify those types of injuries (dental injuries that occur through no fault of the dentist) and eliminate those cases from consideration. After all, it is the goal of every good lawyer to steadfastly pursue the good cases to trial (if that’s what it takes) and not expend valuable resources and time (from the lawyer, law firm, and potential client who is dragged into litigation when ultimately the case has no merit) on a case that falters due to a lack of provable malpractice.

One such injury that is almost always caused by dental malpractice is something called trigeminal neuralgia (TN), which is sometimes known as “the suicide disease.” It is brought on when the brain’s trigeminal nerve, which carries sensation from the brain to the face, is disrupted, sending unfounded but very powerful pain signals to the brain. The trigeminal nerve breaks off into the lingual nerve and the inferior alveolar nerve and these two nerves are involved in the majority of dental nerve injury trigeminal nerve injuries. Typical dental procedures that cause these types of injuries from malpractice are dental implants placed in the lower jaw, root canals of lower molars and extractions of lower back molars.

Researchers estimate that around five in 100,000 people suffer from trigeminal neuralgia, but it is notoriously difficult to diagnose since the symptoms can overlap with other conditions and accurately describing the pain can be challenging for patients.  One woman suffering from trigeminal neuralgia said that the pain might come on while she brushed her teeth, or sometimes, after a gentle gust of wind blew on her cheek. The result was something like an “electric shock,” she said, with no obvious cause. It later evolved into a “constant and excruciating” sensation. When asked by doctors to rate the pain from one to 10, she said it was a 13. “I was thinking, ‘Was I imagining this pain? Where did it come from? Why is it here?'” This is all quite typical of many of my clients who have suffered this injury at the hands of a negligent dentist or oral surgeon.

Early childhood cavities (ECC) is the single most common chronic childhood dental disease. In the treatment of ECC, children are often sedated under general anesthesia. An estimated 100 000 to 250 000 pediatric dental sedations are performed annually in the United States. Many of these procedures are not necessary and are performed by “suspect” children’s dental clinics under the auspices of treating the caries aggressively to stay ahead of the game. As we see below, most times, it is not worth the risk of general anesthesia complications to perform restorative work on a child’s baby teeth.

In 2016, the American Academy of Pediatric Dentistry (AAPD)¹ announced, “Because restorative care to manage ECC often requires the use of sedation and general anesthesia with its associated high costs and possible health risks, and because there is a high recurrence of lesions following the procedures, there now is more emphasis on prevention and arrestment of the disease processes.” The AAPD’s policy statement goes on to enumerate methods of chronic disease management, active surveillance, and interim therapeutic restorations and states, “Non-surgical interventions should be implemented when possible to postpone or reduce the need for [previously accepted] surgical treatment approaches.”

A common rationale for aggressive surgical treatment with sedation or general anesthesia has been the vastly overstated association between tooth decay in primary teeth and subsequent decay in permanent teeth. In fact, this connection is modest, with the relative risk ratios ranging from 1.4 to 2.6.^2,3 One reason the association it not strong is that the shedding of decayed primary teeth eliminates sites for bacterial colonization in the mouth and thus reduces risk of caries in the permanent dentition. The loss of primary teeth with replacement by permanent teeth is a normal developmental process that requires no professional intervention.

Georgia patients are injured every day from dental procedures. Common dental procedures are not always as safe, effective, or durable as we are meant to believe. As a profession, dentistry has not yet applied the same level of self-scrutiny as medicine, or embraced as sweeping an emphasis on scientific evidence. “We are isolated from the larger health-care system. So when evidence-based policies are being made, dentistry is often left out of the equation,” says Jane Gillette, a dentist in Bozeman, Montana, who works closely with the the ADA committee on evidence-based dentistry. “We’re kind of behind the times, but increasingly we are trying to move the needle forward.”

The dean of a major university dental school has filed a lawsuit after being terminated as dean and in his complaint alleges, among other things, the stealing of gold crowns from the dental school and accusing officials of retaliating against him for reporting problems at the College of Dentistry. As an Atlanta lawyer who specializes in dental malpractice, this is an interesting development since many of the experts that we use in our cases in Georgia are deans of colleges of dentistry in other states. In Georgia, with limited exceptions, a dental malpractice lawsuit must contain an affidavit by an expert alleging at least one count of malpractice against the dentist being sued in the lawsuit. In most cases, the affiant will be the dean or former dean of a dental school and have extensive experience performing the procedure at issue in the malpractice lawsuit.

The Dean’s lawsuit cites numerous other problems that the dean allegedly uncovered. They include:

• A departmental deficit of almost $2 million because clinical faculty (dentists) at the dental school were being paid salary supplements based on gross revenue from clinical services, not net revenue. The lawsuit alleges that officials did nothing to address the dean’s concerns;

Root Canals Are Common Procedures In Georgia

Root canals are a common dental procedure performed in Georgia by general dentists and endodontists. If the root canal is not performed correctly, the plaintiff in a lawsuit will allege that the defendant dentist was negligent in performing a root canal and the malpractice resulted in the plaintiff suffering permanent nerve damage. In most cases, the permanent nerve damage causes the plaintiff to endure constant pain in addition to the numbness and, in some instances, intermittent spiking sharp pain. While this may sound odd: i.e., numbness and pain at the same time, it is relatively common for dental nerve injuries such as a lingual nerve injury or inferior alveolar nerve injury from a root canal. Not only is this a common result of dental malpractice, often the numbness and pain are permanent.

Most Complications Involve Root Canals on Back Teeth and Women

As a lawyer in Georgia who regularly handles dental injuries, I come across a lot of situations which result in dental injuries. Some injuries are sustained prior to the patient going to the dentists, while others are caused by the dental treatment itself. Some of the most common situations which result in dental injuries outside of the dental office are:

Car Accidents. The most common situation that I encounter that results in a non-dentist induced dental injury is in accident cases and most commonly in car wrecks. Probably the most common scenario that results in dental injuries is a car accident victim who smashes their mouth into the steering wheel when they are hit from behind while stopped.

Sports Injuries. There’s a reason most sports require you to sign paperwork and waivers before you can play. While fun to participate in, sports put your body in danger. With balls, bats, sticks, and even other players moving quickly around on the field or court, it doesn’t take a lot to cause an injury. Protect yourself while playing any sport by wearing the right protective gear, and be prepared for the unexpected. Unfortunately, most sports injuries occur to children, who do not yet have the self-awareness to appreciate some of the dangers inherent in all sports. A hard tackle in football, a foul ball at a baseball of softball game, or even an elbow in basketball can knock a tooth out or even fracture a jaw.

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.