The State Legislature of Pennsylvania approved legislation on Saturday that would require dentists to carry at least $1M in liability insurance. As an Atlanta lawyer who specializes in dental malpractice, I am eagerly following this bill, and I think it is long-overdue. There are many similar laws in place all over the country which require many professionals to carry malpractice insurance, and the area of dental malpractice should be no different.
Most serious dental malpractice injuries result from negligent root canals or dental implants which cause damage to the Inferior Alveolar Nerve or the Lingual Nerve. Many times, this damage is caused by crushing or severing the nerves and the injury causes numbness, pain, and a permanent disability.
The most common nerves traumatized in implant dentistry are the inferior alveolar nerve (IAN) and its mental branch, the mental nerve. Other nerves at risk include the lingual nerve, long buccal nerve and the infraorbital nerve because of the anatomic location of these structures. Neurosensory impairment may occur during all phases of dental implant surgery, including anesthetic administration, incisions, soft tissue reflection, osteotomy preparation, bone augmentation, implant placement, suturing and/or soft tissue swelling after surgery. The reported incidence of such nerve injuries following dental implant procedures is highly variable, but the most common causes of these dental nerve injuries are during the osteotomy preparation or implant placement. In other words, the nerve is usually crushed or severed when the hole is drilled to place the dental implant, or when the implant is screwed into place and it is screwed right into the nerve.
When a nerve injury occurs, the dentist should be able to recognize the type and extent of injury and provide the most appropriate post-operative care. Traumatic and iatrogenic (i.e., caused by the dentists who was performing the dental care) nerve complications may involve total or partial nerve resection, crushing, stretching, or entrapment injuries. The resulting sensory deficits may range from a non-painful minor loss of sensation to a permanent and severe debilitating pain dysfunction. Presently, no standardized protocol exists for the dentist in the management of nerve injuries after implant surgery. Yet, surveys at the Misch International Implant Institute™ indicate 87% of dentists have encountered situations of neurosensory impairment within their practices. Yet, no organized approach to evaluate and/or treat this condition has been presented. The most commonly used term to describe an altered sensation is paresthesia. For years, paresthesia has been used to describe any altered sensation including pain, numbness, tingling, aching, warmth, cold, and burning. Recently, the Association for the Study of Pain has standardized a nomenclature system that defines the most frequently used neurosensory descriptive terms. There now exists three distinct categories with related subcategories describing neurosensory deficits. The most significant change is paresthesia which is limited to an altered sensation that is not unpleasant. Dysesthesia is defined as any altered sensation that is unpleasant. Anesthesia is the total loss of feeling or sensation. These three main categories are used to describe, diagnose and treat (including referral) the nerve injury in situations in which dental patients have suffered dental nerve injuries due to dental treatment.
If you have suffered a serious nerve injury and suspect that it was caused by Dental Malpractice, please contact us online or call Robert J. Fleming directly on (404) 923-7497 for a free and confidential case evaluation.