Articles Posted in Dental Malpractice

The parents of a 17-year-old girl, who died while she was undergoing oral surgery, have filed a lawsuit against the oral surgeon and anesthesiologist involved in the procedure.

The death occurred in March this year, when the 17-year-old patient visited the dentist’s office for oral surgery. According to the report by the chief medical examiner, she was first given a standard dose of anesthesia. However, the dose was insufficient to get her completely sedated. She was then administered an additional dose of anesthesia. This was also part of standard procedure.

However, when the procedure was underway, she began to experience bradycardia, a slowing down of her heart rhythm. This was followed by a drop in the oxygen saturation in her blood. She went into hypoxic arrest, and at this point, the doctors called in emergency personnel. The teen-aged patient was then rushed to the hospital, where she was in a coma for a few days before finally dying.
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As an Atlanta personal injury lawyer, a large part of my legal practice is devoted to helping those injured by dental malpractice. Many of these injuries occur secondary to the placement of dental implants. Dental implants are preferred for tooth restoration over dental bridges because they are esthetically more appealing and have the functioning ability of real teeth. In addition, due to the implants being anchored in the jawbone, they mimic normal tooth structure and this prevents jaw bone resorption, which occurs when patients go from having teeth to wearing dentures. And though generally considered safe, the procedure does present some risk to the patient. Some reports indicate that as many as 13% of all implant procedures result in some type of nerve injury.

Serious nerve injuries often occur when dentists drill past the jawbone into the inferior alveolar nerve or actually position the implant itself on the nerve. The usual symptoms are numbness, severe pain, and/or discomfort in the patients mouth or face that was not felt prior to the placement of the implant. Therefore, proper location of the nerve prior to performing the procedure is necessary and required under the applicable standard of care.

The most commonly employed method used in finding the position of the nerve is a radiograph, but tomograph and computerized tomography is similarly used. According to the Journal of Implantology, correctly measuring the available bone or the simple use of a drill guard can preclude over penetration.

For well over 25 years, a safety zone of two millimeters has been prescribed between the drill depth for the implant and the jaw nerve beneath. When a patient is injured, ascertaining the cause of the problem will determine the necessary response. And a three-dimensional cone beam (CBCT) x – ray can verify if the jaw nerve was reached during drilling.
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This dentist doesn’t seem to be too keen on waiting till complaints against her evolve into a full-fledged dental malpractice lawsuit. According to a lawsuit that has been filed a dentist has attempted to prevent patients from commenting on her dental work online, and then retaliated against them when they did. Trust me, as an Atlanta Dental Malpractice Attorney who has been practicing law for over 20 years, I have seen it all, including a local Atlanta dentist who attempted to require new patients to sign a form agreeing to arbitration in lieu of being able to file a lawsuit if the dentist committed malpractice.

The lawsuit has been filed against the dentist who also happens to moonlight as a classical singer, by former a patient. According to the lawsuit, the Plaintiff/former patient visited the dental office with a dental problem, and was surprised when she asked him to sign an agreement not to criticize her work online. The agreement called the Mutual Agreement to Maintain Privacy had to be signed before she agreed to work on his tooth.

The Plaintiff/former patient admits to signing the agreement, and then he went on the website Yelp to accuse the dentist of shoddy work. According to his criticism posted on Yelp, she overcharged him by as much as $4,000.  The dentist accused the former patient of breaching their agreement, and retaliated by billing him $100 for every day that the negative comment remained posted on the internet.
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Have you ever wondered if your dentist is filling cavities that, well, may not be cavities after all.  As an Atlanta dental malpractice lawyer, I have received many calls from potential clients claiming just this. A common scenario, a patient has been seeing the same general dentist for 15 years and, for one reason or another, she switches to another dentist. The new dentist performs a thorough intake, a series of high-tech diagnostics including x-rays and maybe cone bean CT scans. Lo and behold, the patient is informed that she needs 10 cavities filled. Now, does this scenario indicate that there might be dental malpractice on behalf of the prior treating dentist, the one who treated the patient for the past 15 years and who has never mentioned these “cavities” or does it indicate that the new dentist may be guilty of malpractice for over-treating. The answer, as always with the law: it depends. New technologies now help dentists locate minor abnormalities that may or may not ultimately turn into full-blown cavities. These problems do not require dental filling procedures, but far too many dentists recommend these anyway.

The New York Times is reporting on increasingly sophisticated dental technologies that allow the detection of minor abnormalities, like incipient carious lesions. An incipient carious lesion is one of the earliest stages of structural damage, usually caused by bacterial infections. These infections may or may not lead to a full-blown cavity. In some cases, the lesion can be treated by minerals in the saliva.

Many experts are of the opinion that these minor cavities do not need to be treated with a dental filling because damage to the enamel has not yet begun. However, a majority of dentists do not hesitate to operate on a tooth that has minor damage, and decay that has not progressed beyond the enamel. These treatments are not only painful, but also expensive.

Some incipient carious lesions cannot be seen with x-rays or the naked eye, but can be detected through fiber-optic techniques and infrared laser scanning. By using these techniques, dentists now find it possible to locate minor cavities that do not require filling, and proceed to perform these procedures anyway.
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No Atlanta dental malpractice lawyer would doubt that modern sedation techniques are safer and more effective than ever before. Yet, every year there are far too many cases involving patients developing serious or even fatal complications after being administering anesthesia. According to a new article in Anesthesia Progress, the risks are especially great when patients have existing medical conditions.

Before performing a dental procedure on a person with a pre-existing medical condition, Atlanta dentists must evaluate the patient’s eligibility for anesthesia. A dentist who is treating a patient suffering from cardiovascular disease, must have a complete review of the patient’s medical history. This must be followed by a physical examination, including a recording of the blood pressure and heart rate. In addition, it is now required by the standard of care to record capnography to ensure patient safety while under general anesthesia.

After this, the dentist must make an informed decision about whether the patient is eligible for a procedure. The researchers advise dentists to refer the patient back to a physician, if they have any doubts about the patient’s eligibility for the procedure, even if that means delaying the procedure. Once the anesthesia is administered, any significant changes in blood pressure readings must be monitored closely.
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The family of a four-year-old boy in California, who died after a dental procedure, is still looking for answers about the reasons for his death. The boy had been taken to a dentist in Oakland, for tooth extractions and dental capping. He was administered a dental anesthetic. However, things worsened rapidly from then on. The boy slipped into unconsciousness, and despite efforts to revive him, died.

The boy had been born with a cardiac defect, involving a hole in the wall separating the right and left ventricle of the heart. When he was about a year old, he had a pacemaker installed. According to his family, he was in good health after he had the pacemaker installed.

The family says that the doctors at the hospital where the dental procedure was performed were aware of the boy’s medical history, because it was the same hospital where he has had his open-heart surgery. Every six months, he visited the hospital for a cardiac checkup.
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The family of a thirteen-year-old girl who died while she was undergoing dental surgery, has reportedly settled a wrongful death lawsuit for $1 million.

The incident occurred at a dental office on December 21, 2010, when the thirteen-year-old was undergoing surgery. The girl had been administered general anesthesia, and during the surgery, suddenly stopped breathing. She died soon after.

Autopsies later confirmed that the death was the result of complications arising from anesthesia use. The girl suffered diffuse hypoxic ischemic encephalopathy from respiratory arrest brought on by anesthesia complications.

Her parents filed a lawsuit against the 81 year-old dentist. The case has now settled and the lawsuit dismissed in exchange for $1 million. The settlement was brought about through the help of the State Dental Board which negotiated between the parties and approved the final settlement. The settlement will be shared by the parents of the girl.
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As an Atlanta dental malpractice lawyer, I come across cases involving negligence by dental professionals every day. In many of these cases, patients might have been able to avoid the trauma of a dental injury if they had been aware of some of the warning signs of a negligent professional.

According to MNN.com, there are certain signs that should alert you to the possibility that your dentist may not be as professional as he or she needs to be. Your dentist should take a complete medical history before he or she decides to recommend a treatment. Oral treatments are no laughing matter. Some oral conditions can affect a person’s cardiac health, while certain medical conditions like arthritis, can affect a person’s dental health. A complete medical history can inform your dentist about a condition that could impact the success of the procedure or treatment. For instance, many people with heart problems should not be given injections containing epinephrine. Still others, who have certain pre-existing health conditions must be given a course of antibiotics prior to dental treatment being administered.
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Injury to the lingual nerve (LN) is a common result from Dental Malpractice. A number of oral and maxillofacial surgical procedures result in damage to the Trigeminal Nerve, Lingual Nerve or Inferior Alveolar Nerve. The most common signs or symptoms of dental nerve damage is numbness (about half) followed by numbness with pain (about 40%). Other signs of dental nerve injury are hyper-sensitivity to stimulation, a crawling feeling in the lip or chin area, burning, stinging or other altered sensation to the lip, chin and gums (for inferior alveolar nerve injuries) and a change in taste,  a heavy-feeling tongue coupled with difficulties talking as normal, and/or a lack of appetite. Still other changed sensations following dental nerve injury include shooting pains in your mouth, the feeling that your tongue is burning, aching, extreme sensitivity and pain when exposed to cold, an inability to taste foods and a “pins and needles” feeling when eating.

Just like other nerve injuries, dental nerve injuries are classified by the degree of injury. The timing and success of the nerve repair depends on the extent of injury. Clinically useful injury grading systems have been developed that allow correlation of the microscopic changes occurring after nerve injury and patient symptoms. Perhaps the most widely accepted are those developed by Seddon and Sunderland.  Seddon divided nerve injuries by severity into three broad categories: neurapraxia, axonotmesis, and neurotmesis. Neurapraxia, the mildest injury type, does not involve loss of nerve continuity and causes functional loss, which is transient. This symptom’s transience it thought to be due to a local ion-induced conduction block at the injury site, although subtle alterations in myelin structure have also been found. Axonotmesis occurs when there is complete interruption of the nerve axon and surrounding myelin while the surrounding mesenchymal structures including the perineurium and epineurium, are preserved. Axon and myelin degeneration occur distal to the point of injury, causing complete denervation. The prospect of recovery is excellent in such injuries because of the remaining uninjured mesenchymal latticework that provides a path for subsequent sprouting axons to reinnervate their target organ. Neurotmesis involves disconnection of a nerve. Functional loss is complete and recovery without surgical intervention, does not usually occur because of scar formation and the loss of the mesenchymal guide that properly directs axonal re-growth.

Sunderland’s classification system further stratifies the three injury types described by Seddon into five categories according to severity. A first-degree injury is equivalent to Seddon’s neurapraxia and a second-degree injury is equivalent to axonotmesis. Third-degree nerve injuries occur when there is disruption of the axon (axonotmesis) and also partial injury to the endoneurium. This categorization places a third-degree between Seddon’s axonotmesis and neurotmesis. Dependent on the extent of the endoneurial damage, functional recovery may be possible. Sunderland divides Seddon’s neurotmesis into fourth and fifth degrees. In a fourth-degree injury, all portions of the nerve are disrupted except the epineurium. Recovery is not possible without surgical intervention. Similarly, a fifth-degree injury involves complete severance of the nerve.

If you have suffered from a dental nerve injury, it is important to seek medical intervention as soon as possible. The longer your symptoms last, the less likely it is that you will regain full sensation in the affected areas of your mouth. Regardless of what you have been told, there are courses of treatment that can help you regain the feeling in your mouth, tongue, cheek and gums.
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Atlanta dental malpractice lawyers have found the failure of the Food and Drug Administration (“FDA”) to warn the public adequately about the dangers of mercury dental fillings or amalgam fillings, perplexing. The calls for the agency to limit the use of mercury fillings, or warn the public about the risks of these fillings, are getting louder. While it is not clear whether these fillings are, in fact, causing the problems that some  researchers and activists are attributing to them, I think the best course of action is to inform the public of what information and evidence is out there and let each person decide for themselves what course of action they want to take with the filling that they get.

This month, dentists, consumers and health care experts are calling on the agency to warn consumers about the risks of these fillings. Among the people adding their voices to these calls is a woman, who alleges that her children were severely harmed by the mercury fillings that were inserted into her teeth during her pregnancies.

It’s not as if scientists, environmental groups and health experts do not agree on the risks to human health from mercury exposure. There is an almost unanimous opinion that exposure to mercury damages human health and risks the environment. However, in spite of this evidence, the Food and Drug Administration has been painfully slow to act on the matter.
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