Articles Posted in Dental Malpractice

Over treatment by dentists is a common occurrence that I see as a dental malpractice lawyer in Georgia.  In a recent collective action, a group of 29 former dental patients was awarded over $29M in damages against a defendant dentist who allegedly had repeatedly performed unnecessary root canals.

While the above case is certainly exceptional, most cases of dental malpractice that we see involve root canals, dental implants, or complicated extractions. These procedures sometimes are performed negligently and can lead to serious and permanent nerve injuries that affect the mouth and face. These types of cases are much different from the cases in which dentists take advantage of their patients and perform unnecessary dental procedures. This type of practice is also sometimes called fraudulent dentistry.

As professionals, dentist (much like other professionals such as doctors and lawyers) are provided great deference by the public and by their patients. The decision as to whether you need a dental treatment is often in a gray area. One dentist will say one thing, while another one will say another. This is normal, and it’s to be expected. But it means that the usual signs of insurance fraud – a practitioner prescribing more procedures than his or her colleagues – are more difficult to detect, because there’s more variation, and it’s more difficult to really pin down a procedure as unnecessary. This being said, I have seen many new clients who have been subjected to unnecessary dental work. Worse yet, they unnecessary work often leads to injury which could lead to a malpractice claim against the dentist if the injury is severe enough.

Over the years, I have head clients complain about the following procedures being done that the client, in hindsight insisted was not necessary: wisdom tooth extractions, fillings, crowns, deep scaling and root canals. To be sure, the client is not always correct, but these are the main areas that I run across that client complain about the most. In particular, I have encountered quite a few situations in which the client was persuaded to have all four wisdom teeth removed (even though they were not causing any problems or in dental terms were asymptomatic) and then, the extraction causes a nerve injury. This is especially true in older clients (generally in their 40’s and older) who have wisdom tooth extractions. This is because, as we age, the wisdom teeth become ankylosed in the jaw. In other words, the teeth become anchored in the jaw in such a fashion that it becomes extremely difficult to remove them without exposing the lingual nerve or inferior alveolar nerve to injury. Since, the whole process was started off by the dentist proposing treatment that was not necessary (because they teeth were asymptomatic and not causing the patient any problems), the injury quite possibly could be caused by dental malpractice.

Attorney Robert J. Fleming has been handling wrongful death cases, automobile accident cases, personal injury cases, dental malpractice and medical malpractice lawsuits for individuals and families who have been harmed, injured or died as a result of the carelessness or negligence of another for more than 20 years in and around Atlanta, Georgia and its surrounding areas, including Alpharetta, Austell, Avondale Estates, Chamblee, College Park, Conyers, Duluth, Decatur, Doraville, Hapeville, Johns Creek, Jonesboro, Lawrenceville, Norcross, Peachtree City, Riverdale, Roswell, Sandy Springs, Stone Mountain, and Smyrna. If you have been seriously injured and would like quality legal representation, contact Robert J. Fleming directly on (404) 525-5150 or contact us online.

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Dental implants have become the procedure of choice to replace extracted teeth. And for good reason. The technology has evolved to the point that dental implants can be safely placed where natural teeth used to be. Unfortunately, the increase in dental implants has resulted in an increase in nerve injuries caused by dental malpractice. There are many facial nerves that can be damaged by negligent dental care and treatment related to dental implants. The most common nerves injured when the dentist fails to take proper precautions include, but are not limited to the inferior alveolar nerve, the lingual nerve, the mental nerve, different branches of the mandibular nerve and the infra-orbital nerve (most commonly associated with the placement of an implant in the maxillary or upper jaw).
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According to reports, an Oregon woman is suing her dentist for malpractice, claiming that the dentist’s napping lead, at least in part, to her adverse reaction to local anesthetics. While I am not familiar with the facts of the Oregon case so I decline to comment on the merits of that particular case, it should be noted that negative reactions to epinephrine are quite common and can be serious in patients who suffer from other medical conditions.
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I receive many calls from potential clients who have been injured during a dental visit. Based on interviewing these new clients, the three nerves that seem to be injured most are the lingual nerve, the inferior alveolar nerve and the infraorbital nerve. When the injury is to the lingual nerve, the client will report an injury history and symptoms somewhat like the following: I suffered the nerve injury after having my wisdom teeth out. My tongue is numb and burns, but only on one side. The oral surgeon says not to worry, but I am very nervous that this numbness and pain is not going to get better– and this is something that I cannot live with. Even though I have been prescribed pain medication (gabapentin or tegretol), nothing seems to help the constant stabbing pain in my tongue. I have read many stories about others that have suffered from this injury and I just can’t believe this is happening to me. Despite my best efforts to keep a positive attitude, I am worried to death that this nerve injury will take over my life, cause me to lose my job or worse. I have been prescribed an antidepressant but I do not know if this will help with the pain and anxiety that I am suffering caused by my lingual nerve injury. This is starting to affect all aspects of my life. I am not able to talk like I used to at work, the pain and numbness interfere with my relations with my partner and, for some reason, I am not as comfortable or confident in social situations as I used to be.

Most of us don’t realize it, but a lot of happiness and enjoyment in our lives is tied to food and the social food scene. Enjoying meals at home with family or eating out and a special restaurant with friends are just two examples of how a lot of our enjoyment in life centers on food. To have an injury to your  tongue and to not be able to taste foods as you did in the past, is certainly a constant reminder of the dental malpractice that caused your injury and it does not go away.
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As an Atlanta lawyer who litigates many dental malpractice cases, I receive calls from many potential clients who have been seriously injured in the dental chair. Many times, the potential client was treated by a general dentist when the procedure required the skill and training of a specialist. There are 9 specialties in dentistry. In medicine, these areas of specialization are referred to as sub-specialties, however they are know as specialties in the area of dentistry. The areas are: Oral and Maxillofacial Pathology, Oral & Maxillofacial Radiology, Oral & Maxillofacial Surgery, Orthodontics and Dentofacial Orthopedics, Pediatric Dentistry, Periodontics and Prosthodontics.
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According to a recent article out of England, one out of 10 dental nerve injuries are caused by implants that damage the inferior alveolar nerve which runs under the teeth in the jaw. As an Atlanta attorney who handles dental malpractice cases on a regular basis, this confirms what I have observed over the last few years: dental implants, root canals, local anesthetic nerve block injections and extraction of mandibular wisdom teeth are the leading causes of dental nerve injuries that I encounter as a lawyer.The malpractice which is causing these injuries that are occurring at an alarming rate from dental implant procedures usually is one of the following:

• Failing to perform an adequate and sufficient pre-surgical implant placement work up and evaluation, including measurements so as to determine the depth of the available bone into which the implant could be placed without injury to the nerve;
• Failing to properly read the post-implant x-ray taken on the day the implant was placed, which shows the implant in the inferior alveolar nerve canal;
•  Failing to take into account the location within the mandible of the inferior alveolar neurovascular nerve bundle so as to allow for the safe placement of the implant without invading the nerve and causing injury to the nerve;
•  Placing the implant so as to violate the nerve canal and injure the inferior alveolar nerve canal;
• Failing to timely treat and/or remove the implant after becoming aware of  complaints of numbness;
•  Failing to adequately monitor the nerve injury and mitigate the consequences of the paresthesia after placement of the implants and failing to timely refer the injured patient to a nerve specialist.

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In order to pursue a dental malpractice lawsuit in Georgia, the injured Plaintiff must attach an affidavit to the complaint from a dental expert stating at least one act of malpractice which caused or substantially contributed to the injuries complained of in the lawsuit. The choice of which dental area specialty the expert will possess is usually dictated by the specialty and or treatment involved in the case.
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As an Atlanta Dental Malpractice Lawyer, I see many pre-treatment x-rays that are below the standard of care because the films do not sufficiently visualize the root apices (root tips) of the tooth that the dental procedure has to be completed on. In many cases, this leads to an extraction or root canal which results in a permanent nerve injury to the client’s inferior alveolar nerve. If proper x-rays are taken by the treating dentist’s staff, the dentist would be able to see the apices, surrounding bone, and the proximity of the roots to the inferior alveolar nerve.
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A large part of my Atlanta personal injury law practice is devoted to dental nerve injuries. Unfortunately, many clients who have been injured after going to the dentist find themselves with little hope of recovery. As indicated by this article by well-regarded micro-neurosurgeon, Shahrokh Bagheri, whether surgery can provide relief depends largely upon the age of the patient and the length of time between the injury and the attempted corrective surgery. In other words, if you are young, and your lingual nerve was injured less than 9 months ago, you are a good candidate for microsurgical repair.

Lingual nerve injury is a complication most often associated with wisdom teeth extraction or other dental procedures that require administration of local anesthetics. In the case of lingual nerve damage secondary to tooth extractions, it occurs because, in the region of the wisdom tooth, the lingual nerve often lies very close to the gum and thin bone known as the lingual plate that lies just on the inside of the crown and root of the wisdom tooth. If the extraction is done below the standard of care and the lingual plate is fractured, the lingual nerve is exposed to trauma from the extraction.

The lingual nerve itself supplies taste and sensation to the front two-thirds of the tongue. So if you have a lingual nerve injury, half of your tongue, could be both profoundly numb, and devoid of the sense of taste. In addition, you could suffer from pain caused by the nerve injury. It can be a devastating injury which can negatively impact ones life and is sometimes permanent.

Repair of dental nerves in the facial region can be done if the diagnosis is made in a timely fashion. These repairs are usually performed by a maxillofacial reconstruction expert of a microneurosurgeon. The sooner the repair is attempted, the more likely the repair will be successful. However, the microneurosurgeon does not want to operate too soon, as intervention is to be avoided if the nerve will regenerate on its own without surgical intervention. Obviously, this is the best scenario, but not always possible.

Robert J. Fleming has been handling dental malpractice, medical malpractice, car accident cases and premises injury cases for individuals and families who have been harmed, injured or died as a result of the carelessness or negligence of another for more than 20 years. He practices in and around the Atlanta, Georgia area including handling lawsuits in Fulton, DeKalb, Clayton, Gwinnett, Cobb and other counties and nearby cities including Alpharetta, Austell, Avondale Estates, Chamblee, College Park, Conyers, Duluth, Decatur, Doraville, Hapeville, Johns Creek, Jonesboro, Lawrenceville, Norcross, Peachtree City, Riverdale, Roswell, Sandy Springs, Stone Mountain, and Smyrna. If you have been seriously injured and would like discuss your case in complete confidence, contact Robert J. Fleming directly on (404) 525-5150 or contact us online.
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As the year progresses, I am seeing a marked increase in the number of calls from injured dental patients. The vast majority of these injuries seems to be dental nerve injuries following dental procedures such as tooth extractions, root canal therapy and dental implants.

Not every dental nerve injury is due to malpractice. However, if you have suffered a permanent dental nerve injury and you suspect it may be the result of dental malpractice, please contact us for a case evaluation.
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