Although the legal principles in pursuing dental negligence claims are no different to any other form of medical negligence, we have identified many recurring themes. This factsheet is not a list all of the potential areas of dental negligence, but reflects those issues that we encounter most frequently. If any of these scenarios are familiar to you, or if you have any concerns in respect of the shortcomings in the standards of dentistry that you have received, please contact us, whereupon one of our team of experienced health lawyers will be pleased to assist.
A dental implant is, in effect, an artificial tooth root that is submerged into the jawbone. When dental work such as a crown or even a full set of dentures is added, one or more missing teeth can be replaced. After the procedure has been performed, the implant is buried in bone and left undisturbed. It is then uncovered, and connected to a small metal post that secures and supports the artificial tooth. In order for the implant to be successful, there must be enough bone in the jaw, and it must be sufficiently strong to hold and support the implant. If there is not enough bone to hold the implant, a bone graft procedure may be necessary.
This procedure has a 75% success rate. Common underlying causes of failure are:
- Failure of the implant to adequately fuse with the bone
- Inadequate assessment of the jawbone and improper positioning of the socket
- Poor quality jawbone
- Infection of the implanted area
- Substandard quality implant
- The patient’s underlying poor health. For example, diabetes or gum infection can both add to the risk of this procedure.
Cosmetic dentistry is any dentistry that is undertaken with the aim of improving the appearance of a person’s teeth, rather than for clinical reasons. It is normally performed by either a prosthodontist or an orthodontist. The most common forms are teeth whitening, reshaping (in order to alter the length, width or positioning of teeth), veneers, or gum surgery. Problems with cosmetic dentistry typically arise when the treatment has not been properly planned, or it has been undertaken by a General Practice Dentist (GPD), rather than a suitable specialist.
Common risks associated with these procedures are:
- Chemical burns or over bleaching arising from teeth whitening
- Nerve exposure, poor shape, or breakage, arising from reshaping
- Gum damage or tooth sensitivity, arising from veneers
- Removal of too much gum, arising from gum surgery.
Restorative dentistry involves the study, diagnosis and integrated management of diseases of the teeth and their supporting structures. The resulting treatment will depend upon the functional or aesthetic requirements of the individual. The most common form of treatment is a filling.
This area of Dentistry is becoming increasingly specialised. Many dental negligence cases involve GPDs carrying out work to an unsatisfactory standard in circumstances where the patient ought to have been referred to a specialist dentist, or a dental consultant.
During the course of dental work and surgery, it is possible that nerves may become damaged. A lingual nerve injury can be caused by an anaesthetic injection or tooth extraction.
Common causes of nerve damage include inflammation of the tissue around the nerve, scalpel wounds, or prolonged contact with rigid surgical equipment. The resulting nerve damage may sometimes be permanent, unless the nerve damage is repaired.
Typical symptoms include tingling or numbness in one side of the face, jaw or neck. This may resemble pins and needles. It can sometimes result in a severe burning pain, and can be treated with pain medication.
Periodontal disease is more commonly known as gum disease, and is responsible for a significant proportion of adult tooth loss. It is caused by bacterial plaque, and can normally be identified by loose teeth and occasional bleeding.
If periodontal disease is not properly treated in time, these symptoms will worsen, resulting in increasingly sore gums and tooth loss. If it is detected in time it can be successfully treated by scaling and root planning, followed by proper daily cleaning.
Informed consent and dental negligence claims
Informed consent is the process by which a patient agrees to undergo the proposed course of treatment, after a discussion of advantages, disadvantages, alternatives, and associated risks. Whilst all dentists should understand the importance of clear communications with their patients, some fail to do so, resulting in unnecessary, risky, inappropriate and expensive surgery. The dentist should use easily understandable language, give the patient the opportunity to ask questions, and be satisfied that the patient does understand the dental procedure. All patients should provide their informed consent before dental treatment begins.
The purpose of informed consent is to ensure that the patient has a full understanding of the proposed treatment. It can be written or verbal. Even if a patient has signed a properly executed form, consenting to treatment, this does not protect the dentist against a claim for negligence. This very point was recently considered by the Court of Appeal in the case of Dean V Phung, where the dentist decided to cap every one of the patient’s teeth, not because of clinical need but for his own financial gain. The Court decided that where the treatment is not necessary, there cannot be any informed consent and that whenever there is a dispute in respect of informed consent, the burden of proof falls upon the medical practitioner.
For further advice on dental negligence claims, please contact one of our expert health lawyers on 4929 3995 or firstname.lastname@example.org