1. Dental Malpractice Cases and Settlements
DH 226: Dental Ethics and Law
Ms. Baker

2. Periodontal Neglect Case
55 year old school teacher who had been under the care of the same general DDS for 32 years.
She returned regularly for dental cleanings by the DDS not the hygienist.
DDS did a FMX in 1970, and regular BWs yearly.
December, 1995, she developed a periodontal abscess, a new FMX was taken.

3. Periodontal Neglect Case
DDS never informed patient about onset or progression of periodontal disease.
DDS referred patient to periodontist.
She lost several teeth and was treated with 4 quads of periodontal surgery.
Case was settled for 100,000 dollars in Dade County, Florida.
August, 2012

4. Periodontal Abscess Case
38 year old mail carrier who went regularly to the same general DDS for several years.
Patient complained about a “white spot” above a maxillary central incisor, with pus also coming out of the spot.
DDS referred patient to another general DDS in the practice.
DDS performed periodontal surgery which caused significant recession.

5. Periodontal Abscess Case
DDS who treated the abscess found a maxillary anterior bridge made by the original DDS to be defective and the cause of the periodontal abscess.
Patient referred to periodontist who was not happy with the previous SCRP treatment.
Patient needed replacement of 3 unit bridge and gingival graft surgery.

6. Periodontal Abscess Case
All dental expenses paid by patient’s insurance.
Case settled for 24,000 dollars prior to trial.
August, 2012

7. Dental Malpractice Case
48 year old, went to general DDS in October, 1985 for dental extractions and dentures.
Med Hx noted past hx of squamous cell carcinoma of the left mandibular retromolar mucosa treated with radiation in Physicians names and numbers also listed on health hx.
DDS never contacted any of the patient’s doctors to review patient’s medical hx.

8. Dental Malpractice Case
DDS extracted 12 teeth and a root fragment in the mandibular left molar area which had been in the path of the 1982 radiation treatment.
Two months after extractions, dentures were placed.
Patient returned to DDS 4 times during the next 3 months complaining that the lower left extraction site was not healing, had a foul odor, and taste.

9. Dental Malpractice Case
DDS told patient it would heal in time due to the radiation treatment in the area
8 months later the patient returned with advanced osteoradionecrosis.
Patient required a resection of his mandible producing a defect.
Over the next 7 years the patient had 3 bone grafts, pectoralis myocutaneous flap, and soft tissue grafts.

10. Osteoradionecrosis

11. Pectoralis myocutaneous flap

12. Dental Malpractice Case
Patient claimed DDS was negligent in failing to consult an oral surgeon, extraction was negligent and improperly monitored and DDS failed to obtain informed consent.
DDS claimed to patient was at fault for failure to follow up with cancer doctor, continued smoking and drinking habits.
DDS also claimed the head and neck surgeon, radiation therapist and hospital were negligent for not having the tooth extracted prior to radiation treatment.

13. Dental Malpractice Case
Patient received a 2.96 million verdict following a 2 week jury trial.
Verdict reduced 5% for comparative negligence and 25% apportionment of fault went to the hospital.
August, 2012

14. Numb Tongue Case 36 year old office worker.
Had surgical removal of her asymptomatic erupted lower right wisdom tooth by general DDS.
During surgery, her lingual nerve was transected, resulting in permanent right lingual nerve numbness and right-side taste disturbance.

15. Numb Tongue Case
DDS never discussed risks of the surgery with patient nor did she sign a consent form.
DDS made no notation of transection of the nerve in her chart nor did DDS tell the patient what had happened.
Patient called the office for months, but DDS avoided the calls.

16. Numb Tongue Case
A year after the extraction, she saw an oral surgeon who informed her of the nerve injury.
She took the dentist to court for having done unnecessary surgery, lack of informed consent, negligent surgery, and failure to inform her and refer her to a microsurgeon for consult about repairing the nerve.

17. Numb Tongue Case Case settled for 140,000 dollars August, 2012

18. Avoiding Dental Malpractice
Oral cancer the most significant condition a DH may see.
Obtain comprehensive histories, thoroughly perform head and neck exams.
Early detection of cancer can save a life.
Malpractice suits are stressful, expensive, and emotionally draining.

19. Top reasons patients sue…
Failure to diagnose cancer in early stages
Failure to refer
Permanent damage such as: loss of teeth, nerve impairment, severe infections, necessary corrective dental work to eat normally and look acceptable to the public
Patient abandonment

20. How to decrease the chances of a lawsuit
Have a good relationship and communication with your patients.
Stay up-to-date with current research and information.
“If in doubt, refer the patient out.”
Follow-up on care, recommendations, and referrals.
Document everything!!!
Take pictures of suspicious lesions with a perio probe to document size.

21. Save a life: Screen for oral cancer
“If you can save just ONE life in your entire career in dentistry, isn’t worth it to do an oral cancer screening exam on all your patients?”

22. YouTube:
Oral Cancer Save-a-life rap