Dental expert witnesses are often called upon by lawyers and their clients to assess claims of dental malpractice or liability. We often also advise attorneys on the facts and issues of their cases so they know how best to proceed. However, there are many different types of malpractice and liability cases—and it’s vital to know when an expert opinion will be most useful.
My career has lasted for nearly 40 years, during which time I’ve advised lawyers representing dentists, dental schools, hospitals, and patients on a diverse range of malpractice and liability cases. Let me show you 8 types of cases where an expert opinion can help you achieve the outcome you and your client want.
Malpractice vs. Liability Cases: What’s the Difference?
Most cases that require a dental expert witness fall into 1 of 2 categories: malpractice cases and liability cases. Here’s the difference between them:
A malpractice case involves a dentist who is being sued over allegations pertaining directly to thei treatment of a patient. In these cases, a dental expert witness may be called in to advise the lawyer representing either the plaintiff (the patient) or the defendant (the dentist being sued).
A liability case generally involves an accidental injury that caused dental or facial injuries. In these cases, the plaintiff is normally suing another party (such as a business) for negligence resulting in their injuries. Either party may call in a dental expert witness to assess the severity and likely cause of the dental or facial injuries in question.
Dental expert witnesses are normally called in to work on malpractice cases much more often than they are on liability cases. In fact, it’s estimated that most dentists will be involved in at least 1 lawsuit alleging dental malpractice at some point during their career. For that reason, we’re going to spend most of this article focusing on malpractice cases—but there are plenty of cases in both categories where the specific knowledge, broad dental background, and dento-legal experience of a dental expert witness can be vital for success.
8 Malpractice Cases Where You Want a Dental Expert Witness
The following are examples of malpractice cases where a dental expert witness can be invaluable. I’ve also included some of the questions that a dental expert witness might be called in to answer for each case:
Misdiagnosis occurs when a dentist either fails to diagnose an obvious issue or provides the wrong diagnosis for the problem at hand. In such cases, dental expert witnesses are typically called in to study the facts of the case and answer the following question:
- Has a correct, appropriate and thorough patient evaluation been performed that is the basis of rendering (or not rendering) care to the patient?
2. Standard of Care Issues
According to most lecturers, “the standard of care is that reasonable care provided to a patient that is provided by similar members of the profession in similar cases and like conditions, given due regard for the state of the art.” However, that definition leaves a great deal of room for interpretation, so many malpractice suits revolve around disagreements over whether the standard of care was met for the plaintiff.
In such cases, a dental expert witness is often called to answer the following:
- Have diagnostic steps been taken and has treatment been rendered that are consistent with what a competent, skilled practitioner in the community would have provided under the circumstances?
3. Dental Implants
Dental implants are surgical fixtures inserted in the jaw, where they are eventually meant to fuse with the bone and support replacement crowns and bridges. However, despite their high success rates, dental implants can sometimes fail.
In some cases, patients whose dental implants have failed may try to sue their dentist for malpractice. The questions a dental expert witness might be called on to answer in such cases include:
- Has the proper preparation for dental implant placement and restoration been undertaken?
- Has the implant(s) been well and safely placed and restored with a sound plan that insures a good prognosis, comfort and function?
- Have 3-D scans been taken and evaluated and has grafting been performed when indicated for safe and successful implant treatment?
- Has nerve injury been carefully avoided?
4. Nerve Injuries After Oral Surgery
Oral surgery is often performed to extract teeth, including wisdom teeth. It can also involve placing dental implants in a patient’s jaw, and many other procedures. When removing wisdom teeth or placing dental implants, great respect to the regional nerves and anatomy must be paid, utilizing 3-D scanning technology, excellent judgment and planning, and careful and expert surgical technique.
Post-treatment nerve injuries—including paresthesia—can be challenging and painful. In cases where nerve damage has occurred after oral surgery, a dental expert witness might be asked to answer:
- Has there been careful and experienced planning?
- Has the procedure been performed with impeccable surgical technique?
- Could a nerve injury have been avoided with different diagnostic steps and care?
5. Failure of Restorative Treatments or Crown & Bridge Work
Crowns are artificial teeth that either cover an existing tooth or a dental implant. Bridges are prosthetic devices that usually cover an area where several teeth are missing. They are generally composed of one or more synthetic teeth held between crowns.
Poorly placed crowns can lead to infections, tooth decay, and more. Bridges may also break or slip out of place. If the patient decides to sue their dentist for malpractice over crown or bridge failure, a dental expert witness might be called by either party to answer the following questions:
- Have the teeth been prepared properly?
- Have the crowns, bridges, or other prosthodontic restorations been placed properly to meet the standard of care regarding comfort, facial and dental esthetics, occlusion, function and longevity?
6. Failure of Cosmetic Procedures or Prosthodontics
It might surprise you, but many malpractice suits involve cosmetic dental procedures. Patients might sue when a cosmetic treatment doesn’t produce the effect they were hoping for, or if they experience pain or discomfort after a cosmetic procedure has taken place.
In such cases, the attorney of either the plaintiff or the defendant might call on a dental expert witness to answer the following:
- Has there been a natural and cosmetically pleasing treatment outcome with porcelain laminate/veneer and crown and bridge esthetic care?
7. Complications from Dental, Endodontic, Periodontal or Oral Surgery Procedures
Endodontic treatments are procedures intended to save teeth, such as root canal. Periodontal procedures focus on the gums and other tissues that support teeth, which can be vulnerable to various diseases. Oral Surgery is undertaken to treat dental and oral structures including teeth, bone and nerves.
When a patient sues over alleged complications due to these general dental or specialized procedures, a dental expert witness might be called to answer the following:
- Have dental, endodontic, periodontal diagnoses been properly made and has the correct treatment been rendered?
- Has there been tooth or bone loss as a result of inadequate endodontic, periodontal diagnosis, or treatment?
- Has there been nerve injury or treatment related infection?
8. TMJ and Bite Problems
The temporomandibular joint (TMJ) connects your jawbone to the rest of your skull, but factors such as genetics or jaw injuries can cause these joints to function improperly and result in limitation, pain or discomfort. In some cases, TMJ disorders can even make it difficult for people to open and close their mouths properly.
Care must be taken by dentists in respecting the TMJ complex in all patients, in order to avoid causing or aggravating a bite problem or a TMJ disorder. In cases where a dentist is being sued over TMJ or bite issues, a dental expert witness may be asked:
- Has appropriate care been taken to avoid creating or exacerbating occlusal or temporomandibular disharmonies?
Find a Dental Expert Witness for Your Specific Case
Since the cases mentioned above often involve specific medical terminology or legal definitions that are open to interpretation, it’s critical to seek out a dental expert witness who can provide meaningful support for your argument. Choose an expert witness with specific professional knowledge pertaining to the facts of your case, a broad dental background, and sufficient dento-legal experience to advise you and your client adequately.