Types of Expert Witnesses in Dental Malpractice Cases

Many dental malpractice cases hinge on the testimony of a dental expert witness, but other skilled professionals can provide vital context as well. In fact, there are many instances in which even a particularly skilled dental expert witness might seek the perspective of specialists in an adjacent field. As an experienced dental expert witness who remains dedicated to providing accurate and useful information whenever I’m engaged by the legal representatives of a practice or a patient, I consider it my responsibility to research every relevant aspect of each case. Below, I’ll list some of the other specialists who I might reach out to during that process and provide examples of situations where each of these different experts provided valuable input.

An Overview of Other Expert Witnesses

Here is a brief list of other experts who I might consult when preparing to provide case analyses or second opinions in a dental malpractice suit. I’ve also included a short description of what each of these specialists does.

Anesthesiologists

Anesthesiologists are physicians or dentists who specialize in controlling pain and levels of consciousness in patients—typically via local anesthesia, oral medication, IV sedation,  general anesthesia or combinations of these agents.

Dermatologists and Oral Pathologists

Dermatologists are medical doctors who specialize in treating conditions affecting the skin, mucous membranes, nails, and hair. Oral Pathologists are dentists with advanced postgraduate training in diagnosing and treating diseases of the soft and hard tissues of the oral and maxillofacial structures. Their perspectives can be useful in evaluating oral issues and conditions that reflect systemic conditions and/or affect other parts of the body.

Dental Manufacturing & Quality Assurance Experts

Various materials experts (often engineers) provide quality assurance for dental technology companies. In cases where a dental instrument, material or product may have adversely affected a patient, dental expert witnesses might seek such experts out to help determine whether causation or liability belongs to the dentist that used the instrument, material or product or the manufacturer that made it.

Immunologists

Immunologists (also frequently referred to as allergists) are medical doctors who specialize in treating allergies, immunologic disorders, and asthma. Due to the materials and chemicals dental patients may come in contact with, an immunologist can provide critical information in malpractice suits that involve a patient who has suffered an allergic reaction.

Metallurgists and Dental Material Researchers

Metallurgists and dental material researchers are typically engineers who oversee the development and transformation of various materials into useful restorative products and instruments. Since various precious and non-precious metals, and composite, plastic and ceramic/porcelain materials are used in the fabrication of dental restorations and prosthesis (such as crowns) as well as dental instruments, the perspective of a metallurgist and materials experts can be valuable when attempting to determine whether a patient has had an adverse reaction to coming in contact with them

Pharmacologists

Pharmacologists are chemists or biologists who study pharmaceutical drugs and other substances to better understand their effects on organic life—typically with the goal of improving their efficacy for treating physiological and psychological conditions. Since dentists often prescribe pharmaceutical products to their patients for various reasons, a pharmacologist can offer information that can help dental expert witnesses offer an opinion on liability when a malpractice suit involves an adverse reaction to these medications.

How Other Experts Might Factor into Dental Malpractice Cases

Dental malpractice suits are rarely simple, and liability doesn’t always clearly belong to a single party. As a dental expert witness, I’m already a focused doctor and active clinician — but sometimes, it’s still useful to supplement my knowledge. For example, if I’m treating a patient’s oral cavity, my knowledge of the sinuses, pharynx and adjacent tissues should be sufficient to deal with most issues— but in specific cases, it might be useful to seek the advice of a colleague— such as an ear, nose, and throat specialist. The same principle applies when providing expert witness testimony during a malpractice suit. The following examples are all cases where a dental expert witness might call upon one of the other specialists listed in the section above for additional information:

Adverse Reactions to Materials

Some patients are hypersensitive to the materials used in dental restorations (which might include porcelain, titanium, precious metal, acrylic resin and others). A patient who suffers a dermatological, mucosal, or systemic reaction (such as a full-body allergic reaction) during their treatment or following the placement of a dental restoration might consider filing a malpractice suit as a result. In such a case, a dental expert witness would likely attempt to pinpoint what kind of reaction the patient suffered and its causation, so as to determine whether potential liability lay with the dentist performing the treatment or with the company responsible for providing the materials. Dermatologists, materials experts, immunologists, metallurgists, and pharmacologists could all provide useful information.

Adverse Reactions to Medication

Some patients file malpractice suits after reacting adversely to medication that has been prescribed to them. In cases where their side effects have been properly documented and published by the pharmaceutical company producing the medication, it’s likely that liability would lie with the dentist—however, that isn’t always the case. In malpractice cases involving a side effect that has not been previously published, a pharmacologist might be required to provide an opinion. This could help determine whether the pharmaceutical company bears responsibility for the reaction as well as (or instead of) the dentist.

Adverse Reactions to Sedatives & Anesthesia

Dentists administer anesthesia routinely and regularly, especially for patients who have anxiety or a low tolerance for pain. However, a dentist should always utilize and deliver anesthetic agents whose usage is within the levels of their education, training and experience and for which they are prepared to assess and manage potential complications or reactions. There is no margin or error allowable here. Imagine a case where a dentist gives a patient valium for sedation or an antibiotic like penicillin to address infection without being experienced in their administration, and the patient suffers an adverse drug reaction? In such cases, a dental expert witness might seek out an anesthesiologist, infectious disease specialist or pharmacologist to help determine whether malpractice occurred.

Dental X-Rays

X-ray technology, nowadays often digitized and three dimensional, isn’t magic—it needs to be installed, operated and analyzed properly in order to function well. If it isn’t, it may not always detect certain pathologies, which can contribute to poor diagnosis and treatment that constitute departures from the standard of care, and possibly grounds for a malpractice suit. In these cases, an engineer or a radiologist might have information that could help a dental expert witness provide an opinion on who bears liability. Did the dentist make a mistake that prevented them from analyzing the X-rays correctly—or was digitalization of the X-ray not properly done through the software, in which case it might be the manufacturer’s responsibility instead?

Instrument Breakage

Endodontic instruments are thin files used to cleanse the insides of a patient’s tooth during root canal procedures. These instruments used to be handheld, but modern endodontic armamentarium is often attached to handpieces that vibrate or rotate during use to provide greater functionality. If one of these instruments were to come loose and/or break off inside a patient’s tooth, it could prove problematic clinically. In a resulting malpractice suit, the dental expert witness might have to determine whether the dentist’s technique or a manufacturing error was responsible for the breakage of the device. Seeking out a materials expert, metallurgist or endodontist could be extremely useful in this scenario.

Building a Network of Experts

Dental expert witnesses are often some of the most important figures in malpractice suits. Our testimony can help protect patients and practitioners by providing informed opinions on a case’s most vital details—but sometimes, we need additional details from various specialists in related fields. Connecting with other medical expert witnesses helps us create a community focused on objectivity, accuracy and truth. If you need the services of an experienced dental expert witness, please reach out to me and get in touch so that we can discuss how I can help.