Practice Areas / Dental Malpractice

• Dental Nerve Injury

• Trigeminal Neuropathic Pain

• Inferior Alveolar Nerve Injury

• Lingual Nerve Injury

• Root Canal Overfill

• Implants

• Gum Disease

• Overcontour

• Inadequate Embrasure Space

• Open Margin

• Shy Margin Of Preparation

• Orthodontic Treatment

• Root Resorption

Dental malpractice can include, among other things: improper root canal treatment; improper removal of teeth; a failure to or delay in diagnosing disease; improper placement of dental implants; improperly performed surgery; the improper administration of anesthetic; or the improper fabrication of dental bridges and crowns. Damages that may result from dental malpractice include lingual nerve or inferior alveolar nerve damage; trigeminal neuralgia; paraesthesia; loss of teeth; the need to replace the crown or bridgework that a dentist had placed you may be entitled to compensatory damages to correct your problems, as well as for your pain and suffering. There are strict time limitations on dental malpractice cases, so if you think you have a valid claim, please call us today for a free consultation.

Dental nerve injuries can be a devastating and traumatic experience for individuals who have been injured. These nerve injuries may be either temporary or permanent, and the symptoms experienced vary, depending on the nerve injured, and the extent of damage to that nerve. While there are many nerves which may be injured during dental procedures, the two most frequent injuries occur to the lingual nerve and the inferior alveolar nerve. For information regarding symptoms of lingual and inferior alveolar nerve injuries, and for a list of dental procedures which most commonly result in injury to those nerves, please use the links provided below.

Common symptoms following an inferior alveolar nerve injury include the following:

• Numbness of the lip, chin, and gums

• Tingling sensation in the lip, chin, and gums

• Pain, Burning, or electric shock sensations in the lip, chin, and gums

• Drooling

• Speech impairment

Procedures:

Inferior Alveolar nerve injuries are most commonly caused by the following procedures:

• Wisdom teeth removal

• Placement of dental implants.

• Overfilled or overinstrumentation of a tooth during a Root Canal Procedure

Filling of the root canal should end at the root tip apex. Overextended filling materials can penetrate the underlying main sensory nerve in the lower jaw or into the sinus in the upper jaw causing a chemical burn to sensitive nerve tissue. Persistent numbness and/or pain in the lip and chin is symptomatic of overfill of lower posterior teeth. If this occurs you should see a maxillofacial microsurgeon to evaluate for immediate decompression surgery to remove the overfill before the nerve becomes irreversibly injured. The Inferior Alveolar Nerve (IAN) or Mental Nerve can be damaged as a result of an overfilled or overinstrumentation of a tooth.

Implants drilled too deep can penetrate the underlying main sensory jaw nerve and cause permanent lip and chin numbness and/or pain. If severe pain and/or numbness persists 8 hours after implant placement surgery, you should contact your dentist.

Trigeminal neuralgia is a neuropathic disorder of the trigeminal nerve that causes episodes of intense pain in the eyes, lips, nose, scalp, forehead, and/or jaw. Trigeminal neuralgia is considered by many to be among the most painful of conditions.

Symptoms:

To describe the pain sensation, people describe a trigger area on the face, so sensitive that touching or even air currents can trigger an episode of pain. It affects lifestyle as it can be triggered by common activities in a persons daily life, such as toothbrushing. Breezes, whether cold or warm, wintry weather or even light touching such as a kiss can set off an attack. Although trigeminal neuralgia is not fatal, successive recurrences may be incapacitating, and the fear of provoking an attack may make sufferers reluctant to engage in normal activities.

In some cases of atypical trigeminal neuralgia, the sufferer experiences a severe, relentless underlying pain similar to a migraine in addition to the stabbing pains. In other cases, the pain is stabbing and intense, but may feel like burning or prickling, rather than a shock. Sometimes, the pain is a combination of shock-like sensations, migraine-like pain, and burning or prickling pain. It can also feel as if a boring piercing pain is unrelenting.

This is a pain condition that happens after an injury to one or more branches of the trigeminal nerve. Trigeminal neuropathic pain is as a result of nerve injury following dental procedures (tooth extractions, root canals, etc), facial fractures, nerve injury from sinus surgery, etc. This condition is often diagnosed as trigeminal neuralgia. This pain is usually continuous and generally is of a burning quality. Many patients with TNP have documented loss of sensation on the face or forehead. It is important to make this distinction, since the surgical procedures that are effective in trigeminal neuralgia, are almost never helpful for TNP, and not uncommonly can make this condition worse.

Cause:

Trigeminal neuralgia in Dental Malpractice Cases is usually caused during Root Canal Procedures resulting in an over extension of a file or an overfill beyond the apex of the root.

Treatments :

Treatments for trigeminal neuralgia include medication and five different procedures Microvascular decompression, radiofrequency rhizotomy, glycerol rhizotomy, balloon rhizotomy, and stereotactic radiosurgery. Atypical trigeminal neuralgia can also respond to the same treatments as “classic” trigeminal, though success rates are slightly lower. Medications used for trigeminal neuralgia are usually anti-seizure medicines, in particular “tegretol”, “trileptal”, neurontin” and “lyrica.” If medication is not helping or patients are experiencing side effects from the medication, then a procedure can be considered. Surgery may be recommended, either to relieve the pressure on the nerve or to selectively damage it in such a way as to disrupt pain signals from getting through to the brain.

Common symptoms following a lingual nerve injury include the following:

• Numbness in the tongue;

• Loss of ability to taste

• Tingling sensation in the tongue

• Pain, Burning, or electric shock sensations in the tongue

• Speech impairment

• Drooling

Procedures:

Lingual nerve injuries are most commonly caused by the following procedure:

• Wisdom teeth extractions

Gum disease is preventable with regular dental care. Periodontal bone loss is detectable on x-rays which may indicate consultation with a periodontal disease specialist called a periodontist. Untreated or inadequately treated periodontal disease usually progresses and causes teeth loss and/or gum abscesses. Damage is caused when a dentist neglects to properly treat the patients gums over a course of time.

Crowns should replicate the natural tooth being restored. If the crown is larger than the natural tooth it will trap bacteria which can cause decay or periodontal gum disease.

Symptoms of overcontour include bleeding gums around the crown or darkening of the gum margin around the crowns . Before turning bluish at the gum margin the gums at the crown margin may turn red and bleed. Healthy gums do not bleed either with or without crowns, bridges or veneers.

Crowns should replicate the natural tooth being restored. If the crown is larger than the natural tooth it will trap bacteria which can cause decay or periodontal gum disease.

Symptoms of overcontour include bleeding gums around the crown or darkening of the gum margin around the crowns . Before turning bluish at the gum margin the gums at the crown margin may turn red and bleed. Healthy gums do not bleed either with or without crowns, bridges or veneers.

A common error is cementing a crowns or veneers with unsealed margins that subsequently leaks and traps bacterial plaque with resulting decay and/or periodontal gum disease. Open margins leave teeth susceptible to decay.

A crown or veneer which does not completely cover the prepared tooth surface over which the crown or veneer is designed to be cemented is defective. Shy margins predispose to tooth sensitivity. Also the exposed dentin surface of the incompletely covered restoration preparation is vulnerable to decay.

Orthodontic treatment can cause serious injury to a patient’s mouth if it is performed improperly. Most of the damage is avoidable. The most serious injuries that occur as a result of poor orthodontic treatment is root resorption leading to loss of teeth and need for implants.

Root resorption can occur during orthodontic treatment. Root resorption is the breakdown or destruction, and subsequent loss, of the root structure of a tooth. Root resorption of adult teeth can occur as a result of pressure on the root surface, most commonly caused by orthodontic treatment. Severe root resorption is very difficult to treat and often requires the extraction of teeth. An orthodontist should take pre-operative x-rays to determine the likelihood of root resorption and should take periodic x-rays to determine if there is any root resorption as a result of the orthodontic treatment. If there are signs of root resorption the orthodontist should closely monitor the situation or remove the braces to avoid the loss of teeth.