Hello Dr. Hall. I had a question about professional negligence.
I do all the preventive appointments/cleaning 2-3 times a year and always ask if everything looks fine. So my dentist had a particular tooth under a “watch” status. But obviously he wasn’t watching very closely, because I ended up needing the tooth extracted and an implant. His excuse was that something on that tooth developed so quickly, like it usually doesn’t. He has kept telling me that things with my teeth develop faster than usual. Anyway, I was very unhappy with my dentist, but gave him the benefit of the doubt.
But then the next thing you know one of the fillings that I also had done at their office about 3 years ago fell out. I went to get it fixed and he tells me that it looks like I need a root canal. So I go to get a root canal done and, surprise, I’m told that I need to do a tooth extraction because the tooth is not savable. So two years in a row I have to pay a lot of money for extractions and implants.
I’ve asked my dentist how is it that I have to do that if I am doing all the preventative appointments/cleaning 2-3 times a year and always ask if everything looks fine.
I could probably understand if this happened to someone who only goes to a doctor when a toothache is killing them. But I do my due diligence and make sure take good care of my teeth. But even the fact that this dentist after the first incident missed warning signs on another tooth is in my opinion is negligence. What do you think about his situation. I will be honest, I want some type of monetary compensation because I am paying thousands of dollars because of poor care.
(See Dr. Hall’s answer below.)
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Yes, I would say that you definitely have a complaint. I’ll need to qualify this by saying that I’m just going from what you’re telling me without seeing these things myself or hearing your dentist’s explanation, but let me try to be helpful by adding what I surmise to what I do know.
It is uncommon but possible for a patient who is faithful in having regular dental checkups to end up needing a root canal treatment. One of the purposes of going in for regular checkups is to prevent that. But I actually had that happen to me several times during a stressful time in my life when I cracked teeth which ended up needing root canals. Another but even less common way that could happen is if there is an old deep filling that gets recurrent decay around it. That decay can quickly progress along the sides of the filling in the softer dentin of the tooth and get under that filling and into the pulp of the tooth. That would more easily happen with amalgam fillings than with the newer composites because the composites are somewhat translucent and it is easier to spot decay that is creeping alongside the filling.
If the first incident you told me about was a virgin tooth that progressed from “watch” to unrestorable in between checkups, that would be gross negligence, in my opinion. With a sharp explorer and the use of x-rays, anything under “watch” status should be quite small.
But I’m guessing that this must have been an old filling that was being watched. Your dentist saw something at the edges of the filling or on the x-ray that indicated there was recurrent decay possibly starting. Here, I’m admittedly going to be just shooting from the hip without knowing all the facts, but it’s difficult for me to justify that tooth going to unrestorable that quickly. For a tooth to be unrestorable, the decay has to progress into the pulp and continue on to the root of the tooth. That’s a lot of decay and how your dentist could miss that is beyond me.
Having a filling just fall out also raises suspicions of poorly done dental work. Yes, it’s possible for a well-done filling to fall out, but not likely, and we’re seeing a disturbing pattern here. Plus, this isn’t just an ordinary “filling fell out” situation, but you are told you need a root canal. And then the question comes to my mind, “Why couldn’t your dentist tell that the tooth was not really restorable? Why did it take the specialist to figure that out?”
So yes, it’s time for you to find another dentist.
About getting some financial compensation here, that’s a little trickier. Is the dentist here vulnerable to a lawsuit? It could be difficult to prove in court that the dentist was negligent in his diagnosis because you wouldn’t have photographs of what the tooth looked like or any documentation about the justification for the “watch” status. You could look at the x-rays at the time, but they may or may not show the problem. So you’re going to be relying somewhat on the good will of your dentist. I would suggest to first switch dentists and then go back and tell this dentist that you don’t want to report this to the dental board or leave a nasty online review but you will unless he compensates you in some way. If that doesn’t work, I wouldn’t recommend going to a lawyer because your case could be tricky to prove.
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.