Medical Malpractice in Dental Treatments

Medical malpractice in dental treatments can occur when dental care is provided in a manner that does not comply with the accepted professional standard of care, resulting in physical, mental, or financial harm to the patient. To establish a cause of action, it must be shown that the dentist owed a duty of care, that there was a deviation from reasonable medical practice—such as a flawed treatment, a misdiagnosis, or a lack of informed consent—and that a causal link exists between the negligence and the resulting harm.

Table of Contents:

• What is Medical Malpractice in Dental Treatment?
• The Legal Difference Between a Recognized Medical Complication and Negligent Dental Treatment
• The Most Common Focus Areas of Negligence by Type of Dental Treatment
• The Duty of Informed Consent in Dentistry (Presenting Treatment Alternatives and Costs)
• Evidentiary Aspects and Compensation in a Lawsuit
• Practical Guide: Step-by-Step for a Patient Who Experienced a Failed Dental Treatment
• Medical Malpractice in Dental Treatments - Frequently Asked Questions (FAQ)

Few people look forward to an appointment with the dentist. Nevertheless, visiting the dentist helps maintain oral health, resolves toothaches, and prevents more complex dental problems. Unfortunately, not all dental treatments go as planned. In rare but significant cases, dentists can cause more harm than good due to negligence or poor-quality care. Can you sue a dentist for the damage caused to you? If a dentist fails to meet the standard of care and you suffer harm, you may be able to file a medical malpractice lawsuit.

What is Medical Malpractice in Dental Treatment?

Medical malpractice in dental treatments occurs when a dentist, oral and maxillofacial surgeon, orthodontist, or another dental professional causes harm by failing to provide care that meets accepted standards. Similar to general medical malpractice, negligence in the field of dentistry is a form of professional malpractice.

To prove medical malpractice, the patient must prove negligence—meaning that the dentist did not meet the required standard of care. Furthermore, the patient must prove that harm was caused and demonstrate a direct causal link, meaning the damage is a result of the negligent treatment.

The Legal Difference Between a Recognized Medical Complication and Negligent Dental Treatment

Medical malpractice lawsuits are considered complex and complicated; malpractice lawsuits in dentistry are considered among the most complex of all. The reason for this is that in most cases, patients do not know how to tell in real-time whether the medical team performed their work properly—due to a lack of understanding, side effects that are normal for the medical treatment, and the inability to monitor the doctor's actions during the treatment.

Not every harm caused to a patient following dental treatment will constitute grounds for a medical malpractice lawsuit, and pain, swelling, or infection do not necessarily indicate faulty treatment. Dental treatments, like many medical procedures, involve risks and side effects. For example, temporary pain after a tooth implant, a feeling of numbness after anesthesia, sensitivity in the mouth following a root canal, and more. These complications are considered part of the risks of the treatment when the patient knew about them in advance.

On the other hand, negligent dental treatment is defined as such when the dentist deviated from the accepted medical standard required of them as an expert. The question asked is whether a reasonable dentist, with similar education, would have acted similarly under the same circumstances. If the answer is negative, there may be grounds for a malpractice lawsuit.

The Most Common Focus Areas of Negligence by Type of Dental Treatment:

Negligence in Diagnosis, Missing X-rays, and Building an Aggressive/Unnecessary Treatment Plan

Skilled dentists are proficient in identifying and treating a wide variety of oral health conditions, ranging from tooth decay to more severe infections or even early signs of oral cancer. But when something is missed or misdiagnosed, the consequences can be severe. A misdiagnosis can lead to incorrect treatment, unnecessary delays, or no treatment at all. For many patients, a misdiagnosis can lead to worsening symptoms, more invasive procedures later on, or permanent damage that could have been prevented.

Alternatively, a dental treatment plan may be considered negligent when the dentist performed unnecessary treatments that it was not at all clear the patient required. For example, performing extractions and root canals or installing crowns in situations that could have been resolved with conservative treatment. In addition, tailoring an aggressive plan that does not match the patient's medical condition may also be considered medical malpractice.

Negligence in Dental Implants: Injury to the Jaw Nerve (Lack of CT) and Implant Failure

Dental implants have become the preferred method for tooth replacement, and these procedures have a very high success rate. The implants, which are surgically embedded into the jawbone and gums, fuse with living tissue and support a crown, bridge, or denture in the same way natural teeth would.

Dental implantology is a complex procedure, and a doctor's error can lead to severe damage. Implants placed in the jaw sit close to nerves, the sinus cavity, and bone structures that can be permanently damaged due to negligent placement. The dentist must evaluate bone density, map nerve canals and sinus anatomy, and ensure there is sufficient bone structure before placing the implant. When dentists skip detailed planning, rush through treatment, or take on cases beyond their skill level, patients get hurt.

Common Injuries in Dental Implants

Sinus Perforation - One of the most serious errors in implant placement is the perforation of the maxillary sinus - the air-filled cavity in the skull located directly above the upper jaw. When a dentist places an implant too high without first performing a sinus lift or a bone graft to create sufficient vertical space, the implant can puncture the sinus membrane.

Sinus perforation causes pain, carries a risk of chronic infection, and often requires the complete removal of the implant before any corrective procedure can begin.

Incorrect Implant Placement - An implant placed too far toward the front of the jaw, too close to the midline, or at the wrong angle, can fail and may be physically impossible to restore.

Buccal Bone Loss - When an implant is placed too far buccally (outward), or when integration fails due to poor placement, the jawbone resorbs. Unfortunately, this process is often irreversible without grafting. Significant buccal bone loss causes both functional and aesthetic problems and substantially increases the cost and complexity of corrective treatment.

Tooth Fragments - Negligent dentists sometimes leave behind root fragments from a tooth during extraction prior to implant insertion. These can cause chronic inflammation and infection, compromise the implant, and even require additional surgical intervention to treat before the implant can be corrected.

Nerve Damage - Implants placed near the inferior alveolar nerve, which runs along the lower jaw, can cause permanent nerve damage. Symptoms include numbness, tingling, pain, and electric shock sensations. Nerve damage resulting from a negligently placed implant may require surgical repair and can cause permanent loss of sensation in the lips, chin, or tongue.

Additional Implant Injuries - Infection of the jawbone, total tooth loss (edentulism), implant fracture, and mini-implant failure.

Negligence in Root Canals: Leaving Broken Instruments in Canals and Defective Fillings

Root canal therapy is considered one of the most common procedures in dentistry, aimed at preserving a damaged tooth by cleaning the root canals and filling them with a sealing material. Proper treatment can extend the life of the tooth by many years, but a failed or negligent treatment can lead to a painful outcome and irreversible damage.

When performing root canals, dentists use thin, needle-like instruments that are prone to breaking. The fact that the instrument breaks does not in itself constitute negligence on the doctor's part, but they must know how to handle these cases and ensure that no remnants are left in the patient's gums. Combined with a post-procedure X-ray, it is possible to verify that no foreign material remains that could cause infection and even the loss of the tooth.

Negligence in Extractions and Dental Surgeries (Damage to Adjacent Anatomical Structures)

Errors made during dental surgeries, such as extractions, implants, or corrective jaw surgeries, are another form of malpractice in dentistry. These surgical errors include nerve damage, injury to surrounding tissues, or extracting the wrong tooth.

Common Injuries to Anatomical Structures:

Sinus Complications – Damage during surgery to the maxillary sinus cavity, causing infections and chronic inflammation.

Nerve Damage - Injury to the lingual nerve or the jaw nerve during the surgical procedure can cause numbness or loss of sensation in the lips, tongue, or chin.

Jaw Fracture – Applying massive and uncontrolled force can cause a fracture in the jawbone.

Negligence in Prosthodontics: Crowns, Bridges, and Bite (Occlusion) Damage

Prosthodontics and oral rehabilitation is a sensitive and delicate field in dentistry because it focuses on complex procedures that sometimes combine several specialties. For example, prosthetic works (installing crowns and bridges), orthodontic procedures, dental implants, and more. Here, when there is a failure in treatment—whether in planning or in coordination between the different stages of the procedure—the damage can be permanent and accompanied by pain along with substantial financial expenses.

Negligent treatment in oral rehabilitation works can include improper fitting of a bridge or crown, which can cause discomfort, a change in the bite, and harm to the aesthetic appearance.

Negligence in Periodontal Treatments (Failure to Diagnose Gum Disease Leading to Tooth Loss)

Gum Diseases

Periodontal (gum) disease is a common medical condition in the population, but if it goes undiagnosed or untreated, it can have severe health consequences.

Gum disease begins as inflammation and, without proper treatment, worsens and leads to gum recession, infection, bone loss, and tooth loss. Periodic checkups at the dentist and good oral hygiene should be enough to identify and treat early signs. But when dental professionals fail to properly diagnose or treat the condition, the consequences can be long-term and painful.

If the gum disease developed or worsened due to poor dental treatment, the patient may have grounds for a medical malpractice lawsuit. This applies if the doctor failed to diagnose the disease at an early stage, failed to refer the patient to an appropriate specialist when necessary, provided inadequate or incorrect treatment, or missed warning signs indicating the deterioration of the disease.

Orthodontics

An orthodontist specializes in straightening teeth and correcting the jaw and bite. Proper orthodontic treatment not only improves appearance by aligning the teeth, but it can also facilitate chewing, eating, and speaking.

Orthodontists install appliances to straighten teeth and then conduct periodic checks, adjustments, and monitoring until the treatment is complete. Afterward, the orthodontist removes the appliance. Common cases of negligence in orthodontic treatment include improperly installed braces or appliances that caused jaw problems, unnecessary tooth extractions, performing redundant procedures, leaving braces on for too long, untreated infections, and more.

Negligence in Aesthetic Dental Treatments (Orthodontics, Whitening, Veneers, and Irreversible Damage to the Tooth)

Cosmetic dentistry is dental care aimed at improving the appearance of the patient's teeth rather than for therapeutic purposes. Treatments include orthodontic work such as "Invisalign" (invisible aligners to straighten teeth), crowns, dental veneers, and teeth whitening.

Cosmetic procedures are not without risks. For example, preparing a tooth for a veneer involves grinding down the tooth enamel to make room for the veneer. It is not uncommon for too much enamel to be removed, leading to microscopic cracks in the tooth. This, in turn, can damage the nerve and lead to pulp necrosis, a condition that requires additional surgical intervention.

In other words, there are cases where not only does the patient's cosmetic appearance fail to improve, but unnecessary damage is caused to the teeth and oral structure. The consequences of negligent treatment in this situation mean additional treatments, financial expenses, and a final result that may not meet the patient's original aesthetic demands.

Negligence in Anesthesia, Sedation, and Pediatric Dental Treatments

Negligence in Anesthesia

Every year, dentists and oral and maxillofacial surgeons perform thousands of procedures on patients under anesthesia. Many patients are children who require sedation due to unique physical conditions or psychological issues such as fear and anxiety.

Types of anesthesia in dentistry include local anesthesia, targeted numbing, sedation (twilight anesthesia), and even general anesthesia. Methods used for dental sedation in children include minimal, moderate, and deep sedation.

Medical malpractice in anesthesia cases can occur due to administering the wrong dosage, allergic reactions, failure to monitor vital signs, failure to review medical history and medication intake, or causing damage to adjacent teeth. In exceptional cases, complications can lead to brain damage and even death.

Negligence in Dental Treatments for Children

When it comes to children and dental malpractice, courts tend to be strict and demand rigorous standards from dentists. The main reason for this is that children are in growth stages, as are their oral and dental structures. A doctor's mistakes during the growth phase can lead to greater and permanent damage. In dental treatments for children, there is a clear preference for preserving natural teeth over extraction and resorting to conservative treatments over surgical ones.

Here, medical malpractice can manifest as unnecessary extraction of a primary (milk) tooth, incorrect dosage of anesthetic, failure to take appropriate sedation measures for the child, damage to a developing permanent tooth, and even failure to properly instruct the parents.

The Duty of Informed Consent in Dentistry (Presenting Treatment Alternatives and Costs)

According to the Patient Rights Law, a dentist must obtain the free and informed consent of the patient for any treatment. They must provide the patient with all the necessary medical information so the patient can decide whether or not they want the treatment.

Under the law, it is established that the doctor must present relevant treatment alternatives to the patient (including refraining from treatment), present the recommended treatment along with its advantages and inherent risks, and present the full picture so the patient can decide for themselves.

If the doctor failed to provide full information prior to the treatment and the patient did not give informed consent, the patient may claim a violation of autonomy and can sue for this within a medical malpractice lawsuit.

Evidentiary Aspects and Compensation in a Lawsuit

For a dental malpractice lawsuit to be accepted, it must be proven that the doctor deviated from the accepted medical standard, demonstrate the harm caused to the patient, and show a direct link between the negligent treatment and that harm. To prove the lawsuit, it is necessary to document the medical file and obtain an expert opinion in the field.

The Crucial Importance of the Medical File, Clinic Records, and X-ray/CT Scans

In medical malpractice lawsuits in general, and particularly in lawsuits seeking to prove the negligence of a dentist, documentation of the medical treatment is of crucial importance. This documentation includes the full medical file, clinic records, tests and X-rays, medications received, and any other existing documentation. Based on the medical documentation (combined with the opinion of a dental expert), it will be possible to prove the harm caused to the patient and the link between the harm and the negligent treatment.

How Do You Prove the Causal Link Between the Failed Treatment and the Prolonged Damage?

Proving the causal link between the negligent treatment and the harm caused relies primarily on the patient's medical documentation and the professional opinion of a medical expert in the relevant field. The expert, based on the medical records and the patient's condition, can indicate whether the doctor deviated from the accepted standard and demonstrate the link between the negligence and the damage ultimately caused.

What Compensation Can Be Received (Including Financing Costs for Future Rehabilitative Treatment)?

Compensation in malpractice lawsuits (and tort lawsuits) is divided into two – compensation for pecuniary (monetary) damage and compensation for non-pecuniary damage.

Pecuniary damage – These are compensations given for damage that can be quantified, such as the costs of financing future rehabilitative treatment, medications, travel, past and future expenses incurred by the patient, and loss of earnings.

Non-pecuniary damage – This is compensation for damage that cannot be objectively quantified and is left to the discretion of the court. This includes compensation for pain and suffering, aesthetic impairment, and loss of function (for example, in cases of nerve damage).

Statute of Limitations in Dental Lawsuits (When Does the Clock Start Ticking?)

As a rule, the statute of limitations for filing medical malpractice lawsuits stands at 7 years from the day of the occurrence. However, a patient does not always discover the damage immediately, and therefore several exceptions exist in the law that allow the limitation period to begin at a later stage.

Late Discovery Rule – In cases where the patient discovered the damage or negligence at a later stage and not on the day of the treatment itself, the statute of limitations will begin counting from the day they discovered the damage, provided that 10 years have not passed since the day of the event.

Minors - In the case of minors, the statute of limitations begins counting upon their reaching the age of 18 (becoming adults), meaning they can file a lawsuit for dental malpractice until the age of 25.

Other Exceptions - In cases of a person who is unfit to make decisions for themselves (physically or mentally), the limitation period may be paused. The same applies to cases where the doctor deliberately concealed information.

Practical Guide: Step-by-Step for a Patient Who Experienced a Failed Dental Treatment

If a patient believes that damage was caused to them due to negligent treatment by a dentist, they must act on several levels:

1. Documenting the material – The patient must collect and keep all medical records regarding the negligent treatment (tests, scans, appointments, medications, etc.).
2. Seeking legal counsel – If there is a suspicion that the dental treatment was conducted negligently, it is advisable to contact a lawyer specializing in medical malpractice lawsuits as soon as possible. Based on the information before them, the lawyer will know how to evaluate whether there are grounds for a malpractice lawsuit and guide the patient on how to proceed.
3. Obtaining a professional expert opinion – A specialist physician in the relevant field will formulate an opinion based on the examination of the patient and their medical file. This is done to prove that there was indeed negligence in the treatment and the causal link between that negligent treatment and the harm caused.
4. Filing a complaint with the Ministry of Health – In parallel with filing a medical malpractice lawsuit to obtain compensation, a complaint can be filed against the treating physician with the Ministry of Health. The complaint is examined by the Ombudsman for Dental Medicine. Handling the complaint is important in order to protect the public from the recurrence of negligent cases.

Collecting the Full Medical File and Dental Scans from the Treating Clinic

The Patient Rights Law establishes that a patient is entitled to receive their full medical file from the entity that treated them. This law also applies to dental treatments, and therefore, the patient must contact the clinic where they were treated and request the entire medical record, including dental X-rays. External imaging centers are also obligated to provide a physical or digital copy of the scans.

The Uncompromising Need for an Opinion from a Dental Expert (Surgeon/Prosthodontist/Endodontist)

In any medical malpractice lawsuit, an opinion from an expert in the relevant field is required to prove the case. The expert can provide the necessary evidence that the doctor deviated from the accepted medical standard (and show how they, as a reasonable specialist doctor, would have acted in such cases). Additionally, the expert's opinion is required to prove the harm caused to the patient and the link between the negligent treatment and that harm. This opinion is not only required to prove the lawsuit but also to quantify the damage and the compensation due to the injured patient. In the field of dentistry, there are various specialists (such as an endodontist who is a root canal specialist, a maxillofacial surgeon, a prosthodontist, a periodontist, etc.). When turning to obtain a professional expert opinion after negligent treatment, it is important to contact a specialist in the specific field where the negligent treatment took place.

Who Bears the Legal Liability? (The Treating Doctor, the Dental Clinic Chain, or the Health Fund)

In medical malpractice lawsuits, you can sue the treating dentist, and in many cases, you can also include the clinic, the clinic chain, or the health fund (Kupat Holim) within the framework of which the treatments were performed.

When it comes to a private doctor, the lawsuit will be filed against them and against the insurance company insuring them. If it involves a doctor operating within a clinic or a private chain, the institution can be included under the claim of vicarious liability. If the treatment was carried out within a public body (health fund or hospital), the lawsuit will be filed against it.

Complaint to the Ministry of Health vs. Filing a Tort Lawsuit

When a dentist is negligent in their duty, action can be taken against them on two levels – a medical malpractice lawsuit (civil) and/or a complaint to the Ministry of Health.

Within the framework of the procedure at the Ministry of Health, the complaint is submitted to the Ombudsman for Dental Medicine, who examines the complaint, and subsequently it is determined if and what sanctions will be set regarding the doctor who was negligent. This is a procedure whose role, on the one hand, is to protect the public from recurring cases of negligence and, on the other hand, is intended to punish the doctor for negligent conduct.

The process of filing a complaint with the Ministry of Health is different from filing a civil tort lawsuit. Within the framework of the lawsuit, the patient sues the doctor/medical institution for the harm caused to them, and they are required to prove that there was negligence, that harm was caused to them, and the causal link between the two.

Filing a civil lawsuit does not contradict filing a complaint with the Ministry of Health, and the patient can act on both levels simultaneously.

Medical Malpractice in Dental Treatments - Frequently Asked Questions (FAQ)

Is every failure of an implant or a fallen crown automatically considered negligence?

No, not every failure of an implant is considered negligence. These are complex dental treatments that also depend on other factors such as the patient's health status, lifestyle, and hygiene. Negligence in treatment may exist when the diagnosis and planning were flawed, the installation of the implant or crown was incorrect, and in other specific cases.

Does signing a consent form before treatment waive my right to sue?

Signing an informed consent form does not waive the right to sue. First, even if there was informed consent, one can sue for the negligent treatment itself. Second, a consent form does not mean that the doctor provided all material information orally, or that the specific risk that materialized was detailed to the patient at all.

Can a lawsuit be filed even if the damage is temporary and completely fixable?

If due to poor treatment a compensable damage was caused to the patient, even if it is a temporary damage, they are entitled to claim compensation.

How long does a legal proceeding for a dental malpractice lawsuit last?

A medical malpractice lawsuit is a long and complex process and can last several years. In many cases, the parties reach a settlement, thereby shortening the duration of the proceeding.

1. Summary and Legal Disclaimer

Negligent dental treatment can cause great damage and bring long-term consequences with it – chronic pain, inflammations and infections, deformity in the mouth structure, mental suffering, and more. If you believe you fell victim to negligence in a dental treatment, it is advisable to act quickly to protect your rights and demand the compensation due to you.