Dental Medical Malpractice - Recommended Lawyers in the Field

Dental treatments are an integral part of our health routine. We entrust dentists with one of the most sensitive and important areas of our body, expecting to receive professional, careful, and skilled treatment. Unfortunately, this expectation is not always fulfilled. When dental treatment fails and causes damage, the crucial question arises: is this a reasonable and unavoidable complication, or is it a case of medical malpractice in dental treatments?

This page is built as a comprehensive guide to understanding the complex field of medical malpractice in dental treatments in Israel. Here at the LawReviews website, you will find a review of legal principles, details of common cases, explanation of the stages of the legal process, and answers to essential questions – all aimed at providing you with knowledge and tools to realize your rights in case of injury. Additionally, you can find details about law firms specializing in medical malpractice in the dental field, for obtaining advice and legal representation when needed.

Legal Elements of Dental Medical Malpractice Claims

A medical malpractice claim is not based on a subjective feeling of disappointment with treatment results. Israeli law requires proof of four cumulative elements, anchored in the Torts Ordinance [New Version], in order to establish grounds for a claim.

1. Existence of a Duty of Care

This is the simplest element to prove in the relationship between a dentist and patient. From the moment a dentist agreed to accept you for treatment, they have a conceptual and concrete duty of care. They are obligated to act with skill, caution, and loyalty toward you, and to take all reasonable measures to prevent harm.

2. Breach of Duty of Care (The Negligence Itself)

This is the heart of the claim. The plaintiff must prove that the dentist deviated from the accepted standard of care. The question is not "what would another dentist do?", but "what would a reasonable and careful dentist do under the same circumstances?". This deviation can manifest in a wide range of ways, from wrong diagnosis, through negligent performance of a procedure, to poor follow-up after treatment.

"The Reasonable Doctor Test": The court examines the conduct of the defendant doctor in comparison to the standard of behavior expected from a dentist with average skill and professionalism. This standard is determined according to professional literature, guidelines from professional associations, position papers, and committees of medical experts.

3. Existence of Damage

The plaintiff must prove that they suffered physical, mental, or financial damage as a result of the treatment. Damage can include pain and suffering, aesthetic injury, tooth loss, need for expensive corrective treatments, loss of work days, impairment of earning capacity, and more.

4. Causal Relationship Between the Breach and Damage

The fourth and decisive element is proving a causal relationship, factual and legal, between the doctor's negligence (breach of duty) and the damage caused. It must be proven that "but for the negligence, the damage would not have occurred" or would have occurred with significantly less severity. For example, it must be proven that the nerve damage caused to the patient is a direct result of negligent performance of extraction, and not a rare complication that could have occurred even with the most careful treatment.

The Importance of "Informed Consent" in Dentistry

One of the central principles in Israeli medical law is "informed consent," anchored in the Patient Rights Law, 5756-1996. According to this law, a dentist is not permitted to treat a patient without obtaining their conscious and free consent.

What is informed consent? Informed consent requires the doctor to provide the patient, in clear and understandable language, with all relevant information for making an informed decision about treatment. This information includes:

• Diagnosis and medical condition (prognosis): What is the problem and what is expected to happen if not treated.
• Nature of the proposed treatment: Detailed description of the procedure.
• Chances and risks: Details of common risks and rare but serious complications involved in treatment.
• Alternative treatments: Presentation of all reasonable therapeutic alternatives, including their advantages and disadvantages.
• The option not to perform treatment at all: And its implications.

Violation of Autonomy:

When a doctor does not obtain informed consent, they violate the patient's autonomy over their body. In many cases, it is possible to file a claim for this head of damage of "violation of autonomy," even if the treatment itself was performed skillfully. If the risk that materialized was not presented to the patient, and the patient can argue that if they had been aware of the risk, they would have chosen a different therapeutic alternative, a solid cause of action may arise. Moreover, treatment without any consent can be considered a tort of "assault."

Common Cases of Medical Malpractice in Dental Treatments

The field of dentistry is broad, and negligence can occur at any stage of treatment and in various areas.

Negligence in Diagnosis and Treatment Planning

• Failure to perform X-rays: Diagnosis and treatment without appropriate imaging (bitewing, periapical, panoramic, CT) that constitute a necessary foundation.
• Wrong interpretation of images: Failure to identify cavities, gingivitis, cysts, tumors, or structural problems in the jaw.
• Building wrong treatment plan: Planning treatment that is not suitable for the patient's condition, or overly aggressive planning that leads to irreversible damage.
• Failure to refer to specialist: A general dentist performing complex treatment (such as complicated root canal treatment or implants in borderline condition) that should have been referred to a specialist (endodontist, periodontist, or oral and maxillofacial surgeon).

Negligence in Conservative and Restorative Treatments

• Fillings and crowns: Filling that is too high, crown that is not fitted and creates pressure on the gums, gaps between crown and tooth allowing bacterial penetration and secondary cavities.
• Root canal treatments (endodontics):
  • Perforation: Drilling through root wall or tooth floor.
  • Instrument breakage in canal: And leaving it without informing the patient or attempting to remove it.
  • Insufficient or excessive root filling: Filling material does not reach the root tip (leaving infection) or exceeds it and causes damage to adjacent tissues.
  • Failure to locate all canals in the tooth.
• Surgical extractions:
  • Extraction of healthy tooth by mistake.
  • Nerve damage: Damage to the mandibular nerve (in lower wisdom tooth extraction) causing loss of sensation in lip and chin, or damage to the lingual nerve causing loss of sensation and taste in tongue.
  • Jaw fracture during aggressive extraction.
  • Penetration into maxillary sinus during upper tooth extraction, without proper identification and repair.

Negligence in Dental Implant Procedures

The implant field is among the most complex and expensive in dentistry, and constitutes fertile ground for negligence claims.

• Poor planning: Performing implants without adequate assessment of bone quantity and quality, usually in the absence of CT imaging.
• Wrong implant placement: Inserting implant at wrong angle, or damaging critical anatomical structures such as the mandibular nerve canal, maxillary sinus, or adjacent teeth.
• Choosing unsuitable implant: Using implant that is too short, too long, or too wide for the given situation.
• Infections: Lack of adherence to sterility during surgery, leading to infection and implant failure.
• Poor restoration on implants: Building crowns or bridges that are not fitted and create excessive load on implants, leading to their loss.

Negligence in Orthodontics

• Poor diagnosis and planning: Starting orthodontic treatment without complete diagnosis of skeletal and dental problems.
• Applying excessive force: Causing damage to tooth roots (root resorption) or gum tissues.
• Lack of proper follow-up: Failure to perform periodic X-rays to examine root condition during treatment.
• Premature treatment completion: Leaving patient with unstable bite or poor aesthetic result.

Process of Filing Dental Medical Malpractice Claims

The legal process in these claims is complex and requires patience and close professional guidance.

1. Collection of medical documentation: The first and most important step is collecting all relevant documentation from the treating dentist, as well as from any other doctor or medical institution visited for corrective treatments. Documentation includes medical records, X-rays, referral letters, and summaries.
2. Consultation with attorney specializing in the field: It is important to contact an attorney with experience and specific expertise in medical malpractice claims, particularly in the dental field. The attorney will examine the material and assess the claim's chances.
3. Obtaining medical-legal opinion: According to civil procedure regulations, a medical malpractice claim cannot be filed without attaching an opinion from a medical expert. The attorney will refer the case to a specialist dentist (usually in the field relevant to the damage), who will examine the case and write a detailed opinion. The opinion will determine whether there was deviation from the accepted standard of care, what damage was caused, and what is the causal relationship between negligence and damage.
4. Filing the claim in court: After receiving a supporting opinion, the attorney will draft a detailed statement of claim and file it with the competent court.
5. Managing the legal process: After filing the claim, the defendant (dentist and their insurance company) will file a defense statement and medical opinion on their behalf. The process includes stages of document discovery, filing affidavits, and sometimes appointing an expert on behalf of the court. In many cases, the process ends in settlement between parties. If no settlement is reached, the case will reach the evidence stage and judgment.

What are the Heads of Damage and Expected Compensation Amount?

The purpose of compensation is to restore the situation to its original state, as much as possible. Compensation is divided into two main types:

Monetary damages (special and future damages):

• Medical expenses: Cost of corrective treatments, medications, consultations, and any medical expense required and that will be required in the future.
• Loss of earnings and lost wages: Past lost wages due to absence from work, and compensation for impairment of future earning capacity if damage limits work ability.
• Travel expenses and third-party assistance: Travel costs for treatments and household help if required.

Non-monetary damages:

• Pain and suffering: Compensation for physical pain and mental suffering caused to the patient as a result of negligence. This is a significant component determined by the court according to severity of injury, age of injured party, and its implications on their life.
• Loss of enjoyment of life: Compensation for impairment of ability to enjoy activities and hobbies.
• Violation of autonomy: Separate compensation for violation of patient's right to make decisions about their body, as mentioned above.

Statute of Limitations in Dental Medical Malpractice Claims

It is important to be aware of the time limit for filing a claim. According to the Limitation Law, a medical malpractice claim becomes time-barred after 7 years from the day the cause of action arose. However, the "limitation race" is often suspended and begins to count only from the moment the patient discovered (or should have discovered) the damage and its connection to negligence ("discovery rule"). In the case of minors, the limitation period begins to count only from reaching age 18, so they can file a claim until age 25.