Dental implant problems and a dentist’s duty.

The report confirms that in 1997, 10% of all nerve injuries caused by dental work were associated with dental implant problems, resulting from the implant procedure. In 2007, this figure had risen to 30%.

An implant is a rod-shaped screw or clip usually made of titanium which acts as an artificial tooth root. It is inserted into the jaw canal to hold a replacement tooth or bridge after a tooth has been removed or lost. The Report states that it is estimated that 1% of all implants result in nerve injuries each year in the UK.

The cause of the nerve injury can be from the injection of local anaesthesia but, more commonly, dental implant problems can be caused by a dentist mistakenly drilling too far through the jaw canal or the implant itself being too long and asserting pressure onto the nerve causing damage.

The consequences of nerve injuries were highlighted by the analysis of 30 patients with nerve injuries undertaken by King’s College London Dental institute. The subjects had painful symptoms causing problems with speech, eating and kissing.

The study demonstrated that patients were not being given adequate advice and/or care throughout the implant process.

Of the 30 patients analysed, 8 of them felt they were not warned about the possibility of nerve injury and over half of them suffered constant pain or discomfort after the surgery with 40% complaining of numbness.

Increased and continued pain, discomfort and numbness are signals of nerve damage even when the implant procedure was uneventful. Despite these clear signals and widely accepted evidence that early treatment can resolve or minimise nerve damage, 70% of the 30 patients were not referred to a specialist nerve injury clinic until 6 months after surgery.

Dentists have a general duty of care towards their patients and this includes a number of responsibilities, for example, adequately warning patients of the risks of a procedure and adequately preparing for a procedure by assessing the patient and listening to them to determine whether any complications are likely.

Should a dentist fail to warn their patients of the risks of a procedure, or fail to recognise, diagnose and treat a complication that any other reasonable and competent dentist would have recognised, diagnosed and treated, they are likely to have fallen below the standard expected of them and a dentist negligence claim can be made if injury is suffered as a result.

The Dental Negligence Team has recently concluded a claim in relation to nerve injury caused by an implant procedure.

Mrs W had an implant fitted in the lower left side of her mouth in January 2009 under the care of her dentist. During the procedure, despite anaesthesia having been administered, she felt an excruciating pain that she described as a jolt of electricity. Her dentist reassured her and continued with the procedure.

Immediately following the procedure and for 3 days, Mrs W experienced numbness in her lower lip and the left side of her chin. Mrs W’s dentist reassured her again that her symptoms would resolve in time and she received similar advice when she sought a second opinion. However, two years later, the numbness persisted.

The Dental Negligence Team pursued a dental negligence claim for Mrs W.  It was alleged her dentist had failed to assess her treatment appropriately by inserting an implant that was too long and that he should not have continued with the treatment once he was aware that Mrs W was experiencing pain.

Further allegations were that, even as late as 3 months after surgery her dentist had failed to assess or recognise that the implant had gone through the lower jaw canal when she complained of continuing numbness and had failed to refer her for nerve treatment to minimise the damage caused.

Sadly, Mrs W’s nerve damage is expected to be permanent. The Dental Negligence Team achieved a substantial out of Court settlement for Mrs W for her pain and suffering.

Sometimes complications occur as part of the inherent risks in a procedure but problems can develop and continue due to inadequate dental treatment and lack of appreciation of the risks involved. In these circumstances it is therefore important to seek the professional advice of a specialist dental negligence lawyer who can ensure the treatment is fully investigated.