Do you have a case?
If in doubt, use an inexpensive “Desk-top“ report
A desktop report is a short inexpensive independent opinion which can be prepared in order to determine whether your present case have adequate foundation for advancement – is it likely to have potential cost benefits for both client and legal counsel? It will also advise the scientific basis and required evidence of the plan forward.
So-often in the the assessment of a a larger injury, little weight is placed on resultant dental/oral/jaw injuries. Such omission can cost the case and the patient dearly in immediate compensation, pain and suffering as well as loss of function and future costs too.
If the Desk Top report shows the case has merit and and foundation, a full report can strengthen a case, as well as providing the required treatment and quantum.
Potential predictive forensic testing
Sometimes, the ability to foresee the likelihood of success in treatment proposed to rectify or manage injuries sustained can clearly be valuable in some cases. Such predictive testing may alone indicate not only the merits of the case and likely success of treatment, but also the probable means of best correction, this may ‘make the case’.
Areas of expertise include;
Negligence, Causation & Quantum.
Dental practice is changing dramatically in BC as patient’s expectations increase, dental techniques, technologies and new approaches grow almost exponentially while outside influences such as corporate dentistry, often with ‘performance expectations’ and commercial concerns constantly test the market.
Aware of just some of these, The College of Dental Surgeons of BC are reassessing quality control throughout the province. BC Dental Association members are now being encouraged to purchase extra Insurance for legal coverage, advice, representation relating to college complaints, investigations, discipline or appeals.
Claims of dental malpractice.
Failure to provide informed consent
Failure to provide informed consent is a remarkably common occurence these days, along with appropriate record keeping the Dental Expert Witness can assist in indicating what is required, what is not – reasonable, what not.
Diagnosing unsubstantiated or unnecessary treatment
Diagnosing unsubstantiated or unnecessary treatment(s) is unfortunately not an isolated or rare occurence any more. Practice costs and pressures can extend some practitioners values. A Dental Expert Witness can assess this in an impartial manner.
Causation of TMD or other facial or oral pain
Causation of TMD or other facial or oral pain is an area rarely considered which is surprising given its frequency and the general lack of knowledge of general practitioners due largely to poor undergraduate curriculum coverage. A Dental Expert Witness can assist in it’s determination and causation.
Night guards made inappropriately.
Night (grinding) guards made inappropriately or without explanation of possible airway consequences can no longer be condoned. There is adequate evidence from several studies yet still, thousands of night guards are made in B.C every month, frequently with a total disregard to the potential medical consequences. A Dental Expert Witness with experience and an adequate knowledge base [ especially holding Diplomate standing in the American Academy of Dental Sleep Medicine] can assess this rationally.
Failure or delay to diagnose or refer
Failure or delay to diagnose or refer regarding a serious medical condition that consequently worsens leaves the practitioner open to legal action. While there are certain specific things the dentist must do first, there is a balance which a Dental Expert Witness can determine as being appropriate given the “apparent” dental basis of many decisions in Dental Practice.
Inappropriate and/or excessive prescribing
Much press has been dedicated of late to the prescribing habits of doctors and dentists and while it is clear that most indefensible, inappropriate and excessive prescribing is by medical practitioners – dentists must adhere to both codes and common sense.
Nerve damage or neuralgia is a commonly questioned area of practice. Knowing the potential dangers of doing different procedures in different areas of the mouth is a clinical requirement but often requires a common sense, balance of risk and understanding of personal skill level insight. A seasoned Dental Expert Witness may be invaluable in such areas.
Treatment on or removal of the wrong tooth
Treatment on or removal of the wrong tooth must be assessed carefully after the event to ensure that not only was there a mistake performed, but that damage will likely result and what the consequences, including costs will be.
Poorly performed root canals
Poorly performed root canals resulting in excessive pain is a commonly ‘legally’ asked question for which a Dental Expert Witness is usually required. Skill and experience may determine what is poor, adequate, best possible or excellent in result.
Procedures leading to oral or dental pain and/or dysfunction
Any procedure that leads to oral or dental pain and/or dysfunction. Although this may seem obvious, dentistry is not an easy profession to practice given its association both physically and psychologically with pain. A Dental Expert Witness with training in chronic facial pain may obviously be of great assistance.
Chronically or inadequately treated disease.
Gum disease is insidious but progressive. All patients should have a gum “charting” performed routinely. More teeth are lost through gum disease than cavities. Sometimes dentists “look” for cavities to the exclusion of gum review, sometime searching for crowns allows a blindness to the basic diseases of dentistry.
Financial indiscretion (s) were see common after computerization but are becoming more common now despite this. Few medical or dental patients see what is billed through MSP or third party carriers and the chosen ignorance may carry unforeseen consequences to patients and/or clinicians. I have seen a dental team exercise financial discretions and I have seen dentists perform the same illegal activities and try to blame their staff. Clearly such activity is not always cut and dried.
General clinical dentistry and Dental Competence
General clinical dentistry and Dental Competence. There are times when the dentist, despite appearances has done all they can and done it correctly but failed the ‘hoped for’ result. Dentistry is not an easy profession at times! There are times that patient’s expectations (with or without explanation) are simply inappropriate. Equally there are times when this is not so. A Dental Expert Witness may highlight what has been missed in the heat of the moment.
Personal Injury Causes & Quantum, specifically;
1 – MVA, bicycle (Personal Injury), may be dental, oral, jaw or jaw joint type.
Dental, oral, face, jaw and jaw joint are commonly injured due to the head’s prominence, relative instability and vulnerability.
2 – Whiplash type Injuries – jaw injuries are almost always associated due to their anatomical connection.
It is extremely common to see temporomandibular derangement and dysfunction (TMD) in association with Whiplash Type Injuries (WTI), these may be subclinical and materialize after compensation has been made.
3 – Work , falling, tripping, slipping related injuries often give rise to dental injuries.
Just as in the MVA scenario, dental, oral, face, jaw and jaw joint are commonly injured due to the head’s prominence, relative instability and vulnerability especially in a fall without hand or arm intervention.
4 – Sports/Leisure Injuries also often give rise to dental injuries.
Helmets, mouth-guards and other protective devices are clearly of value when worn, although there may be mitigating circumstances to be considered in a case involving sports or leisure injuries in association with the specific injuries themselves.
5 – Others may include assault, airline injuries or food related (foreign object) dental damage.
Other injury causation in the dental, facial and jaw joint (TMJ) areas should be reported and recorded.
(T) – 250 – 575 – 0717