Wrong Tooth Extraction

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Pulled the Wrong Tooth Out? – Wrongful Extraction Claims.

It will probably not surprise you to read that a wrong tooth extraction is probably the most dreaded of dental errors. It is the stuff of nightmares for clients and is practically indefensible from a practitioners point of view. There are however a surprising amount of issues here that are rarely contemplated by many lawyers or in fact by their clients.

Was the tooth in need of extraction anyway?

This is the first and possibly the simplest question to ask yourself. If the wrongfully extracted tooth was rotten to the core, it is still a breach of duty to take it out without consent. It must be recognised though, it is hardly a loss!

This is often the first port of call for a dentist who is not being entirely straight with the patient. Do you remember having any issues with that tooth? Had the dentist mentioned it before? Does this “excuse” strike you as odd?

Are you being blamed for the error?

The second “defence” in wrong tooth extraction claims and one that seems to arise with annoying frequency is: “its the patients fault for pointing at the wrong tooth”. Incredible as this sounds, it is far from rare.

It is not the patients job to diagnose teeth that may need extracting. It is the responsibility of the dentist to ensure that when an extraction is being contemplated, it is being done so for the right reasons ie that the tooth itself is not salvageable. Dentistry is not the same as a haircut. These extracted teeth will not grow back (usually). Professional service must follow.

Instructing a lawyer on a wrongful tooth extraction claim is not just a matter of them getting a refund for the extraction. You are likely to need a dental implant – future maintenance costs and re-crowning for the rest of your life also – you may still need an extraction of the original tooth.

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What happens next to the gap in my teeth?

In General tooth extraction is associated with some post-surgical effects such as pain, inflammation, bruising, bleeding and infection. Just because the wrong tooth has been extracted doesn’t mean that these symptoms will not be present. You should expect them. They will, thankfully, usually subside in a day or two or a few weeks at most.

Non steroidal anti inflammatory drugs such as ibuprofen can help (if you can take them) to manage these symptoms. Continued bleeding and the heat that is usually present from infection of the area are less common. These may require further management if they occur, such as treatment with antibiotics for an infection.

The anesthetic typically deployed prior to extraction can be associated with other risks, such as oral damage, nausea, and dizziness. There is also a small risk of death with general anesthesia (1 in 100,000 to 200,000 cases.)

Following a wrong tooth extraction, the remaining teeth may drift, leading to misalignment of the teeth, changes to the bite and even altering the appearance of the face. This can usually be prevented by implementing techniques to compensate for the missing tooth. For example, the other teeth can be moved orthodontically or the removed tooth may be replaced with a dental implant, bridge or denture.

Other Issues associated with wrongful extraction

Collapse of the Bite (Loss of Vertical Dimension Occlusion)

Patients, particularly those with large rear molars removed , suffer a collapse of the bite. This loss may occur. This is also known as loss of vertical dimension of occlusion and involves the rotation of the lower jaw closer to the upper jaw. That is a particularly complex way of saying that if you remove the structure of the teeth, the changes in the muscle contractions needed to chew can present and eventually lead to symptoms such as dry, chapped or cracked lips and even the shape of the face.

Delay in Healing

A healthy tooth has a greater bind to the gum matrix that holds it in place. forcefully extracting a healthy tooth is inevitably going to damage that soft tissue far more than in the extraction of a damaged tooth or one wreaked through chronic periodontal disease. That damage may not heal as quickly leading to a prolonged period of bleeding and discomfort while talking or eating.

Dry Socket

When a tooth is extracted, healthy or otherwise, a blood clot naturally forms over the area where the tooth previously was located. In some cases, this blood clot may be dislodged prematurely, which can lead to a condition known as osteitis or dry socket. It is a difficult condition to manage but if not managed by a dental surgeon it could lead to a deeper infection or even an abscess. An abscess could lead to a further tooth loss.

Nerve Injury

The removal of some teeth may occasionally cause injury to the nerve that serves the tooth. In rear lower molar removal, even deep lying facial nerves can be effected. As a result, the area may feel numb or tingly on a permanent basis. This is a rare complication but can affect some patients.

Maxillary Sinus Exposure

A wrong tooth extraction and in particular an unplanned extraction of an upper molar can be very problematic. These teeth are associated by proximity the sinus area of the face. There is a risk of a hole being opened into the maxillary sinus, if a healthy tooth is ripped away from its supporting structure. This will need to be repaired and failing to spot this and repair it properly or refer elsewhere for that repair may be a breach of duty by itself.

Wrongful Extraction as a “symptom” of Health Inequality?

There is good evidence that there is a difference in oral healthcare between the north an the South of England. This is documented by the Nuffield Trust and the Health Foundation in its oddly titled “Root Causes in quality and Inequality in Dental Health” report (https://www.nuffieldtrust.org.uk/research/root-causes-quality-and-inequality-in-dental-health) The question becomes is the demand on regional dentistry also one that leads to an increase in basic dental error?

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