By Robert G. Sullivan, Esq.
In my last article, I reviewed how important it is for a patient considering cosmetic dentistry to understand the benefits and risks of procedures recommended to them. An investigation into the qualifications of your dentist is equally important.
Here are two examples of what can go wrong when a person does not take the time to investigate the risks of dental procedures and the credentials of their dentist.
“Rosa” was employed at a hospital where she met and befriended one of the doctors in training in oral maxillofacial surgery, “Dr. Bob”. Rosa never liked her overbite, and, since childhood, had wanted to correct the appearance of her face and mouth. One day, she discussed this issue with Dr. Bob. Dr. Bob told her that there was a simple surgery to make her face “perfect.” He said that the surgery would only take a few hours, and that she would be able to return to work in one week. The dentist did not explain that the surgery involved pulling back the skin and tissues of her face to expose her top jaw (maxilla), cutting out a piece of the bone of the jaw on both sides, and then cutting a piece of the hard palate in between the two sides of the jaw. He did not inform her that if not done correctly this surgery could cut off the blood supply to the front part of her jaw, allowing it to die and decay. He did not inform her of his lack of experience in this surgery, and neglected to mention that his superiors had very little experience in this procedure.
As a result Rosa had the surgery with no idea of the risks she was facing. The surgery, planned for three hours, ended up lasting twelve hours. The blood supply to the front of her jaw was severed, but Dr. Bob did not realize this. Postoperatively, Rosa developed a severe infection in the front of her upper jaw and it decayed. She had to be admitted back into the hospital for antibiotic treatment and additional surgery. Ultimately, she was left with a hole in the front of her mouth, including her front top teeth. She sought the care of many other doctors who specialized in facial reconstruction, and underwent multiple surgeries to fix the problem. All efforts to repair the hole were unsuccessful because of the lack of blood supply during the initial procedure. She now requires a plate to block the hole in the top of her jaw. Her attempts to go back to work have failed. She cannot eat or speak normally. She is horribly disfigured. The pain and emotional anguish suffered by Rosa as a result of this surgery have left her depressed, and extremely self-conscious about the way she looks and speaks. She does not socialize or go out of the house unless she has to.
A less drastic example of choosing the wrong dentist involves “Sally”. Sally is a beautiful 40 year-old woman who wanted to improve her appearance. She was not happy with the appearance of her top front two teeth. One had been capped a number of years ago, and the porcelain was cracked. The tooth next to it also had a crack in its enamel. She went to a local dentist, “Dr. James”. He told her that he was an expert in cosmetic dentistry. Instead of replacing the cracked crown and placing a veneer covering on the other tooth that concerned her, he proposed a plan involving her front top eight teeth. This required drilling away significant parts of the tooth structure of each tooth and replacing them with porcelain crowns. Over a period of months Sally went faithfully to the dentist, undergoing the painful tooth preparation, wearing temporary caps and finally getting her new eight crowns. Although they looked beautiful, within hours of having them placed she was in agonizing pain. Her mouth burned. She could not eat or drink without pain. Over the ensuing months this Dr. James removed the crowns and had new ones made. They did not fit. Sally developed infections of the teeth requiring painful root canal therapy, and, in one instance, removal of infection from the bone of the jaw. She had to go a root canal specialist and an oral surgeon, which cost more money. After three failed attempts, Sally gave up on Dr. James and went to another dentist. The new dentist immediately sent her to a prosthodontist. She then learned that the work done by Dr. James was negligently performed.
First, she never needed to have her front eight teeth crowned. All she needed was a new replacement crown and a veneer on the next tooth. Second, this alleged cosmetic dentist had never fitted her crowns properly. They were too short, and, as a result, allowed delicate and sensitive tooth and root structure to be exposed to the contents of her mouth, resulting in infection. Ultimately, it cost Sally over $60,000 to correct what the original dentist had done improperly at a charge of $12,000.00. In addition, she had to endure over one year of painful surgeries, root canals and revision of the work done.
The lesson to be learned from these two examples is that before undertaking any dental work, you must investigate not only the person recommending the work but the nature and risks of the work proposed. Again, request a written plan outlining the anticipated course of treatment, including the cost of what is proposed. Make sure that if your dentist is proposing a major procedure, he or she is board certified in the area of dentistry involved. Understand what is being offered, and ask questions. Know the time the entire process will take from the beginning to end, the risks involved and the other treatment that is available to achieve the results you are looking for. Just because it is a dental procedure, do not hesitate in getting a second opinion.