Endodontists specialize in treating the inner structures of teeth, particularly the dental pulp and root canals. While their work is critical for preserving teeth and relieving pain, endodontic procedures carry inherent risks. If patients believe that they have suffered harm due to negligence or improper treatment, in all likelihood they will file a claim or file a lawsuit against their endodontist. Below are the top reasons many patients sue their endodontists.
Misdiagnosis or Delayed Diagnosis
Patients expect endodontists to correctly identify and treat their dental conditions. Misdiagnosing an infection, failing to detect cracks or fractures, or delaying the necessary treatment can lead to worsening conditions, pain, and even tooth loss.
Liability Issue:
If an endodontist fails to conduct a thorough examination using X-rays, CBCT scans, or other diagnostic tools, they may be held liable for negligence.
Nerve Damage During Treatment
Endodontic procedures, particularly root canals, involve working close to nerves. If an endodontist uses excessive force, drills too deeply, or applies toxic substances improperly, it may result in permanent nerve damage, leading to pain, numbness, or loss of function in the affected area.
Liability Issue:
Patients who experience lasting nerve damage may file a malpractice claim against their endodontist, thereby alleging an improper technique or lack of reasonable care was used during the procedure.
Overfilling or Underfilling of Root Canals
A successful root canal requires precise filling of the canal space. Overfilling can cause material to extend beyond the root tip, leading to pain, inflammation, and possible nerve damage. Conversely, underfilling can leave bacteria inside, leading to reinfection.
Liability Issue:
If improper filling leads to ongoing infections or additional corrective procedures, an endodontist may be liable for failing to meet the standard of care.
Instrument Breakage and Retained Foreign Objects
During a root canal, tiny instruments such as files can (and will) break. While some cases of instrument breakage are unavoidable, failing to inform the patient, not attempting retrieval, or leaving fragments that cause an infection can lead to a malpractice claim.
Liability Issue:
Endodontists may face claims of negligence if they fail to remove or address broken instruments properly and do not inform the patient of the risk.
Failure to Treat Infection or Prevent Its Spread
Root canal therapy is meant to remove infected pulp and prevent further infection. If an endodontist does not properly clean and seal the canal, bacteria can remain and cause recurrent infections, abscesses, or systemic complications.
Liability Issue:
A patient who develops a severe infection, especially if the infection spreads to the jawbone or bloodstream, a malpractice claim may be brought against the endodontist for failing to properly eliminate bacteria or provide adequate post-treatment care.
Perforation of the Tooth or Surrounding Structures
Endodontists must carefully navigate the tooth’s internal anatomy. If an endodontist accidentally perforates the root, this may cause pain, infection, and treatment failure.
Liability Issue:
A perforation that significantly affects prognosis or requires additional surgery will be grounds for a malpractice claim, especially if the error was due to lack of skill or inattention on the part of the endodontist.
Inadequate Informed Consent
Patients have the right to be fully informed regarding the risks, benefits, and alternatives of endodontic treatment. If an endodontist fails to provide a comprehensive informed consent, patients may claim that they were unaware of the potential risks.
Liability Issue:
A malpractice claim may arise if a patient experiences an adverse outcome, and especially if the patient alleges that they were not properly informed of the risks associated with the treatment.
Failure to Refer to a Specialist
Some complex cases, such as those involving severely curved roots, calcified canals, or extensive infections, may require a referral to a more experienced endodontist or even to an oral surgeon. Failing to refer to a patient when necessary may result in a malpractice claim.
Liability Issue:
An endodontist may be held liable for proceeding with treatment beyond their expertise when a timely referral could have prevented the patients’ complications.
Improper Use of Medications or Materials
Using incorrect or excessive amounts of anesthesia, antibiotics, or disinfecting agents can result in adverse reactions, toxicity, or ineffective treatment.
Liability Issue:
If a patient suffers an allergic reaction, tissue damage, or treatment failure due to improper medication use, an endodontist will probably have a malpractice claim presented against them.
Prolonged or Unnecessary Pain
While some discomfort is expected after a root canal, severe or prolonged pain can indicate a mistake, such as missed canals, inadequate cleaning, or nerve injury. Patients may present a malpractice claim if they believe that the actions on the part of their endodontist’s caused unnecessary pain and suffering.
Liability Issue:
Failure to diagnose and address the cause of post-treatment pain can result in a malpractice claim, especially if the patient requires retreatment or loses the tooth.
How Endodontists Can Reduce Liability Risks
To minimize the risk of a malpractice claim, endodontists should:
- Perform a thorough evaluation utilizing diagnostic imaging in order to detect all potential issues.
- Ensure precise treatment execution, by carefully cleaning, shaping, and sealing root canals.
- Provide a clear and detailed informed consent form for the patient to sign, and document, document, document all discussions with the patient.
- Use proper techniques and materials in order to avoid complications like perforations or overfilling.
- Follow strict infection control protocols to prevent post-treatment complications.
- Communicate openly with patients, addressing concerns and managing expectations.
- Refer out difficult cases when necessary, rather than attempting high-risk procedures beyond their expertise.
By adhering to high standards of care and maintaining strong patient communication, endodontists may be able to significantly reduce their liability risks and improve patient outcomes.
