Dental expert advises on failure to diagnose broken jaw


Dental expert examines xrayA dental expert advises on a case involving a patient who presented to defendant dentist for examination and treatment after she lost a tooth due to trauma. Defendant took and reviewed a panorex x-ray that showed a right mandible fracture. The defendant did not diagnose, treat or refer plaintiff in connection with this injury/condition. Instead, he took an impression of the tooth area and fitted her with a temporary prosthesis to fill the space of the missing tooth. Prior to this treatment, plaintiff had no complaints or signs and symptoms of any inferior alveolar nerve injury resulting from her fractured jaw. The jaw fracture was later diagnosed and surgically repaired by a physician.

Plaintiff sued the dentist for negligence based on his failure to diagnose the jaw fracture. Delay in treatment resulted in nerve damage that has left her with tingling and numbness in her jaw.

Question(s) For Expert Witness

  • 1. Should the defendant have diagnosed the broken jaw?
  • 2. Was this failure a breach of the standard of care?

Expert Witness Response

Upon reviewing materials regarding examination of treatment of plaintiff, and based on the facts, my education, training and experience in the dental care profession, and my knowledge of the standards of care, skill and diligence exercised and required of by the dental profession and dentists, it is my opinion that the defendant failed to exercise the degree of skill, care, and diligence in treating plaintiff that is ordinarily exercised by dentists. As the direct and proximate result of such failure, plaintiff was damaged and injured.

It is my opinion that defendant practiced below the standard of care in the following ways:
• In failing to diagnose plaintiff’s jaw fracture;
• In proceeding to take an impression of the tooth area and fit a alveolar prosthesis in such area, thereby applying forces to the fractured mandible and the fracture segments; and
• In failing to refer plaintiff for treatment of her jaw fracture.

It is my further professional opinion, to a reasonable degree of dental and medical certainty, that defendant’s failure to exercise the appropriate degree of care, skill and diligence proximately resulted in injuries and conditions for which plaintiff required subsequent treatment, and further, that such injuries and conditions and the need for further treatment could have been prevented, or lessened, to a reasonable degree of dental and medical certainty, had defendant exercised the appropriate and required degree of care.

The expert has been a dentist for 30 years and has experience diagnosing and treating patients with fractured jaws.

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