Emerging Trends in Dental Malpractice

Complex procedures, often associated with high fees, remain a high-value target for dental malpractice claims. These include, but are not limited to:

• Full-mouth rehabilitations
• Implant placement and restoration
• Cosmetic dentistry

• Complex oral and endodontic surgery

Claims are often triggered by procedure-related errors, especially those that would have been avoided with proper diligence and comprehensive pre-treatment diagnostic protocols; by results that fail to meet patient expectations; and by a lack of high-level communication between the dentist and the patient.

Here are some examples:

• Scope of practice: General practitioners (GPs) are increasingly held to the "Specialist Standard of Care" when performing endodontics, implant surgery, full-mouth rehabilitation, or oral surgery. Assessing case complexity and your competence remains vital to pre-treatment planning.
• Nerve injury protocols: Lingual or inferior alveolar nerve injuries during third molar extractions or implant placement often result in high-value claims. Plaintiff attorneys and courts often seek evidence that the standard of care was followed, such as a documented "nerve injury protocol" (immediate referral to a microsurgeon, etc.) rather than "watchful waiting."
• Implant restorative failure: While integration failure remains a concern, poor restorative positioning of the implant is a key factor in claims. Even if the implant is integrated and healthy, it may be viewed as a planning mistake if it cannot be restored functionally or aesthetically.

• CBCT scans: If you use this technology, you are legally responsible for reviewing the entire image volume, not just the area of interest. Missing an incidental finding (such as a tumor, carotid calcification, or other abnormality) can lead to malpractice issues. When unsure, have a radiologist review the image and ensure your training in this area is comprehensive and up to date.

Prevention Strategies
To mitigate these risks, dental professionals should self-assess their “competence” level for the procedure they plan to perform. Use precision in your diagnostic procedures. Depend on the latest in diagnostic technology. Make sure your charting is accurate, honest, contemporaneous, and complete. Progress notes must be specific to each patient. Avoid using templated "S.O.A.P." notes that look the same for every patient. It is hard for a defense attorney to protect a dentist whose notes lack patient-specific clinical observations. Referring to a specialist early or when complications develop should be a key part of patient care.

Informed Consent
Informed consent remains a crucial tool for ensuring that the patient is properly “informed” before giving consent. The dentist-patient relationship rests on a foundation of trust and honesty. Good communication with patients has always been vital in healthcare and is the cornerstone of the dentist-patient relationship. Open, honest communication improves patient outcomes and satisfaction and often reduces professional liability risks.

The informed consent discussion is one of the most important and effective ways to build a strong dentist-patient relationship. The conversation should include information so the patient understands what the procedure involves and what will happen, how it may benefit them, how it might cause harm (including the most likely, foreseeable, and serious risks), the potential long-term effects, their other treatment options (alternatives), the risks and benefits of those options, what to expect if they decline the procedure (informed refusal), how they might feel immediately afterward, their recovery timeline, the medications used for pain management or sedation, their follow-up responsibilities, and all financial obligations. This entire discussion must be documented in the patient record.

The patient should feel comfortable asking questions whenever needed. They must be encouraged to do so. Make sure they understand that no one has promised or guaranteed specific results. The patient should acknowledge that the dentist may need to modify the plan during the procedure if unexpected issues arise. Photos and videos can be taken and used by the dentist for documentation. The patient should sign a form confirming their understanding of the conversation, indicating that their questions have been answered, and showing they agree (give consent) to the procedure as discussed. 

Minimize Your Risk
Emerging trends in dental malpractice claims increasingly focus on complex, high-cost procedures. To mitigate risk, dentists should carefully assess their competence before performing advanced procedures, use accurate diagnostics, maintain detailed, patient-specific charting and progress notes, and promptly refer to specialists when complications arise or cases exceed their expertise. Extra caution is necessary to avoid restorative positioning errors with implants. A comprehensive informed consent process paired with transparent, honest communication remains one of the most effective defenses. It helps strengthen the dentist-patient relationship and minimize liability risk.

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The information contained on the DentistCare Blog does not establish a standard of care, nor does it constitute legal advice. The information is for general informational purposes only. We encourage all blog visitors to consult with their personal attorneys for legal advice, as specific legal requirements may vary from state to state. Links or references to organizations, websites, or other information is for reference use only and do not constitute the rendering of legal, financial, or other professional advice or recommendations. All information contained on the blog is subject to change.