Dental Work - Need Some Perspective on Legality or/and Ethics

JH100 on 02/03/2016 - 19:35
Last edited 02/03/2016 - 19:49

I just had a tooth filled on Monday by new (to me) dentist. It required a hole be drilled to take a pin to support the filling. The job was well done except for one thing.

While drilling for the pin the dentist hit the nerve and now there is a constant irritation and I am feeling feverish and possibly looking at the prospect of root canal work, I suspect - won't know until Friday when dentist gets back and I have given the nerve time to settle, or otherwise.

The filling cost me $300 and the dentist has a good rep and is well regarded but my concern is possible cost, being on a pension. I don't know what will happen but having been here before with dental work, poorly done and costing me more and more, I would like to have a better understanding of my rightful position before seeing the dentist on Friday.

What do you guys think, is the dentist liable for fixing the problem or am I liable for the cost regardless of it being caused directly by dentists work?

My thinking is the dentist is liable but what is the accepted or enforceable legality or ethical view?

Or what would be the most practical position to adopt?

Any help is appreciated.

Health & Beauty

Comments

haylazf16 on 02/03/2016 - 20:02

+1

Hi Mate,

I am so sorry to hear your problem with dentist by being someone who suffered enormously cos of dodge dentist with badly done dental work. I have had far worse issues than you so not going through all that here now.
However, the dentist will likely tell you that your decay was too deep. He tried to save it with normal filling but unfortunately it didn't work. He is not gonna take the blame for sure. You have to have a root canal and crown on top of it. The cost will be like between $1500-$2500.
The best advice for you I can give that you indirectly imply it was his fault rather than blaming him directly so that you can get discount as much as you can.
Other advice is that if you will get root canal definitely and do not wanna have problem later on, you should get root canal from Endodontist.
Good luck
- JH100 on 02/03/2016 - 20:34
  
  Thanks Haylaz …
  
  This is just the latest issue with dental work, the list is long. And I'm not going into it either. :-)
  
  There was no nerve pain before the drilling. The dentist already said he got all the decay, the drilling was below the already cleaned out tooth. So a claim the decay went deeper than thought is untenable by his own word. But I hear you, how to counter the dentists claim when he is the expert.
  
  I also understand it best not to take a confrontational stance. I just want to find the best position to take in the event of a negotiation for costs, if he won't accept any responsibility up front.
mskeggs on 02/03/2016 - 20:49

Be aware a root canal/crown has about a 10 year life. Something that wasn't explained to me when I spent over $2000 12 years ago.
- JH100 on 02/03/2016 - 21:28
  
  I know that to my detriment. The bone eventually went with the teeth so implants are no longer viable.
thatonethere on 02/03/2016 - 21:23

A colleague has had some success making a complaint via http://www.ahpra.gov.au/Notifications/What-is-a-notification…
- JH100 on 02/03/2016 - 21:30
  
  That could be useful.
  
  I'm amazed there is so little publicly available information on this subject, given we hear of so many complaints. Everybody I know has a story of incompetence and/or dishonesty on the part of dentists.
  - thatonethere on 02/03/2016 - 21:56
    
    Personally I wouldn't like to make a complaint and then go back to the same dentist for rectification. My work colleague went to another dentist and was reimbursed.
    
    In regards root canal - it is really expensive and you will have to pay big bills to the endodontist (the dentist who kills the nerves in your tooth then scrapes the dead bits out) plus after that you go back to the dentist for a crown to be fitted. Private health insurance pays bugger all. However, don't listen to the doomsayers who say a root canal only lasts 10 years - if done right it will last a lot longer (https://en.wikipedia.org/wiki/Endodontic_therapy).
    
    If you have a pension card then you are probably entitled to some free or heavily discounted dental treatment - but book in ASAP as the queue is usually years long. What is available varies from state to state. Your profile says Brisbane so check out https://www.qld.gov.au/health/services/oral-eye-ear/dental-s…
    - JH100 on 02/03/2016 - 22:05
      
      Thanks, I saw that early on and know the wait list is so long nobody will say. I'll keep it in mind though.
      
      Googling Dental Horror Stories, just saw this from 2013 - http://www.crikey.com.au/2013/01/18/rundle-extortionate-dent…
    - JH100 on 03/03/2016 - 11:20
      
      "If done right"
      
      Unfortunately my experience suggests its a lottery and if you don't win you lose. I might just have the tooth out. Don't want to but I don't like gambling either.
      
      Can you say, what were the circumstances of your colleagues successful complaint?
    - thatonethere on 03/03/2016 - 18:07
      
      @JH100: Older root canals used less fancy techniques and equipment.
      
      They had a filling done but the tooth cracked the next day. Unluckily for the original dentist they were interstate and got another dentist to inspect it who wrote up the work as incompetent (no love lost between dentists it seems). Easier for the original dentist to pay for it to go away I suspect.
    - JH100 on 03/03/2016 - 19:15
      
      @thatonethere:
      
      With one saying the other was incompetent you couldn't lose. :-)
JH100 on 02/03/2016 - 21:42
From - http://www.ada.org.au/app_cmslib/media/lib/1302/m482656_v1_p…

Dentists must accept responsibility for all treatment undertaken by themselves and as permitted by law, by allied dental personnel acting under their supervision.

Does the second part of sentence cancel out the first …
tj101 on 02/03/2016 - 22:12

I spoke to the public dentist about a root canal and was advised they pull the tooth rather than root canal and crown. Sometimes you can pay by instalment. I had a filling that irritated the nerve- quite common and the dentist cannot predict this. Get extras cover and some places waive waiting periods and this covers some dental, but not root canal and crowns.
- JH100 on 02/03/2016 - 22:34
  
  That is my understanding too, pull not fix. I suspect your right, about irritating fillings.
  
  Did the nerve die or what happened in the end?
  - tj101 on 03/03/2016 - 11:09
    
    Nerves are commonly irritated during fillings- this is normal. One dentist I saw said I needed root canal. Called dentists to get a price- hugely variable prices. Settled on one, went there and he said I didn't need a root canal, but to wait and see if the nerve settled down. Which it did. Had I not got a second opinion, I would be $2000 poorer. But nerve irritation is not the dentists fault. Nor is having to get a root canal, as they can't predict this. It sucks to have to get dental work done, we should have medicare dentistry IMHO.
    - JH100 on 03/03/2016 - 11:25
      
      "we should have medicare dentistry IMHO."
      
      Yes, the temptation to put money over health is maddening, for everyone at some time.
eatwell365 on 03/03/2016 - 00:13

+1

honestly if there is any mistake from the dentist, it would be the lack of documentation on informed consent on risk, complexity of case and possible complication.
It is great temptation for form prejudice and blame. Many practitioners would rather not to make money, or in some cases would flog out own time/money, in order to keep a patient happy and avoid headache. Personally I believe in good karma,
As you quoted, this dentist has a good name, be fair to him and yourself. have an open and honest conversation. Told him you are a pensioner and cannot afford extra costs because it has not been discussed.
- JH100 on 03/03/2016 - 02:15
  
  "honestly if there is any mistake from the dentist, it would be the lack of documentation on informed consent on risk, complexity of case and possible complication."
  
  You seem to be suggesting any follow up work, regardless of cause, is all my own responsibility? If I go to a mechanic and he breaks something that wasn't broken, and we both know it wasn't broken, he fixes it at his own cost, or we come to terms if we can agree the extra work/expense 'maybe' was going to happen anyway - which might be fair. Wouldn't you say?
  
  "It is great temptation for form prejudice and blame."
  
  True, there is, but that's not what's happening here. I am looking to form a rational position in the matter that takes account of actual responsibility, and not just take it all on myself because the dentist may have had all the paperwork, disclaimers, warnings, etc in order.
  
  "Many practitioners would rather not to make money, or in some cases would flog out own time/money, in order to keep a patient happy and avoid headache."
  
  I have met one dentist of 6 (or so) in 20 years who I could say was more interested in my well-being than in money.
  
  "Personally I believe in good karma,"
  
  That's a topic for another time. But I get what you mean. I actually think people, me included, should be accountable for their actions that impact negatively on others - in fact and truth it happens anyway, that's karma. And those others should be responsible enough to deal with it gracefully - it has to be learned, that changes karma.
  
  "As you quoted, this dentist has a good name, be fair to him and yourself. have an open and honest conversation. Told him you are a pensioner and cannot afford extra costs because it has not been discussed."
  
  From what I've been reading I suspect the odds of getting a favourable outcome are stacked against me. The ADA have a history of custom and practise developed and designed to protect their members from claims.
  
  I have a statement of personal position, if I have, which is basically that there was nothing wrong with the nerve and now, after the drilling/pin/filling, there is. And I don't have the money to fix it.
  
  At this point all I can do is ask if he will fix it for free, or what will it cost. Probably payment terms, to be realistic, long ones … :-)
  
  We'll see.
- Geewhizz on 03/03/2016 - 07:16
  
  honestly if there is any mistake from the dentist, it would be the lack of documentation on informed consent on risk, complexity of case and possible complication.
  
  When does any dentist ever pull out a consent form for a filling?!
  - eatwell365 on 03/03/2016 - 09:40
    
    could be verbal consent and put in patient's notes
doctordv8 on 03/03/2016 - 09:09

Wait until Friday and speak to the Dentist in question. It may be all sorted by itself by then, the Dentist may sort it for you, or if still an issue after this, then see another Dentist for a proper educated opinion after investigating the problem in person. Ya gotta give them a opportunity to sort this out to help you for the long run.

As you are on a pension and in Queensland, there is a Government funded Dentist Scheme available, immediate FREE assistance if it is severe pain or dramas. https://www.qld.gov.au/health/services/oral-eye-ear/dental-s…
- JH100 on 03/03/2016 - 11:33
  
  I made inquiries about the Gov scheme and the earliest one can get an appointment is a month for emergencies but they prefer to issue a voucher to have it done at a private dentists, at most two in a year, which covers most fillings or extractions.
  
  They also offer a denture service but the waiting time for that is so long nobody will estimate.
ramb9 on 03/03/2016 - 09:41

Before major dental work (drilling) didn't he get you to sign a consent form where he should have also mentioned the risks involved in the surgery by speaking with you first? This is supposed to happen before they start drilling anywhere.

Generally, dentists SHOULD know that there is a risk that you might damage the nerves when drilling and they should have referred to scans before proceeding with any work.

If you didn't sign any consent form saying 'you understand the risks involved with the surgery' then you really would have a case.
- JH100 on 03/03/2016 - 12:48
  
  I'm not sure a consent - to all and sundry - form signed just before work commences is ethical, especially given work will probably be denied if you don't sign? I don't know, so I ask. Any way I look at that it looks like duress.
  
  I actually thought going in the tooth would be removed and was resigned to that but then happy it wasn't to be so. And I thought it reasonable to expect the dentist knew what he was doing and a filling was a good thing. He was so confident and was done in the shortest time.
  
  I didn't have it anywhere in my mind I might get nerve damage from the procedure and that it would cost me pain and distress, and money I don't have, to fix.
Sweet3st on 03/03/2016 - 16:43

I'm no fan of dentists, but it sounds like he has done his best to save the tooth for you by attempting to fill it. If it was a big filling, and needed the pin, and the drilling has irritated the nerve, well you're in the same situation as when you went to him, ie expecting to lose the tooth or have root canal. I think blaming him for doing the drilling for the pin that was essential to securing the filling is a bit unfair. As others have said, nerve irritation due to dental work often subsides on it's own, so I would wait with fingers crossed. If the filling turns out to be a failure, I guess you're down $300, but wasn't it worth it to try to save the tooth for minimum cost? Given a choice between root canal therapy for a molar (>$3,000) and extraction, I just opted for extraction.
- JH100 on 03/03/2016 - 17:01
  
  You might be right, I don't know. If you read what I've said you'll see I am not blaming, just looking for the most reasonable position. I don't think that's unfair.
  
  The way things are I doubt there is any position other than the one I started out with, accept things as they are, see what a dentist can reasonably do, and move on.
eatwell365 on 04/03/2016 - 23:01

Hi OP, Any luck today?
- JH100 on 04/03/2016 - 23:41
  
  I didn't see the point in going to the dentist today. The irritation has subsided, more or less. It still feels like it could flare up again but it's not something to further irritate with intervention while there is still a possibility it will settle.
  
  It's wait and see … If something happens that could help others I will update here.
  - eatwell365 on 05/03/2016 - 06:07
    
    glad you are getting better more or less. good luck.

Dental Work - Need Some Perspective on Legality or/and Ethics

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