Dentaltown April 2016 - (Page 72)

general practice column YOU BE THE JUDGE The Case of the Lazy X-Rays by Jeffrey J. Tonner, JD Jeffrey J. Tonner is a full-time dentalmalpractice defense attorney in Phoenix who lectures nationally on dental risk management and record keeping. Tonner created Ideal Charting for General Dentists, a prophylactic system that provides more robust templates, consent forms and update and alert bulletins to help dentists prevent malpractice action before they are filed. For more information, go to thedentaladvocate.com. 72 APRIL 2016 // dentaltown.com This article is the first in a series in which readers get the facts behind a real-life dental board or civil malpractice case, then compare the verdict they would have delivered with the actual outcome. In consideration of privacy, the names and dates of all involved in this case have been altered. The case history "Jane," a 59-year-old patient, had an established long-term, trusted relationship with Dr. Jones, but unexpectedly fractured the porcelain on a lower right bridge while her dentist was on vacation. Jones did not leave a voice-message referral name, so Jane used the Yellow Pages to choose Dr. Smith (the defendant) to do the work. 06-09-14: At the emergency visit, Smith performed a limited examination and smoothed the porcelain. The bridge was intact and needed no further treatment. At the same time, a cursory exam revealed decay and an open mesial margin on tooth #15. Jane remembered that Jones previously had recommended an onlay for this tooth, so the diagnosis was not surprising. Rather than wait for her dentist to return, Jane authorized a replacement PFM. The tooth was appropriately prepared. Three try-in appointments were needed. During the first two visits, the crown did not fit and new impressions were needed. 08-21-14: On the actual seating date, Smith's assistant removed the temporary crown and excess cement, fitted the crown on the preparation without cement, and took a bitewing radiograph. It showed an open distal margin. Smith was alerted to this situation, made adjustments and requested a second X-ray. Again, an open margin was visible. This procedure was repeated a third time, until the radiograph showed closed margins (although the angle was not ideal). Jane was not pleased with three try-in appointments and three X-rays at the final visit, so she returned to Jones four days after delivery for the specific purpose of examining crown #15. His progress notes read, in pertinent part: Consult-second opinion on work done at [Smith's dental office]. Pt. explained she recently had LR bridge break. They smoothed the broken porcelain of the broken pontic and did an exam that pt. had not asked for. The Dr. placed a crown on 15. Jones explained that #15 was misdiagnosed, as onlay was placed in 2011. Took PA. http://www.thedentaladvocate.com http://www.dentaltown.com

Table of Contents for the Digital Edition of Dentaltown April 2016

On Dentaltown.com
HOWARD SPEAKS: Lessons from Asia
PROFESSIONAL COURTESY: Today’s Active Topics
Continuing Education Update
Industry News
Love It!
Poll
What Do You Use to Calculate Offi ce Metrics?
When’s the Last Time You Googled Your Practice?
How is My Curing Different From Pulse Curing?
OFFICE VISIT: Family Ties
Breaking the Cookie Cutter: Finding Our Way Back to Individuality with Shape, Form and Texture
Choose Your Weapon: Finding the Best Fluoride Option for Your Patient
(Your Own) Practice, Made Perfect
Braces vs. Aligners: The Science of Picking the Best Appliance
You Be the Judge: The Case of the Lazy X-Rays
Product Profile: Premier
Principles of Flap Design and Closure
Any More Tips on This Extraction?
Dentistry’s Great Marketing Untruths
Product Profile: CreoDent Prosthetics
Product Profile: Ivoclar Vivadent
You Should Know: Dental Planet
New Products
Ad Index
Bio-Minimalism: Trends and Transitions in Endodontics
Material Classifi cation and Shade Selection Protocol for All-Ceramic Restorations
Dentally Incorrect

Dentaltown April 2016