Health History Risk for the Dentist

Failing to properly consider patient’s medical history could cost a life—and millions of dollars. In 2009, a New Jersey court awarded the family of a 21-year-old man $11 million in a lawsuit against an oral surgeon. The man had a genetic disorder that caused his throat to swell during surgery, thereby suffocating him. The court found the surgeon, who knew about the condition, to be negligent.

Claims of malpractice may result from careless decisions made during or after a procedure. Yet many involve poor treatment planning and patient evaluation issues that occur before the patient ever touches the chair. While accidents during procedures can always happen, failure to understand your patient’s health risks do not. Here’s what you need to know to help keep your patients safe during procedures and keep your practice safe in court.

Elements of dental malpractice lawsuits

An injured patient makes a successful case for dental malpractice when they establish the dentist-patient relationship, the appropriate standard of care (determined by the witness of other dentists), a breach of that standard of care leading to injury, and the severity of the injury.

It’s important to understand that you are liable for harm to patients in even the worst or most complicated condition. This principle is called the “egg shell” plaintiff rule, and it makes getting informed consent and installing other preventative practices extremely important.

Best practices for dentists and oral surgeons

Here are the four ways to protect yourself from claims of malpractice due to overlooking a patient’s health history.

1. Look for red flags. While you need to do a thorough evaluation of every patient, there are certain indicators in a patient’s health record that suggest they require extra concern. Patients with a history of smoking or any systemic diseases that could affect healing or bone density should be given an intensive pre-operative evaluation. Don’t hesitate to consult other medical or dental professionals if you see something out of the norm in a patient’s medical history.

2. Communicate. This rule applies to patients and other professionals. It’s extremely important that you acquire written informed consent from patients before any procedure. In other words, tell your patients exactly what you’re going to do and what the risks are, and don’t do anything until they’ve signed a written document that states they’re willing to undergo the procedure anyway. States determine exactly how informed consent should be implemented.

Additionally, making sure you and your staff are simply attentive and courteous to your patients can also lower your risk of malpractice suits. Many injured patients filing malpractice claims feel cheated by their dentist and ignored by the staff.

Finally, if any patient is referred to you or will be referred to another professional, make sure a comprehensive report on their medical history gets transferred along with them. This includes any notes on potential changes to their condition and concerns the patient has verbally brought up.

3. Document everything. Written informed consent and any patient refusals of treatment are especially important documents to protect against claims of malpractice. A comprehensive dental record also includes a clear chronology of events, treatment plans, communication between patient and dentist, copies of written informed consent, the patient’s health history form and evidence that the dentist reviewed it with them, and notes about the patient’s treatment.

4. Carry insurance. Unfortunately, dentists are occasionally accused of malpractice without cause. Even in cases where proper documentation and communication proves that a dentist upheld the standard of care, these lawsuits can be expensive. Dental Malpractice insurance can cover the cost of malpractice lawsuits.

When evaluating a patient, don’t neglect their health history. Look for red flags, such as a history of smoking or genetic disease. Make sure to communicate and document constantly. Making these steps routine will reduce the risk of unintended injury to your patient and unmanageable cost to your practice.

As always, we are here to help you any way we can. Please don’t hesitate to call or email if you need us.

The Deerfield Team


“Why Dentists Can’t Afford to Overlook Patient Health History.” Allied Health.

Bacter, Crystal. “A Review of Dental Negligence.” Dentristy IQ.

Chowdri, Prathyusha. “Dental Malpractice Lawsuits.” NOLO.



This article is intended only as a general discussion of these issues & we cannot guarantee the accuracy thereof. It does not purport to provide legal, accounting, or other professional advice. If such advice is needed, please consult with your attorney, accountant, or other qualified adviser. The Views expressed here do not constitute legal advice. The information contained herein is for general guidance of matter only and not for the purpose of providing legal advice. Accordingly, the information provided herein is provided with the understanding that Deerfield Advisors is not engaged in rendering legal advice. Deerfield Advisors strongly advises that clients and/or the reader of this publication contact an attorney to obtain advice with respect to any particular issue or problem discussed here. Also, please know that discussions of insurance policy language is descriptive only. We strongly advise that one’s individual policy & one’s advisor be consulted regarding this subject matter before any action is taken in any way. Coverage afforded under any insurance policy issued is subject to individual policy terms and conditions. The Deerfield Advisor White Paper Series is a registered trademark of Deerfield Asset Management Inc. DBA, Deerfield Advisors and is produced by Deerfield Advisors for the benefit of its clients, and any other use is strictly prohibited. All rights reserved. Copyright © 2016

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