Dental Expert Advises on Failure to Provide Antibiotics Post-Surgery

In this dental medicine case, a dental expert was called by the plaintiff to establish whether the standard of care was met following oral surgery preformed on the plaintiff by the defendant. The plaintiff appeared for a dental care appointment at the defendant’s office. According to defendant, he had poor oral hygiend, including supragingival calculus, tobacco stains, generalized gingivitis and mild periodontitis. The defendant recommended extraction of plaintiff’s four wisdom teeth, crowns for two other teeth and fillings for five others. Plaintiff signed an informed consent form, initialing a paragraph acknowledging the infection risk associated with extraction.

The wisdom teeth extractions were the final procedures. Plaintiff was provided an antibiotic following extraction of two teeth. A few weeks later, the final two teeth were removed. There were no signs of infection or pericoronitis. Defendant instructed plaintiff not to smoke for 72 hours. Plaintiff cancelled and failed to show up for follow-up appointments. He instead sought medical treatment at a hospital for swelling and pain. A CT of the facial region showed conditions consistent with dental infection. The infection was drained, and the plaintiff was discharged two days later.

Question(s) For Expert Witness

Expert Witness Response

Based upon my review, I conclude that the care and treatment provided by defendant complied with the standard of care applicable to general dentists. The treatment plan and dental treatment was appropriate and within the standard of care. Plaintiff signed a consent form for the extraction of teeth. After the first extraction, defendant prescribed an antibiotic, due to plaintiff’s pericoronitis. Following the second extraction, there was no evidence of infection or pericoronitis. Based on defendant’s evaluation of plaintiff and the procedure he performed, the standard of care did not require administration of antibiotics. It is appropriate to prescribe antibiotics following an extraction when there are signs of infection; it is appropriate and within the standard of care not to prescribe antibiotics after the extraction of a tooth where there are no signs of infection.

It is my opinion that to a reasonable degree of medical probability, there was no act or omission on the part of defendant that caused, contributed to, or was a substantial factor in bringing about any injuries or damages as alleged by plaintiff. Plaintiff was a smoker who had an open wound post-extraction.

This dental expert has been a dentist for nearly 25 years and is a professor of dentistry at a university hospital.

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