Negligent Root Canal Treatment

Root canal treatment, or endodontics as it is technically known, is a dental procedure that is carried out to treat infection within the centre of the tooth (called the dental pulp).

The tooth is made of the crown, the part of the tooth that is visible above the gum line, and the root, which extends into the bone of the jaw and anchors the tooth in place. The dental pulp is the soft tissue at the centre. This can get infected by bacteria, causing painful symptoms and eventually resulting in the death of the pulp.

If a bacterial infection exists in the pulp of the tooth, the only available options are extraction or root canal treatment. This treatment aims to remove the bacteria from the root canal system of the tooth before it can do any lasting damage.

During the treatment, the dental practitioner will remove the nerve and pulp from the tooth and thereafter clean, fill, and seal the tooth. Assuming the treatment is carried out to a satisfactory standard, a tooth can survive for up to 15 years after root canal treatment.

Unfortunately, we receive a constant flow of claims that consist of substandard root canal treatments. It is a tricky dental procedure that is sometimes difficult to get right.

Are all failed root canal treatments negligent?

Not necessarily. Root canal treatment is a procedure used to repair and save a tooth that is badly decayed or becomes infected.

Unfortunately, despite a dentist’s best efforts they sometimes do fail, particularly if the tooth was badly decayed in the first place.

How do you know you have a successful claim?

Successful root canal treatment cases generally concern the following:

A sodium hypochlorite spillage (as explained below) which has caused injury
The tip of a file retained in or around the treated tooth, which the dentist who carried out the root canal treatment did not tell you about at the time of treatment
The failure to fill the canals of the tooth completely, which generally occurs when a dentist fails to accurately record the lengths of the canals prior to treatment
The failure to use a rubber dam (which is explained below), which has allowed bacteria to seep into the treated tooth and cause infection
A perforation of the tooth which has occurred after a dentist has over filled a root canal, which can lead to nerve damage. Perforations need to be repaired as soon as possible, as they can cause bone loss otherwise

We would also investigate several other factors when assessing whether a root canal treatment was negligent, such as the failure to take x-rays (technically known as radiographs) before and after the treatment.

If you decide to contact the Dental Negligence Team, we will ask you to describe the events that have caused your concerns. Sometimes, we may also ask you to obtain your medical records or make a complaint to a dental practice. After we have all the information we need, we will let you know if your potential case has reasonable prospects of success.

My dentist spilt sodium hypochlorite in my mouth or down my throat. Is this negligent?

Sodium hypochlorite is a bleaching agent commonly used during root canal treatment to clean the canals and pulp chamber of a tooth to dissolve any bacteria present.

In order to prevent a sodium hypochlorite spillage during root canal treatment, a dentist should use a rubber dam, which is essentially a thin piece of rubber that isolates the tooth that is being treated.

Expert evidence suggests that a rubber dam should be used at every stage of root canal treatment, and one must always be used during the second stage. If you have suffered an injury resulting from a sodium hypochlorite spillage during root canal treatment (this can include burns or even nerve injury), this is likely a result of negligence, particularly if a rubber dam has not been used.

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Recent cases

£6,000 Substandard root canal treatment

Samantha Swaby recovered £6,000 for a Claimant who suffered burns following a hypochlorite spillage during root canal treatment.

The Claimant attended for root canal treatment to her upper right second premolar (UR5) in January 2015. She immediately reported pain and discomfort, and a hypochlorite spillage was suspected.

The Claimant returned to the practice one week later and it was noted that she had a “lump” on her gum and lip, which had gone slightly numb. She was then referred to the Oral Maxillofacial Department of her local hospital, where it was noted that the sodium hypochlorite may have gone through the apex of her tooth.

She returned to the Defendant’s practice in March 2015 and was advised that she would require an extraction as her UR5 was unable to be root filled due to the previous event. Her UR5 was eventually extracted in May 2015.

£3,000 Substandard root canal treatment

Sophie Angwin recovered £3,000 for a Claimant following substandard root canal treatment.

The Claimant was seen by the Defendant dentist in January 2012 for root canal treatment to his lower left second molar (LL7), which had been causing him pain.

The Defendant dentist later retired from practice, and the Claimant was seen by a different dentist who advised him that the root canal treatment had been inadequate.

The Claimant required re-root canal treatment by a private dentist as a result.

£6,000 Substandard root canal treatment

Katie Parr acted for a client who received £6,000 following substandard root canal treatment.

The Claimant attended the Defendant dentist in March 2011 for root canal treatment. The Claimant later returned to the practice, complaining that the root treated tooth still felt painful.

The Claimant attended an appointment with a different dentist for a second opinion, and was told that the root canal filling had been substandard. The root filling was short and the crown preparation had been inadequate and caused an abscess. As a result, the Claimant’s tooth required extraction and replacement with an implant.

How long will it take to make a claim?

As a general rule, cases concerning substandard root canal treatment should conclude between 12-18 months after the first time you contact us. However, each case is different and this may vary dependent on the facts.

How much compensation might you receive? How is it calculated?

Any compensation received will depend on the injury you sustained. For example, if you sustain an injury to your soft tissues (this would most likely occur from a sodium hypochlorite spillage) you will receive less than if you lose a tooth.

Compensation received following a successful claim for dental negligence will be comprised of:

an award for pain and suffering – this will compensate you for any pain you have endured, and also things like inconvenience, social effects (such as embarrassment) and any changes in your eating or sleeping habits
an award for future treatment costs – for example, if you require an apicectomy (a procedure to remove a retained file), or restorative treatment such as a bridge or an implant having lost a tooth. We will also take into account the future maintenance costs for any treatment you may require, including future crown cycles and specialist appointments
past loss – this may include past prescription costs, travel or dental treatment. For instance, if a root canal treatment failed for a negligent reason and you require another one, the cost of this will likely be recoverable.

The substandard root canal treatment was done by a dentist who has since retired. Can you sue a retired dentist?

You can sue a retired dentist, as long as your claim is not statute barred.

By law, all dentists must be registered with the General Dental Council (GDC), and must have appropriate indemnity and insurance arrangements in place; this allows patients to seek any compensation they may be entitled to.

Therefore, even after a dentist retires they will still be responsible for the treatment which was carried out when they were practising as a dentist.

How long do you have to make a claim?

You have three years to bring a claim of dental negligence, from the date of negligence or knowledge of it, under the laws concerning ‘limitation’ in England and Wales. These laws state that a Claimant must issue court proceedings within this time period, or else their claim would be statute barred.

Generally, we would advise you to contact us at least 6 months before the limitation period in your case is due to end. However, this can be reviewed on a case by case basis; if you believe that your limitation period may expire soon, we encourage you to contact us as soon as possible.