[Forensic evaluation of injuries to nerves and jaw bone after wisdom tooth extraction from the viewpoint of current jurisprudence]

Abstract

The removal of lower wisdom teeth is one of the most frequent operations in oral surgery. Iatrogenic lesions of the lingual and inferior alveolar nerve and fractures of the lower jaw are rare, but can lead to actions for damage and compensation for personal suffering. The aim of our investigation was to elaborate recommendations for the oral surgeon from the legal point of view. Therefore we investigated in two data banks all court decisions concerning wisdom teeth and analysed them in regard to the obligation to provide information, documentation and the minimum requirements of the surgical treatment. In 57% of all court decisions the obligation to provide information was omitted by the surgeon. Surprisingly, regarding injuries of the lingual nerve we found different opinions from various law courts. In some former decisions only the fact of the damage was equivalent to a lack of care, while recently other courts had the opinion that an injury of the lingual nerve could also be caused in spite of careful treatment. With regard to lower jaw fracture all courts emphasized that the patient must be informed about the risk by the surgeon. Moreover, minimum requirements for the removal of wisdom teeth were given. In conclusion, the recent court decisions restrict the liability for complications but demand the observance of minimum requirements for the surgical treatment. Additionally, all courts stress that informed consent about the risk of nerve damage of jaw fracture must be obtained before the removal of wisdom teeth.