Of all facial injuries, tooth injuries are the most common in children and may also involve the jaw, lips and oral muscles. The most common causes of tooth injuries are falls (day care accidents, playground accidents), followed by automobile accidents (and also bicycle accidents), abuse (battered children), and sports injuries.

I am writing this post to address two questions. First, under what circumstances should a parent talk to a lawyer after a dental injury? Second, what unique considerations are present when a lawyer brings a claim on behalf of a child who has suffered a dental injury (how does it differ from a claim that involves an adult with a similar injury)?

DO I NEED TO TALK TO A LAWYER ABOUT MY CHILD’S TOOTH INJURY?

Lawyers are sometimes ridiculed for answering questions with “Well, it depends.” But it really does depend! Ask yourself the following questions:

• Where did the injury occur? This information may have legal implications – for instance, did the injury occur at your home while your child was under your supervision? Or was your child being supervised at another home or a day care center? Did the injury occur while the child was in a motor vehicle and if so, does the at-fault driver have insurance? In the event the other driver may not have insurance, do you have uninsured motorist coverage that will compensate your child?
• How did the injury occur? What doctors call the “mechanism of injury.” This may lead to identification of hidden injuries. For example, a chin injury is often combined with crown or crown-root fractures in premolar and molar regions.
• When did the injury occur? How much time has gone by since your child was hurt? This matters both because it is best to start collecting legal and medical documentation as soon as practicable after an injury and because the more time that passes the harder it gets for your doctor to address the all-important issue of causation (in their records.) Causation has to do with making sure the dental records clearly link the cause of the injury to the injury. You would shocked at how hard some insurance companies work to attack causation by blaming “intervening events” (things that happened to your child after the injury and before he/she was diagnosed with the injury.)

Of course, sometimes it will be obvious you need to talk to an attorney. I am currently handling a case for a little boy that fell while he was at a day care center. The center told the child’s mother that he knocked a tooth out during diaper changing time. What the center did not tell the mother (and a video subsequently revealed) was that the teacher left the boy on a table while taking all the other children in the room out into the hall. The boy did what boys do – he tried to follow and, being alone and unsupervised, fell off the table and his tooth was knocked completely out. In this case there was an attempt to cover up what really happened. Anytime you sense a cover up, it is important to contact an attorney so that a sifting investigation can take place.

In general, if your child was injured and you feel it was due to someone else’s negligence or lack of supervision, you should call me. It costs you nothing to get my opinion and I would like to hear about what happened and talk you through whether you have any legal options.

UNIQUE LEGAL CONSIDERATIONS INVOLVED WITH CHILD DENTAL INJURIES

You already know that baby teeth differ from adult teeth. A child’s mouth will be full of 20 teeth eventually, which is a few less than the 32 adult teeth that come later.

Baby teeth (dentists call them primary teeth) are important to your child’s dental health and not just during the few years before they fall out! They help shape the mouth for the permanent teeth. They help guide the adult teeth into position. If your child loses teeth (or has damaged teeth) the permanent teeth are more likely to overlap or not come in at all (dentists call this “disturbance in eruption”.)

Also, an impact to a baby tooth can lead to the death of a permanent tooth. Under your child’s baby teeth are tooth buds (also called tooth germs). They are the “pre-teeth,” the beginnings of the permanent teeth. They are, in essence, the embryonic structures that will become the adult teeth.

One way traumatic dental injuries differ in children (as compared to adults) is that a knocked out tooth (dentists call this an “avulsed” tooth) typically will not be put back in (called replanting.) This is because attempts to replant a baby tooth can actually damage the permanent tooth that is growing inside of the bone.

Another unique consideration with child dental injuries is that sometimes the dentist can’t do anything for your child right away, particularly in the case of a knocked out tooth in a very young child. In a recent case my client was just 18 months old. The dentist told the parents that they would need to wait until the child was 6-7 years old to see if the permanent tooth would come in normally (the effected tooth was a central incisor and the permanent teeth don’t normally come in until age 6 or 7.) For my clients, presenting their legal claim to the insurance company was complicated by the reality that the future dental expenses were going to be the most significant part of their claim.  I worked with the family and their dentist and was provided with estimates of the cost of future care, which we adjusted upward for the cost of dental inflation over the 5-6 year time frame in question (Did you know there was such a thing? There surely is and the latest government predictions have it running at 3.4% per year.)

Another unique legal consideration is that in order to have a successful claim it may be important to get your child to a pediatric endodontist. Endodontists specialize in saving teeth and choosing one who specializes in pediatric care can be important. It is important to ask your lawyer to “vet” any doctor you are considering. Some doctors are willing to work with your lawyer to document your child’s claim; others are hostile to legal claims. It won’t do to take your child to a dentist that refuses to help your legal advocate.

CONCLUSION

Trauma that results in tooth injury raises unique and sometimes complex legal considerations. It is imperative to assess whether your lawyer has expertise in handling dental injury claims. If you find yourself in need of such an attorney, I hope you will consider giving me a call. I’d be honored to assist you.

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Attorney Pete Pearson practices law in Atlanta, Georgia and has a special interest in helping families with injured children. He is a father to six and lives with his wife and children near Atlanta, Georgia. He can be reached directly at Six-Seven-Eight 358-2564.