How dentists fared in U.S. TMD malpractice trials in 6 decades

Dentists were the victors in approximately 8 in 10 dental malpractice trials related to temporomandibular disorders (TMDs) that occurred between 1960 and 2022. The review was published on October 11 in Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology.

However, nearly half of the cases were in favor of dentists because the statute of limitations had expired, the authors wrote.

"Given the large number of patients with TMD symptoms, the changing concepts of TMD diagnosis and treatment over the study period, and the relative lack of education in this field, it is remarkable how few malpractice cases have resulted in court trials," wrote the authors, led by Dr. Briana Burris of Massachusetts General Hospital in Boston.

In the U.S., an estimated 1,500 new dental malpractice cases are filed each year. However, about 95% of malpractice cases are settled or dropped without a court trial. There is a dearth of research available on these cases and their outcomes.

TMDs can cause pain, limited mouth opening, and jaw dysfunction. However, there is a lack of evidence for the majority of TMD treatments, making outcomes complicated.

To give U.S. dental professionals who treat patients for TMDs better information about the trends in litigation leading to trial, a retrospective review was conducted. After a search of the Westlaw database was conducted, 57 malpractice court trials with federal and state jury verdicts in the U.S. from 1960 to 2022 were included in the review. Settlements reached outside of a trial were not included in the review, according to the study.

Of the cases, 46 (81%) were found in favor of the dental provider. Only 10 (18%) were found in favor of the patient. In each of the cases in which the patient won, it was adequately proven that the dental professional breached the standard of care, the authors wrote.

Of the cases in which the provider won, the reason for the ruling in 19 of them was due to the statute of limitations running out. Other reasons for rulings in clinicians' favor were that providers were found to have acted within the limits of the standard of care or there wasn't enough evidence to justify litigation, they wrote.

Nevertheless, the study had limitations. The Westlaw legal database only includes records from full state law trials. Therefore, the study didn't include settlement in its analysis, the authors wrote.

"Most court cases with claims of malpractice after treatment of TMD ruled in favor of the defendant," Burris et al wrote.