What Are the TOP 6 Reasons for Orthodontic Lawsuits or Regulatory Complaints?
I. Introduction
● Dr. Amanda from StraightSmile Solutions begins a series on liability in orthodontics for general dentists and pediatric dentists.
● She is not a lawyer, but has spent years auditing CE courses and collecting data on common claims.
● Her advice: stick with Phase One interceptive cases when possible risk drops exponentially compared to adult treatment.
II. Reason #1: Failure to Diagnose or Manage Periodontal Disease
● The number one reason for orthodontic complaints almost always in adults.
● Even if you’re managing perio inhouse, there are specific protocols to follow.
● A full video will be dedicated to this topic.
III. Reason #2: Root Resorption
● Whether you caused it or not, the key is how you manage it.
● Past, present, or future root resorption must be documented and monitored.
● Another full video is planned.
IV. Reason #3: Impacted or Ankylosed Teeth
● Includes canines, premolars, second molars even if you didn’t cause the impaction.
● Failure to notice, diagnose, or manage an impacted tooth properly is a common trigger for complaints.
V. Reason #4: TMJ/TMD and Myofunctional Complaints
● Jaw joint issues and myo problems are a growing source of litigation.
● Dr. Amanda’s strong advice: don’t take these cases unless the patient has clearance from a specialist.
● If the case is a mess before you start, refer it out.
VI. Reason #5: Decalcification and Caries
● Unacceptable. Period.
● If a patient develops white spots or cavities during orthodontic treatment, it’s on you.
● You should not have started treatment on a highrisk patient, or you must remove braces if they can’t maintain hygiene.
● Managing this is standard of care.
VII. Reason #6: Miscellaneous Crap
● A catchall category for random oopsies, bad karma, and poor practice management.
● Includes appointment scheduling, staff errors, discontinuing treatment improperly, and patient communication failures.
● Much of this is basic dental school stuff unacceptable in any specialty.
VIII. The Bottom Line
● Adult orthodontics carries the highest risk. Phase One kids are much safer.
● If a patient needs ENT, myo, or perio clearance, get it before starting.
● Dr. Amanda is strict because she wants to sleep at night and she’ll drop clients who ignore red flags.
● Protect yourself: document, screen, and don’t take cases you shouldn’t.