Scenario Gallery
Scenario #1:
A tooth is listed for replacement with an implant. Was this accident related? Or was it a pre-existing condition?
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The missing tooth in the example on the right above has been gone for a significant amount of time, since long before the accident in question. NADENT consultants use key findings to determine this.
For example, bone changes with time. In some cases, some teeth shift over time. In many cases, a thorough dental exam and comprehensive treatment plan accounts for listing a bridge or implant to replace a missing tooth, even though it was missing before the accident and was not accident related. By submitting your dental injury claims to NADENT for review, our consultants serve to clear up any confusion over what is accident related, and what is not related.
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Scenario #2:
A claimant states that some of his teeth have been loose "ever since the accident." The dentist confirms some teeth are loose and plans to extract some of them and do periodontal surgery on a few others. Is this accident related? Or was it a pre-existing condition?
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NADENT consultants evaluate the bone support around the roots of teeth. This is a key indicator to determine if the condition is due to a traumatic impact, or was caused by periodontal disease, a long-standing infectious condition. Other key indicators are also evaluated, such as periodontal charting, dental chart notes, and history of tooth loss.
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Scenario #3:
A patient (claimant) has been told his tooth is abscessed (due to a dead nerve) and must have a root canal filling, post and core, and a crown. Another claimant was told his abscessed tooth must be extracted. Is this trauma related? Or pre-existing?
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If an x-ray reveals the tip of the root of a tooth has a circular shaped dark shadow around it, this indicates a tooth that has been dead for quite awhile. This is one of the criteria that NADENT consultants evaluate to determine how long a tooth has been dead - which helps to determine if this condition is pre-existing, or if it could be due to the accident in question. In addition, NADENT consultants check for other indicators on the x-rays to determine if the cause was deep decay, as it so often is, or if it was due to trauma, which is possible. By having a NADENT consultant review this type of claim, the actual injuries can be more clearly identified, recommending a payment amount that is appropriate for the injuries sustained, without including additional procedures which are unrelated to the accident.
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Scenario #4:
A tooth is "broken down," allegedly due to biting on a hard object, or due to an impact that jammed the teeth together. Was this due to pre-existing decay, large fillings, old cracks following years of wear and tear? Or is it due to a traumatic encounter as claimed?
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NADENT consultants will study photos like this one, along with x-rays, and advise you whether the condition is due to trauma or simply due to years of wear and tear, coupled with decay or cracks. They will also advise you whether the treatment proposed is appropriate and necessary, and if the fee is reasonable and customary.
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