Undergoing surgery on your face, jaw, or mouth requires a tremendous amount of trust in your surgical team. These procedures are often essential for correcting painful issues, repairing injuries, or improving function such as eating and speaking. Because this area of the body is so complex and highly visible, the standard of care provided must be exceptionally high.
When that standard is not met, the consequences can be life-altering. You may be left with permanent nerve damage, facial weakness, scarring, or chronic pain that affects your quality of life and your ability to work. At Michael Boylan LLP, we understand that looking for answers after a failed surgery is daunting. You need to know if what happened to you was an unfortunate complication or the result of avoidable negligence. Our team is here to help you navigate that difficult question with empathy and expertise.
What maxillofacial and oral surgery covers
Maxillofacial and oral surgery is a specific area of medicine that sits somewhere between dentistry and general surgery. It generally involves treating conditions affecting the mouth, jaws, face, and neck. While routine dental work is usually handled by a general dentist, more complex structural issues are referred to a consultant surgeon, often within a hospital setting or a specialist clinic.
We handle cases involving a wide range of procedures in this field. We focus on the outcome and the care provided, rather than getting lost in complex medical terminology. Commonly, this area covers:
- Surgical removal of difficult teeth: This includes impacted wisdom teeth or teeth that are buried deep in the gum.
- Jaw realignment: Surgery to correct the position of the upper or lower jaw to fix bite problems or facial symmetry.
- Facial injury repair: Treating fractures or broken bones in the face following an accident.
- Biopsies and growth removal: Investigating or removing cysts, lesions, or patches of tissue from inside the mouth or on the face.
- Salivary gland surgery: Procedures to treat blockages or problems with the glands that produce spit.
- Dental implants: Complex bone grafting or placement of metal posts to hold replacement teeth.
Complication or substandard care?
All surgical procedures carry risks. Before you undergo any operation, your surgeon is required to explain these risks to you clearly so you can give informed consent. For example, you might be told that temporary swelling, bruising, or short-term numbness are expected outcomes of the surgery. If these occur, they are generally considered accepted complications rather than negligence.
However, a complication becomes a potential legal case when it is caused by substandard care. If the injury happened because the surgeon deviated from the accepted medical practice, this is not just "bad luck",it is avoidable harm.
Patterns that often point to negligence include:
- Injuries that should not happen: Severing a major nerve in a routine procedure where the nerve position is well-known and should have been protected.
- Failure to spot obvious warning signs: Ignoring clear symptoms of infection or nerve distress immediately after surgery.
- Lack of skill: A surgeon attempting a complex procedure they are not adequately trained to perform.
- Inadequate history taking: Failing to check for medical conditions or medications that make surgery dangerous for you.
When these patterns occur, documentation is vital. Your medical notes and the consent forms you signed are the first place we look. If the specific risk that caused your injury was never explained to you, or if the surgical notes show that safety protocols were skipped, this forms the basis of a negligence claim.
Common maxillofacial and oral surgery issues that may lead to a claim
Medical negligence claims in this area often stem from specific errors at different stages of your treatment. You do not need to be a medical expert to recognise when something feels wrong. Below are common scenarios where patient safety is often compromised.
Pre-operative issues
Mistakes made before the surgery even begins can be devastating. Proper planning is just as important as the operation itself.
- Wrong diagnosis: Mistaking a serious condition for something minor, leading to delays in the correct treatment.
- Failure to image: Operating without taking up-to-date X-rays or scans, meaning the surgeon is effectively "working blind" regarding nerve positions or bone depth.
- Failure to refer: A general dentist attempting a complex surgery that should have been sent to a specialist consultant in a hospital.
- Inadequate planning: Failing to map out exactly how a jaw surgery or implant placement will work, leading to a poor final result.
- Allergies and medication history gaps: Failing to ask if you are on blood thinners or allergic to certain antibiotics or anaesthetics.
Intra-operative issues
These are errors that occur while you are under sedation or anaesthetic during the surgery itself.
- Wrong-site or wrong-tooth events: Removing a healthy tooth instead of the damaged one, or operating on the wrong side of the mouth.
- Avoidable nerve trauma: Cutting, crushing, or stretching a nerve because the surgeon was not careful or used excessive force.
- Instrument and implant problems: Broken drill bits left inside the jawbone or using the wrong size of screw or plate for your face shape.
- Haemorrhage management: Failing to control heavy bleeding during the operation effectively.
- Thermal injury: Burns to the lips or surrounding skin caused by overheated surgical instruments.
Post-operative and aftercare issues
The surgeon’s duty of care does not end once the stitches are in. Poor aftercare can make a manageable situation life-threatening.
- Missed infection: Dismissing a patient who returns with a high temperature, swelling, or discharge, leading to severe illness (sepsis).
- Delayed review: Refusing to see a patient quickly when they report complications.
- Inadequate pain control plan: Failing to provide appropriate medication for severe post-surgical pain.
- Unmanaged numbness or weakness: Ignoring reports of permanent numbness, missing the narrow window of opportunity to repair a damaged nerve.
- Failure to investigate deterioration: Assuming everything is "fine" without checking properly when a patient’s condition gets worse.
Practical impacts of the negligence
When we discuss negligence, we are really discussing the impact it has on your life. The medical terms usually translate into painful, practical realities for our clients.
- Infection: This is not just a sore gum; deep infections can eat away at the jawbone, require hospitalisation for IV antibiotics, and leave lasting weakness in the bone.
- Wound breakdown: When the surgical site does not heal and opens up again, it can lead to scarring, exposed bone, and the need for further painful surgeries to close the gap.
- Avoidable deterioration after oral surgery: This refers to situations where a patient was healthy, went in for a standard fix, and has ended up with chronic pain or functional issues that they never had before.
- Orthognathic planning errors and occlusion problems: If jaw surgery is planned poorly, your top and bottom teeth may not meet correctly (your bite). This can make chewing difficult, cause jaw joint pain, and require years of orthodontic work to fix.
- Plate/screw fixation issues and revision surgery scenarios: If metal plates or screws used to hold bones together are placed incorrectly, they can become loose, infected, or palpable under the skin. This almost always requires a second "revision" surgery to remove or replace them, adding to your recovery time and trauma.
What to do if you are concerned after maxillofacial or oral surgery
If you suspect something has gone wrong following a procedure, it can be difficult to know where to turn, especially if your surgeon is dismissing your concerns.
- Get appropriate medical care first: Your health is the priority. If you are in pain, have signs of infection, or persistent numbness, see your GP or attend an Emergency Department. You may need a second opinion from a different consultant to assess the damage.
- Request records and preserve evidence: Ask for a copy of your clinical notes and X-rays from the clinic or hospital where the surgery took place. You have a legal right to these documents under GDPR. Keep any letters or emails sent between you and the clinic.
- Keep a practical symptoms timeline: Start a diary or a simple list of what symptoms appeared and when. Note down dates of appointments and what was said. Photos of swelling or injuries are also very helpful evidence.
How maxillofacial & oral surgery negligence claims work in Ireland
Bringing a claim for medical negligence is different from a standard personal injury case (like a car accident). To succeed, we must legally prove three specific elements:
- Duty of Care: We must show that the surgeon or hospital owed you a duty of care (this is usually automatic in a doctor-patient relationship).
- Breach of Duty: We must prove that the treatment you received fell below the standard expected of a reasonably competent professional in that field.
- Causation: We must prove that this specific breach caused your injury. In other words, we must show that the harm you suffered was not just part of your underlying condition, but was directly caused by the error.
The role of independent experts
You cannot simply claim that the surgery went wrong. In Ireland, we must obtain a report from an independent medical expert (usually a consultant maxillofacial surgeon from outside the jurisdiction, often the UK). This expert reviews your records and confirms whether the care was substandard. Without this expert support, a claim cannot proceed.
Court proceedings
It is important to note that medical negligence claims are not assessed by the Injuries Resolution Board (formerly PIAB). These cases are complex and are generally managed through the court system, typically the High Court, due to the severity of injuries. However, the vast majority of cases we handle are settled through negotiation or mediation before they ever reach a courtroom trial.
Time limits and “date of knowledge” in maxillofacial & oral surgery negligence claims actions
In Ireland, the statute of limitations for medical negligence is strict. You generally have two years to start legal proceedings.
However, the clock does not always start on the day of the surgery. It starts from the date of knowledge. This is the date you knew, or ought to have known, that your injury was significant and was likely caused by negligence.
For example, if you had surgery and were told your numbness was temporary, but six months later another doctor told you the nerve had been cut, your "date of knowledge" might be that later date. However, determining this date is legally complex. We strongly advise you to seek legal advice immediately if you have any concerns, rather than waiting, to ensure you do not fall outside the time limit.
Who might a claim be brought against?
In maxillofacial and oral surgery cases, there may be different parties responsible for your care depending on where you were treated. We will identify the correct defendant for you.
- The Health Service Executive (HSE): If your surgery took place in a public hospital, the claim is usually brought against the HSE.
- Private Consultants: If you were treated privately, the claim is often brought against the individual surgeon, who will be indemnified by a medical defense organisation.
- Dental Practitioners: For procedures performed in a dental clinic, the claim may be against the individual dentist.
- Private Clinics: In some cases, the corporate entity or clinic itself may be responsible for systems failures.
Complaints and patient options alongside legal advice
You do not always have to choose between making a complaint and taking legal action; often they can happen in parallel, though they serve different purposes. A legal claim is the only mechanism designed to compensate you for the financial and physical impact the negligence has had on your life. This includes recouping costs for corrective surgery, loss of income, and compensation for pain and suffering.
- Practice-level complaints procedures: Every hospital and dental practice in Ireland must have a complaints procedure. You can write to the practice manager or the hospital's "Patient Liaison" asking for an investigation. This can provide answers and sometimes an apology, but it rarely results in financial compensation for your injuries. Be mindful that the complaints process does not stop the two-year legal time limit from running.
- Dental Council complaints route: If a dentist or surgeon has behaved unethically or professionally poorly, you can report them to the Dental Council of Ireland. The Council investigates fitness to practise. While they can sanction a practitioner, they cannot award you compensation for lost earnings or suffering.
Frequently asked questions
Is nerve damage after wisdom tooth removal always negligence?
No. The nerves in the jaw are very close to wisdom teeth. Even with the best care, temporary or permanent nerve damage is a known risk. It becomes negligence only if the surgeon failed to assess the risk (e.g., didn't take an X-ray), used poor technique, or failed to warn you of the high risk beforehand.
What if the consent form mentioned nerve injury as a risk?
Signing a consent form does not give a surgeon permission to be negligent. It only confirms you accept the inherent risks of the surgery when performed correctly. If the injury was caused by a mistake or incompetence, the consent form does not prevent you from making a claim.
What if symptoms appeared weeks or months later?
Some issues, like infections around implants or failure of bone grafts, take time to develop. If the delay in symptoms was caused by the initial surgery or a failure to follow up, you may still have a valid claim. The "date of knowledge" rule is very important here.
Does it matter if treatment was abroad but complications were managed in Ireland?
This is a complex area. If you travelled abroad for dental tourism and the surgery was negligent, suing a foreign clinic can be difficult. However, if you returned to Ireland and received negligent aftercare or emergency treatment here that made the situation worse, a claim might exist regarding the Irish portion of the care. We assess these on a case-by-case basis.
What records are most useful to request first?
The most critical records are your pre-operative X-rays or scans, the operation notes (written by the surgeon immediately after the procedure), and the consent form. These three documents allow our experts to see what was planned, what was agreed, and what actually happened.
How long do I have to take action in Ireland?
As per the Statute of Limitations, you generally have two years less one day from the date of the injury or the date of knowledge to issue legal proceedings.
How Michael Boylan LLP approaches maxillofacial and oral surgery cases
At Michael Boylan LLP, we know that facial and oral injuries are deeply personal. They affect how you look, how you eat, and how you interact with the world. We approach every case with sensitivity and a rigorous focus on the facts.
Evidence-led assessment
We do not make empty promises. We gather your medical records and construct a clear timeline of events. We engage leading independent experts to review your case objectively. If the evidence supports a claim of negligence, we will fight tirelessly to secure the best possible outcome for you.
Clear explanations of options and next steps
Legal jargon is the last thing you need when you are recovering. We explain your options in plain English. We will tell you clearly if you have a case, what the process involves, and what the likely timeline will be. We ensure you feel supported and informed at every stage, with no pressure.
Get in touch with our specialist team today
If you have suffered due to errors during maxillofacial or oral surgery, our experienced team is ready to listen to your story and help you understand your rights.
Contact Michael Boylan LLP today to arrange an initial consultation.
*In contentious business, a solicitor may not calculate fees or other charges as a percentage or proportion of any award or settlement.
In contentious business, a solicitor may not calculate fees or other charges as a percentage or proportion of any award or settlement.
