Each month, our team at Lightning Dental Charts reviews recent cases and rulings from the Arizona Dental Board to identify patterns that matter for practicing dentists. These cases provide insight into how the Board evaluates clinical judgment, treatment timing, and documentation.
Below are three instructive takeaways from the December 2025 meeting of the Arizona Dental Board, along with commentary on why they matter for clinical decision making and charting practices.
Paresthesia Following Extraction and Timing of Advanced Imaging
A general dentist extracted tooth #17 in what initially appeared to be a routine procedure. During the twenty-four hour follow up telephone call, the patient reported numbness. The dentist managed the condition conservatively with neurosensory mapping and steroid therapy. The symptoms improved over the next two months and then plateaued.
At that point, a CBCT scan was obtained and showed a partially severed inferior alveolar nerve.
The Board considered whether advanced imaging should have been taken earlier or at the time the paresthesia was first reported. It ultimately determined that the standard of care does not require automatic CBCT imaging following reports of numbness.
However, earlier CBCT imaging and a prompt referral to an oral surgeon may have been the better clinical course. Reconnective nerve surgery can be successful in some cases, but outcomes are more favorable when specialist involvement occurs within the first three months.
The primary lesson from this case is the importance of documenting symptom progression, clinical reasoning, and referral timing. Once symptoms plateau, delays become more difficult to justify, particularly if the chart does not clearly explain the rationale for continued conservative management.
Implant Failure and Freehand Placement Technique
A general dentist placed six mandibular implants intended to support a screw-retained overdenture. Within six weeks, two of the implants failed and were removed. Bone graft material was placed for potential future use.
Post placement radiographs showed that the implants had been positioned buccally. During the Board’s review, it was revealed that the dentist had used freehand placement rather than a guided implant system.
The Board questioned the clinician’s technique and ultimately criticized the delivery method. The focus was not simply on the implant failure itself, but on whether the chosen placement approach was appropriate given the anatomy and restorative goals.
This case reinforces that implant failure alone does not establish negligence. When outcomes are poor, however, the Board will closely examine technique selection. Dentists should ensure that their charting clearly documents why a particular placement method was chosen and how anatomical risks were evaluated before surgery.
High Risk Patients and the Importance of Behavioral Documentation
A recurring trend continues to appear in implant-related board cases. A disproportionate number involve patients who smoke and or have diabetes.
One common documentation gap involves the failure to record post-placement observations that conflict with patient self reporting. Simply noting that a patient denies smoking may be insufficient when clinical indicators suggest otherwise.
Objective observations can and should be documented. An example might read, “Patient denies smoking. Strong odor of tobacco noted during appointment.”
The lesson here is straightforward. Risk factors must be documented thoroughly and objectively. When patient behavior increases the likelihood of complications or failure, contemporaneous chart notes carry far more weight than explanations offered after the fact.
Final Thoughts and How Lightning Dental Charts Helps
Cases like these underscore a consistent reality. Most dental board actions arise from documentation and timing issues rather than from egregious clinical errors.
Clear charting that explains why decisions were made, when conditions changed, and how risks were addressed often determines whether a case is defensible during board review.
If you are looking to modernize your charting workflow while reducing legal exposure and saving meaningful time each day, you can try Lightning Dental Charts with our 14-day free trial. Our system is designed to help dentists produce clear, structured records while freeing you and your team up to focus on patient care.
