The Elder Law Forum

The Elder Law Forum by Professor Michael Myers Editor's Note: The Elder Law Forum is a public service of the University of South Dakota School of Law, an extension of the SENIOR LEGAL HOTLINE available at no cost to persons 60 and older at 605-677-6343 and during regular business hours. The Elder Law Forum delivers information and educational material by radio, a weekly newspaper column, and Law School research papers placed on the USD School of Law Web site. Professor Myers teaches Elder Law at the School of Law.

How Much Is a

Central Incisor Worth?

How much is a permanent front tooth � a "central incisor" � worth? Or, put another way: How much money would you demand to allow someone to knock out one of your central incisors, painlessly, while you were asleep?

The cost of replacement with an artificial tooth � about $1,000? The cost of replacement plus $2,000 for the inconvenience of living with an artificial tooth? Three-thousand-dollars? Five-thousand-dollars? Ten-thousand dollars?

That was the question posed by a caller to the USD Senior Legal Helpline (1-800-747-1895; She entered the surgical suite of a community hospital for thyroid surgery, both central incisors intact. When she awoke from general anesthesia one was missing.

"The hospital has agreed to pay the cost of an artificial tooth, about $1,000," she said. Her question: "Would it be appropriate to ask the hospital for some compensation related to the physical and emotional discomfort related to the dental work and having to live with an artificial tooth that just doesn't feel right?"

"Yes," I advised.

"How much?" she asked.

I told her about a crude guideline often used to settle certain types of claims: three times actual out-of-pocket costs � in this case three times the cost of replacement, which would be $3,000 plus the $1,000 dental cost.

"If you were to back off to two times costs, $2,000, I believe the hospital would respond positively to such a request, particularly when there are no attorney fees involved," I speculated.

Her request was firmly rejected. The hospital risk manager advised her by letter that her intubation was "difficult," and that having a tooth knocked out during the administration of anesthesia was one of the risks a patient assumes when agreeing to undergo surgery.

I wrote the hospital administrator, asking her to reconsider the hospital's "$1,000-take-it-or-leave-it" position. I suggested that such an incalcitrant position is contrary to what I teach in my health management courses: That an apology for an unintended but nevertheless unfortunate incident, coupled with some compensation, builds solid community relations and avoids costly, unneeded litigation.

The dislodgment of a tooth during anesthetic intubation is rare. Within the context of a multi-million-dollar hospital cash stream, and a million-dollar advertising budget, the treatment of this event as a customer relations matter rather than an unadulterated legal claim, would be in the hospital's best interest.

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