Preventing Dental Malpractice.

By Dr Ian Aires         November 2018

What can Dentists do to reduce or eliminate dental malpractice law suits?

Unfortunately dental treatment sometimes leads to an unfavorable outcome.
The unfavorable outcome may not be anything specifically related to the dentists skill or expertise or care.The dentist maybe practicing well within the standard of care.
Dental treatment as in medical treatment does not always have 100% success rate.
From my experience practicing 35 years as a dentist and 30 years as an expert dental witness it is evident that patients mostly do not sue dentists because of bad outcomes.
Patients sue dentists for dental malpractice mostly because of how the dentist handles the situation once a problem occurs.
The best way for Dentist’s to reduce or eliminate malpractice suits is to address the problem immediately.
Advise the patient immediately that a problem has occurred with the treatment. Advise the patient that this sometimes happens.
Tell the patient that you will do whatever you can to remedy the situation. It may mean redoing some treatment at no cost, doing additional treatment for a reduced cost or possibly referring the patient for a specialist consultation.
The key is to show the patient you really care. Calling the patient at home in the evening is a good start to showing the patient that you are available for them and will do whatever you can to assist.
Patients really get upset when they leave messages for the dentist and calls are not returned.
Dentists should give specific instructions to their staff that if a patient calls with a complaint they should relay this to the dentist immediately, and a timely response must take place.
I have seen lawsuits initiated against dentists when staff have not relayed the patient’s complaints to the dentist and the dentist was unaware that the patient was unhappy.

The staff was trying to protect the dentist from an unhappy patient but the patient became irate when the dentist did not return her repeated calls.
The patient then assumes you do not care about them and only want their dental fees.
In summary even the best most proficient dentists sometimes have treatment outcomes that are not ideal or that go wrong.
Addressing the problem immediately will reduce and hopefully eliminate any future lawsuits for dental malpractice.

A take-home message is don’t ignore a patient’s complaints especially when treatment has not turned out well.

What are the key steps dentists should be doing to prevent malpractice and if sued to win the malpractice case.

Medical and Dental History.

A thorough medical and dental history should be taken. Any unusual information should be followed up. When it’s necessary to obtain a patient’s physician approval for treatment its best to use a fax as the communication tool with the physician.

There now are numerous drugs prescribed by physicians to prevent osteoporosis some of which may not be recognizable as drugs for osteoporosis.

Informed consent

Inform before you perform.

A thorough informed consent process is necessary. When explaining treatment options to patients its important to give patients all viable options. Even if you don’t offer a particular treatment option its necessary to inform the patient about it and why you don’t recommend it.

In a recent case that I reviewed the dentist, who does not believe in socket preservation, prior to extracting teeth did not inform the patient of this option. After consulting with an implant surgeon for implants who informed the patient that bone grafting was needed she sued the dentist for not informing her about socket preservation. The dentist lost the law- suit for dental malpractice.

The informed consent information should include possible risks in the different treatment options discussed as well as the risks in not doing any treatment. The discussion should include the benefits of the different options.

In addition its best to have a written informed consent form that is signed by the patient and the dentist.

Charting and Radiographs

One of the biggest areas where dentists get into trouble is inadequate or inaccurate charting and insufficient or poor radiographs.

Pre-treatment radiographs are key to supporting treatment. However notes of the clinical findings can be just as important.

Dentists should sign off any notes that are written by the staff.