A recent study by Givol, Rosen, Taicher & Tsesis, published in the Journal of Endodontics, points out some interesting facts about malpractice claims in endodontics.
Endodontic claims are the most frequently filed malpractice claims in dentistry. It has been reported that there are twice as many endodontic malpractice claims than other specialty areas. Endodontic claims have been reported to be 14% - 17% of the total malpractice claims in dentistry.
The study by Givol et. al. was a review of malpractice claims made in Isreal between 1992 - 2008. Some interesting data comes from this review. Of the 720 complaints that were analyzed, 72% were considered "justified" and 27% were considered "unjustified" complaints.
Errrors found and analyzed were categorized as pre-operative, intra-operative or post-operative.
Most of the errors occurred in the intraoperative phase of treatment. These included access preparation, detection of canals, instrumentation or filling.
Swelling & pain as the only complaint were reported in 100 cases and none of them were considered "justified" complaints. Swelling and pain are considered a side effect of treatment and not a complication. Patients should be informed of this possible side effect during informed consent. It has been reported by Tsesis et. al. that pain and swelling can occur following endodontic treatment in 1.5% - 20% of cases. Helping patients understand this possible side effect can help prevent misunderstanding and hopefully prevent unnecessary malpractice claims.
The lack of adherence to strict treatment protocols resulting in poor quality treatment was a common cause of malpractice claims.
Endodontic treatment requires exceptional technical skill and strict adherence to accepted treatment protocols. Proper case selection and appropriate referral to a specialist can also prevent unnecessary complications.
Givol N, Rosen E, Taicher S, Tsesis I. Risk Management in Endodontics. J Endod 2010;36:982-984.
Tsesis I, Faivishevsky V, Fuss Z, Zukerman O. Flare-ups after endodontic treatment: A meta-analysis of literature. J Endod 2008;34:1177-81.
Thank you for the post. Your argument was incredibly articulate and well supported. It seems that focusing on clear and comprehensive communication from doctor to patient both before and after the procedure could prevent some malpractice cases.
Hopefully technology will continue to bring us more advances to shut down the occurrence of malpractice, whether justified or not.
17% is quite a lot and given the next statistic that 72% of 720 complaints were valid, what is happening here???
I think that additional seminars can help increase the knowledge of dentist so that they can run their practices better and avoid malpractice claims.
Well, no matter how small the percentage of this case would be, it will be best to impose a strict treatment protocols to avoid the escalating number of malpractice.
I did not expect endo to be the leading malpractice producer. I always thought it was Oral Surgery. Good thing I refer out most of my root canals.
Thanks for the info
Dentist Los Angeles
I have encountered one or two cases on malpractice claims about endodontics. Some stem from wrong procedures.
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