Over recent years there has been an increased emphasis on improving patient safety in all branches of medicine, with reducing wrong tooth extraction being a priority in dentistry. The true incidence of wrong tooth extraction is unknown but it is considered an avoidable harm and is a significant source of dental litigation. Interventions to reduce wrong tooth extraction include educational programmes encompassing human factor training, patient assisted identification, the use of checklists, marking of surgical sites and implementation of patient safety guidelines. Identified risk factors which make wrong tooth extraction more likely include; suboptimal checks and/or cross checking of relevant clinical information, unclear diagnosis, unclear documentation, ambiguity regarding notation of molar teeth, orthodontic extractions, and extractions where there are multiple carious teeth and extractions in the mixed dentition. Accurate and timely reporting of wrong tooth extraction incidents followed by analysis and sharing of findings together with implementation of improved practice will help to minimise risks of wrong tooth extraction.

Substance misuse is a major health concern in the United Kingdom, as the consequences for individuals are significant and may include multisystem organ damage. It is important for the dentist to know which patients are misusing substances as some pharmacological agents routinely used in dental practice may be contraindicated. The dentist should be aware of the range of clinical presentations that may arise from substance misuse and when suspected, a thorough drug history must be obtained. Patients may require special consideration and further investigations when planning elective procedures, particularly under intravenous conscious sedation. Therefore, management within a specialist centre and liaison with other health professionals may be indicated to ensure treatment is provided safely.

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Aim The aim of this study was to assess the frequency of patients contacting the Oral Surgery Department at Manchester Dental Hospital with post‐operative concerns. This will facilitate local improvements within the department for the effective management of patients re‐presenting with complications. Materials and methods Between August 2013 and October 2013, the records for 31 patients re‐attending the Oral Surgery Department at Manchester Dental Hospital after a surgical procedure were analysed retrospectively. All data collected were stored on a secure university hard drive and analysed using Microsoft Excel Spreadsheet. Results Ninety‐three per cent of patients who re‐attended the department required only one unplanned episode for treatment. Surgical procedures that resulted in re‐attendance included removal of third molars (57%), extraction of non‐third molar teeth (25%), implant placement (10%), apical root end surgery (3.5%) and excision of a ranula (3.5%). It was noted 36% of patients included in the audit were diagnosed with post‐operative pain or normal healing. Conclusion The management of patients attending with unplanned episodes of treatment places an additional strain on the service delivery of clinics and inconvenience to patients. The study highlights the range of post‐operative complications that patients present with. Service delivery research and review enable improvements within the department to improve the efficiency and effectiveness of patient management. This study will allow specific training to facilitate improvements in delivery of care within the dental team.