Patient safety: reducing the risk of wrong tooth extraction

Abstract

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.

Segurança do paciente no cuidado odontológico: revisão integrativa

“…Studies on safety in surgical procedures were highlighted, possibly due to their more invasive nature. One study 78 discussed the process of marking the surgical site as an opportunity for communication between patients and professionals, allowing to reduce the odds of errors such as switched tooth extractions, which is a major concern 44,79 . Improvement in communication led to the development of a chart for display in the hospital setting, in which healthcare professionals recorded the unsafe events that occurred during routine dental care, and which contributed to periodic discussions of quality improvement by the team 64 .…”

Tobacco control: Safer without snus

“…Since then, this has been found to be the most frequent wrong site surgery 'Never Event' reported with most of the reports emanating from hospitals and community services, so clearly dentistry has room to improve on issues of patient safety. 3,4 In 2016, NHSI went out to consultation on the Never Events policy and framework and in its submission the ADH made several of the points raised by Dr Barclay. NHSI of course ultimately decides which views it wishes to follow and the resulting new guidance, to which Dr Barclay refers, was only released in late January of this year (2018) for implementation shortly thereafter at the start of February.…”

Reducing Dental Plaque Scores in Long-term Care Facilities Using a Checklist and Random Inspections: A Pilot Study

“…The World Health Organization surgical safety checklist has been shown to successfully improve a variety of patient outcomes under differing circumstances and has already been implemented by hospitals all around the world 1,9,10) . While a search of the literature by the present authors yielded publications describing the introduction of checklists to improve clinical outcomes in oral surgery and endodontics, they do not provide information on their success in improving dental outcomes over time 5,6) . The specific aim of the present study was to investigate the effect of a checklist for oral care supplemented by random inspections by a charge nurse on improving oral hygiene.…”