Lessons learnt on patient safety in dentistry through a 5-year nationwide database study on iatrogenic harm

Area of Science:

• Dental Public Health
• Patient Safety Epidemiology
• Health Economics

Background:

• Safe dental care delivery is paramount, yet epidemiological data on patient safety incidents remains limited.
• Understanding the scope and cost of harm in dentistry is crucial for improving care quality.

Purpose of the Study:

• To classify patient safety incidents in Danish primary dental care (2016-2020).
• To identify dental treatment categories associated with nerve injury and tooth loss.
• To assess the financial burden of patient harm claims.

Main Methods:

• Analysis of claims data from the Danish Dental Compensation Act (DDCA) database (2016-2020).
• Categorization of claims by reason for compensation, treatment event, type of harm, and financial cost.
• Statistical analysis of 9069 retrieved claims, with 5079 deemed eligible for compensation.

Main Results:

• Root canal treatment (48%), delayed diagnosis (18%), and surgery (17%) were the most frequent causes for compensation.
• Damage to the tooth root (54.36%) and nerve injury (16.81%) were significant outcomes.
• Total compensation costs reached over €16.3 million, with surgery and endodontic treatment being the most expensive.

Conclusions:

• Patient harm is prevalent across all dental specialties, with endodontics and surgery being particularly high-risk areas.
• Diagnostic delays and neglect contribute substantially to patient harm, indicating issues beyond direct procedural errors.
• Dental treatment harm imposes considerable societal costs, necessitating targeted interventions to enhance patient safety.