Ethical considerations and legal allegations in endodontic practice

Endodontics is often cited as one of the leading dental disciplines involved in malpractice claims. This focus article aims to explore the ethical and legal aspects of endodontic treatment, with particular focus on identifying the underlying reasons for malpractice allegations, while highlighting the standard of care (SOC). A literature search was conducted to identify patterns in malpractice claims and adverse events related to endodontic treatment. Findings are organized into a clinically relevant classification of adverse events, as local, regional, or systemic, based on the location and response to injury. Not all adverse events result in negative outcomes, nor do they necessarily lead to litigation. Common dental malpractice claims often arise from diagnostic failures, lack of informed consent, deviation from SOC, and delays in referring patients when necessary. Allegations related to root perforation, lack of rubber dam usage, wrong tooth therapy, and infections have generally favored the plaintiffs. Ethical principles form a foundation for professional responsibility. Good communication, risk assessment, and record keeping are prerequisites to enforce patient safety and reduce the risk of malpractice. Targeted improvements in organizations, competence, resources, research, and education can ultimately benefit both patients and practitioners, ensuring higher SOCs and safety.