Evaluation of malpractice fears and defensive approaches in orthodontists' clinical practice

This study aimed to evaluate the impact of medical malpractice litigation and associated defensive medicine practices on the clinical decision-making of orthodontists.

This study was conducted between December 2025 and February 2026. Questionnaires were emailed to 2,526 orthodontists registered in the database of the Turkish Orthodontic Society (TOD), and 252 orthodontists completed the survey. Of the participants, 64.3% (n = 162) were female and 35.7% (n = 90) were male. In addition to demographic questions, participants completed the Fear of Medical Error Scale (FMS), the Defensive Medicine Practice Attitude Scale (DMPAS), and clinical preference questions specific to orthodontic practice. The level of statistical significance was set at p < 0.05.

Overall, 51.2% (n = 129) of the participants exhibited a high level of fear of medical malpractice. Orthodontists aged over 35 years had significantly lower FMS scores than younger orthodontists. According to the DMPAS, 53.6% of orthodontists exhibited a high level of defensive medicine behavior, while 15.5% exhibited a very high level.

Orthodontists' clinical decision-making appears to be influenced by concerns about legal repercussions. To mitigate the legal pressure experienced by physicians, education in health law should be strengthened for physicians and other healthcare professionals, and medical malpractice legislation should be revised to provide a more balanced framework that also safeguards physicians' rights.