How to reduce malpractice claims in endodontics

Jul 8, 2010

More clearly explaining that postoperative swelling often occurs following endodontic treatment could help reduce the number of malpractice claims, according to a study in the Journal of Endodontics (June 2010, Vol. 36:6, pp. 982-984).

Endodontic claims are the most frequently filed malpractice claims in dentistry, wrote researchers from Chaim Sheba Medical Center in Israel. The aim of their study was to categorize and review errors and complications related to endodontic procedures that resulted in legal actions against the treating practitioner.

All dental malpractice complaints reported to Medical Consultants International in Israel between 1992 and 2008 were retrospectively analyzed. All complaints were categorized as either financial risk bearing (justified) or financial nonrisk bearing (nonjustified). The treatment errors that were found in the files were categorized according to phases of treatment: preoperative, intraoperative, and postoperative errors.

A total of 720 complaints were analyzed. Of these, 520 (72.2%) that were found to be justified and 200 (27.8%) were judged nonjustified. Swelling and pain as the only complaints were reported in 100 cases, and none of these cases was considered justified because swelling and pain are a side effect of endodontic treatment, not a complication.

Most of the treatment errors occurred during the intraoperative phase, the researchers noted. In lower anterior teeth and in cases involving more than one tooth, significantly more errors were found during instrumentation and root canal filling (p < 0.05). The lack of adherence to strict treatment protocols resulting in poor quality treatment was a common cause of malpractice claims.

"The technical skills of the dental practitioners performing root canal treatments require improvement," the researchers concluded. "All possible risks and complications should be considered and explained to the patient before treatment."