Operator-related aspects in endodontic malpractice claims in Finland

Abstract

Objective: We analyzed operator-related differences in endodontic malpractice claims in Finland.

Materials and methods: Data comprised the endodontic malpractice claims handled at the Patient Insurance Centre (PIC) in 2002–2006 and 2011–2013. Two dental advisors at the PIC scrutinized the original documents of the cases (n = 1271). The case-related information included patient’s age and gender, type of tooth, presence of radiographs, and methods of instrumentation and apex location. As injuries, we recorded broken instrument, perforation, injuries due to root canal irrigants/medicaments, and miscellaneous injuries. We categorized the injuries according to the PIC decisions as avoidable, unavoidable, or no injury. Operator-related information included dentist’s age, gender, specialization, and service sector. We assessed level of patient documentation as adequate, moderate, or poor. Chi-squared tests, t-tests, and logistic regression modelling served in statistical analyses.

Results: Patients’ mean age was 44.7 (range 8–85) years, and 71% were women. The private sector constituted 54% of claim cases. Younger patients, female dentists, and general practitioners predominated in the public sector. We found no sector differences in patients’ gender, dentists’ age, or type of injured tooth. PIC advisors confirmed no injury in 24% of claim cases; the advisors considered 65% of injury cases (n = 970) as avoidable and 35% as unavoidable. We found no operator-related differences in these figures. Working methods differed by operator’s age and gender. Adequate patient documentation predominated in the public sector and among female, younger, or specialized dentists.

Conclusions: Operator-related factors had no impact on endodontic malpractice claims.

Keywords:

• Patient insurance
• dental malpractice
• indemnity of malpractice claims
• service sector
• avoidable injuries

Acknowledgments

The authors thank Sirpa Pöyry, DDS, who assisted with inspection of the 2002–2006 cases, as well as Ville Lilja, MSc, and Mika Sirviö, MSc, who helped with data collection.

Disclosure statement

The authors report no conflicts of interest.

Notes on contributors

Miira M. Vehkalahti, DDS, PhD, is an Adjunct Professor (Docent) of Oral Epidemiology and a Senior Researcher at the Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland.

Outi Swanljung, DDS, MSc (Food), is a Specialized Dentist of Endodontics and a Senior Advisor at the Patient Insurance Centre, Helsinki, Finland.