Patient safety in dental care: A challenging quality issue? An exploratory cohort study

Abstract

Objective. Little is known about patient safety in primary oral healthcare. The aim of this study was to describe and analyze patient safety incidents in primary oral health care. Materials and methods. A random sample of 1000 patient records from 20 dental practices was reviewed retrospectively over 60 months. All adverse events (AEs) were noted: unintended events happening during treatment that resulted or could have resulted in harm to the patient. Results. A total of 46 (95% CI = 33–59) AEs was identified, of which 18 (95% CI = 10–26) were considered preventable. From these, 15 related to treatment, 10 to diagnostics and one to communication. Conclusions. The low incidence of AEs and absence of major harm to patients suggests that primary oral care is safe for patients. However, the low quality of record keeping may imply underestimation.

Key Words::

• Patient safety
• quality of oral care
• health services research
• risk
• epidemiology

Acknowledgments

The Dutch Ministry of Health, Welfare, and Sport (VWS) initiated the project and supported the project financially (without restrictions on the scientific work; grant number 313741). The authors would like to thank all participating primary oral care practices and their staff for their data.

The study presented in this paper is part of a larger national study on patient safety in primary care. We also thank our co-workers S. Gaal, P. Giesen, E. de Feijter, A. Jacobs, L. Martijn, M. Tacken, R. Nijhuis-van der Sanden and M. Harmsen for their input and support.

The research team visiting 20 dental practices have strongly contributed to the results of this study: Leontien van Eeten-Kruiskamp, general dental practitioner, Roland van der Horst, lecturer, Dental School Radboud University, Joost den Boer, researcher, NMT, Ilona Mooren and Loes van den Heuvel, undergraduate master dental students.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.