An analysis of dental patient safety incidents in a patient complaint and healthcare supervisory database in Finland

Abstract

Objective. Few studies of patient harm and harm-prevention methods in dentistry exist. This study aimed to identify and characterize dental patient safety incidents (PSIs) in a national sample of closed dental cases reported to the Regional State Administrative Agencies (AVIs) and the National Supervisory Authority for Welfare and Health (Valvira) in Finland. Materials and methods. The sample included all available fully resolved dental cases (n = 948) during 2000–2012 (initiated by the end of 2011). Cases included both patient and next of kin complaints and notifications from other authorities, employers, pharmacies, etc. The cases analyzed concerned both public and private dentistry and included incident reports lodged against dentists and other dental-care professionals. Data also include the most severe cases since these are reported to Valvira. PSIs were categorized according to common incident types and preventability and severity assessments were based on expert opinions in the decisions from closed cases. Results. Most alleged PSIs were proven valid and evaluated as potentially preventable. PSIs were most often related to different dental treatment procedures or diagnostics. More than half of all PSIs were assessed as severe, posing severe risk or as causing permanent or long-lasting harm to patients. The risk for PSI was highest among male general dental practitioners with recurring complaints and notifications. Conclusions. Despite some limitations, this register-based study identifies new perspectives on improving safety in dental care. Many PSIs could be prevented through the proper and more systematic use of already available error-prevention methods.

Key Words:

• Degree of harm
• dentistry
• error prevention
• incident type
• malpractice

Acknowledgments

The authors gratefully acknowledge the financial support received from the FINDOS Helsinki, Doctoral Program in Oral Sciences, the University of Helsinki Medicine Fund Grant 2013 and the Finnish Dental Association Apollonia Joint Fund of the Dentistry Organizations’ Grant 2014. The authors also thank the Regional State Administrative Agencies (AVIs) and the National Supervisory Authority for Welfare and Health (Valvira) for their co-operation.

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