Wrong tooth extraction: root cause analysis.

Tooth extraction is a common procedure in dental practice, making it all the more curious how rarely wrong tooth extraction is mentioned in the literature and the fact that its incidence is unknown. Given that medical errors in general tend to be underreported,1 it seems reasonable to assume that the known figures on wrong tooth extraction are lower than actually is the case, as well. Numerous extractions are performed based on a referral from another clinician, without the operator’s being acquainted with the patient and the referring clinician’s overall treatment plan. This gap could result in the need for taking corrective measures should an error occur, an event that could be expensive and certainly aggravating to both the patient and the clinician. In 2005, the ADA Council on Members Insurance and Retirement Programs conducted a survey on the frequency, severity, and causes of dental malpractice claims reported between 1999 and 2003. Fifteen of the leading dental professional liability insurers across the country participated, which together insured nearly 104,600 licensed dentists. In the report of the results, the ADA published that statistics on dental malpractice claims are available only from the insurance companies that underwrite dental professional liability insurance.2 But these companies do not publicly disclose the data they collect, most likely for competitive reasons. In the survey, the definition of “incidence” of professional liability claims was the total number of reported claims divided by the total number of the company’s dentist policyholders, and a “claim” was defined as an occurrence in which a patient demanded damages from the insured company. The survey revealed that 4.8% of the allegations involved in paid claims were due to treatment of the wrong tooth.2 Wrong tooth extraction: Root cause analysis