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Brauer HU, Bartols A. Dealing with Evidence in Dental Professional Liability Lawsuits-General Recommendations for Dental Expert Witness Work Using the Example of Germany: A Narrative Review. Eur J Dent 2024. [PMID: 39013450 DOI: 10.1055/s-0044-1788320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2024] Open
Abstract
Dental treatment can lead to disputes between patients and dentists, which are then brought before the civil courts as medical malpractice cases. The court regularly commissions a dental expert to answer questions of evidence in court. In the majority of cases, the expert is able to answer these questions based on his professional expertise and practical experience. In order to make the assessment comprehensible and credible for the judge and the parties, it can be helpful and reasonable to cite relevant literature references from dental textbooks and specialist journals. In individual cases, it may be necessary to carry out a systematic literature search on specific topics. Based on the situation in Germany, this narrative review makes recommendations of how to perform a literature search and make citations specifically for expert opinions that are generally applicable independent of national jurisdiction.
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Affiliation(s)
- Hans Ulrich Brauer
- Dental Academy for Continuing Professional Development, Karlsruhe, Germany
| | - Andreas Bartols
- Dental Academy for Continuing Professional Development, Karlsruhe, Germany
- Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University Kiel, Kiel, Germany
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Ho JCY, Chai HH, Lo ECM, Huang MZ, Chu CH. Strategies for Effective Dentist-Patient Communication: A Literature Review. Patient Prefer Adherence 2024; 18:1385-1394. [PMID: 38974679 PMCID: PMC11225999 DOI: 10.2147/ppa.s465221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 06/10/2024] [Indexed: 07/09/2024] Open
Abstract
The effectiveness of high-quality dental care predominantly lies on the communication between dentist and patient. However, little literature has reported the importance of these "soft skills" in dental practice. The aim of this literature review is to explore strategies for effective dentist-patient communication. Dentist-patient communication is a bidirectional process involving the exchange of ideas that should be clear (easy to understand), correct (accurate), concise (to the point), complete (with essential information), and cohesive (well-organized). Effective communication empowers patients with the knowledge required to make an informed decision about their own oral health. It not only improves the dentist's efficiency and boosts patient confidence, but also alleviates patients' dental anxiety and fear, addresses patients' needs and preferences, increases patients' adherence, and enhances patient satisfaction. To enhance dentist-patient communication, dentists should take the patient-centered approach as a premise. The approach comprises understanding patients' illnesses, shared decision-making, and mindful intervention at the patient's own pace. In addition, dentists should use simple, succinct language, proper body posture, gestures, facial expressions, and eye contact when interacting with patients. Dentists should show empathy, encourage questions and feedback, employ visual aids, and give ample time to patients. Nowadays, dentists and their patients use messaging applications in their communication. This form of telecommunication is not only a convenient way of communication but also reduces the costs associated with a dentist visit. In conclusion, effective dentist-patient communication is vital for the success of dental practice. Dentists who prioritize communication and build positive relationships with their patients are more likely to achieve positive outcomes and foster the expansion of their dental practice.
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Affiliation(s)
- Jasmine Cheuk Ying Ho
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, People’s Republic of China
| | - Hollis Haotian Chai
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, People’s Republic of China
| | - Edward Chin Man Lo
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, People’s Republic of China
| | - Michelle Zeping Huang
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, People’s Republic of China
- Department of English, The Hang Seng University of Hong Kong, Hong Kong, People’s Republic of China
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, People’s Republic of China
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Macpherson I, Sanagustín E, Roqué MV, Giner-Tarrida L. Evaluation of relational factor in patient satisfaction with the treatment received by dental students. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2024; 28:548-558. [PMID: 37986272 DOI: 10.1111/eje.12980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 10/08/2023] [Accepted: 10/29/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION The study focused on the importance of the relational factor and empathy in the general satisfaction of patients for the treatment received by university dental students. To achieve this objective, a tool capable of evaluating the most humanistic dimensions (empathy, kindness, trust) in the development of dental treatment has been designed. MATERIALS AND METHODS A review of the literature was carried out and, based on its findings, a questionnaire was designed to assess patient satisfaction with the dental student's empathy. It consisted of 20 questions and was completed by 80 patients. The questionnaire was subjected to a validation process using the Delphi method (content validity) and psychometric analysis (construct validity), through a principal components analysis (PCA). RESULTS The results of the PCA showed the existence of four components that suggest grouping the 20 questions into three blocks with a sequential structure, in which the questions would describe the patient's satisfaction throughout their treatment: reception and explanation of the treatment; development and progress of treatment; and expectations and completion of treatment. In each of these blocks, satisfaction was determined by a specific humanistic dimension: communication, trust and benevolence. CONCLUSION The validated questionnaire is an effective tool to analyse the relational factors that determine patient satisfaction in a treatment. Furthermore, the analysis of the questionnaire suggests that communication, trust and benevolence are elements that acquire singular importance throughout the care process. This analysis is essential for the acquisition of humanistic skills by future professionals and to optimize the dentist-patient relationship.
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Affiliation(s)
- Ignacio Macpherson
- Bioethics Unit, Department of Humanities, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Elisa Sanagustín
- Faculty of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | - María Victoria Roqué
- Bioethics Unit, Department of Humanities, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Lluís Giner-Tarrida
- Faculty of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
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Putrino A, Marinelli E, Agrillo A, Zaami S. New Perspectives in Third Molar Auto-Transplantation: Literature Review and a Case Report of Clinical, Financial and Forensic Implications. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:473. [PMID: 38541199 PMCID: PMC10972373 DOI: 10.3390/medicina60030473] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/05/2024] [Accepted: 03/11/2024] [Indexed: 07/23/2024]
Abstract
Third molar extraction is the most common procedure in oral and maxillofacial surgery. Third molars are considered less functional than other teeth and are often extracted. Sometimes, they are also used for auto-transplantation for the benefit of oral rehabilitation. Since many biological factors are involved in this surgical approach, herein, we outline a review of the biological characteristics of medico-legal/forensic interest, in addition to presenting a successful clinical case. A scoping review of currently available research data (following the principles of PRISMA-ScR or the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) on third molar auto-transplantation was conducted by drawing upon the main databases (Scopus, PubMed, Google Scholar and LILACS) to evaluate biological and clinical characteristics possibly relatable to forensic issues. All the collected data were summarized and elaborated on for the purpose of this article. A patient underwent extraction of the right upper first molar and auto-transplantation of the unerupted ipsilateral third molar. Many biologic and clinical factors are involved in the success of this clinical procedure. Knowledge of third molar anatomy, of its development and viable surgical approaches are all essential elements; just as important are the treatment of the tooth before and after transplantation and the integrity of the periodontal ligament. Follow-up of the clinical case for 5 years made it possible to verify the stability of the procedure over time. Third molar auto-transplantation is feasible and cost-effective. However, the use of third molars as donor teeth in auto-transplantation may have medico-legal implications. The lack of official protocols and consistent evidence-based guidelines for operators still prevent such a procedure from becoming mainstream; therefore, it is viewed with suspicion by clinicians and patients, even though the biological factors herein detected point to a reasonably high degree of safety. The understanding of many specific biological and clinical factors involved in the stability of third molar auto-transplantation allows for a thorough understanding of the forensic implications relevant to clinical practice. Effective communication and information provision are therefore of utmost importance, in the interest of both patients and doctors.
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Affiliation(s)
- Alessandra Putrino
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy;
| | - Enrico Marinelli
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy;
| | - Alessandro Agrillo
- Maxillofacial Surgery Unit, San Filippo Neri Hospital, 00135 Rome, Italy;
| | - Simona Zaami
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy;
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Blanchard JR, Koshal S, Navaratnam A, Machin JT, Briggs TWR, Jones E. Hospital dentistry litigation in England: clinical negligence claims against the NHS 2015-2020. Br Dent J 2022:10.1038/s41415-022-4965-4. [PMID: 36068267 DOI: 10.1038/s41415-022-4965-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/09/2022] [Indexed: 11/08/2022]
Abstract
Introduction Litigation against the NHS in England is rising. The aim of this study was to determine the incidence and characteristics of hospital dentistry clinical negligence claims in England.Methods A retrospective review was undertaken of all clinical negligence claims in England held by NHS Resolution relating to hospital dentistry between April 2015 and April 2020. Analysis was performed using the information for cause, patient injury and claim cost.Results A total of 492 claims were identified, with an estimated potential cost of £14 million. The most frequent causes for clinical negligence claims included failure/delay in treatment (n = 175; £3.9 million), inappropriate treatment (n = 56; £1.8 million) and failure to warn/obtain informed consent (n = 37; £1.5 million). Wrong site surgery was cited in 33 claims. The most frequent injury reported was dental damage (n = 197; £4.3 million), unnecessary pain (n = 125; £2.3 million) and nerve damage (n = 52; £2.4 million).Conclusion Clinical negligence claims in hospital dentistry are related to several different aspects of patient management and are not limited to treatment complications alone. Human ergonomics and patient perception of dentistry cannot be controlled but a focus on patient safety measures and effective communication can serve as tools to combat these factors.
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Affiliation(s)
- Jessica R Blanchard
- Department of Oral Surgery, Royal National ENT and Eastman Dental Hospitals, University College London Hospitals, 47-49 Huntley Street, London, WC1E 6DG, UK.
| | - Sonita Koshal
- Department of Oral Surgery, Royal National ENT and Eastman Dental Hospitals, University College London Hospitals, 47-49 Huntley Street, London, WC1E 6DG, UK
| | - Annakan Navaratnam
- Royal National ENT and Eastman Dental Hospitals, UCLH, 47-49 Huntley Street, London, WC1E 6DG, UK; Getting it Right First Time Programme, NHS England and Improvement, Wellington House, 135-155 Waterloo Road, London, SE1 8UG, UK
| | - John T Machin
- NHS England and Improvement, Wellington House, 135-155 Waterloo Road, London, SE1 8UG, UK
| | - Tim W R Briggs
- NHS England and Improvement, Wellington House, 135-155 Waterloo Road, London, SE1 8UG, UK
| | - Elizabeth Jones
- Getting it Right First Time Programme, NHS England and Improvement, Wellington House, 135-155 Waterloo Road, London, SE1 8UG, UK
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