Preventability of Dental Office-Originating Adverse Events

Objectives: In a previous work, we established that adverse events (AEs) occur in dentistry at a rate similar to those reported in Medicine; and that extractions and endodontic procedures were the ones most likely to be associated with the occurrence of AEs. The present work aimed to explore the preventability of these dental office-originating AEs, with the ultimate goal of instituting mechanisms to forestall their occurrence.
Methods: Five national patient safety experts, through a unanimity criterion approach (full consensus), reviewed the list of dental office-originating AEs; and assigned preventability on a 4-point scale. 1 = not preventable; 2 = probably not preventable; 3 = probably preventable and; 4 = preventable. A preventable AE was primarily defined as an AE which could have been averted if adequate actions had been taken during the patient’s contact with the healthcare system.
Results: Of the 27 AEs that have been fully reviewed so far, none was considered ‘not preventable’, 4 (15%) were considered ‘probably not preventable’, 16 (59%) were considered ‘probably preventable’ and 6 (22%) were considered ‘preventable’. One was unclassifiable due to insufficient information.
Conclusions: Not all provider error leads to patient harm (or AEs) and; not all AEs are a consequence of provider error. AEs that are however the consequence of provider error are referred to as preventable AEs. Our preliminary results show that the overwhelming majority of dental office-originating AEs are probably preventable. Consequently, if more attention is paid to patient safety, the dental profession has the opportunity to prevent most AEs.