Common mistakes, negligence and legal offences in paediatric dentistry: a self-report

AIM: To identify the type and relative prevalence of mistakes, negligence and legal offences (MNLOs) performed or nearly performed by paediatric dentists during their entire career. METHODS: The population consisted of 25 (29.4%) certified and 48 (56.5%) non-certified paediatric dentists, and 12 (14.1%) residents in paediatric dentistry. A structured anonymous questionnaire accessed occupational characteristics and frequencies of MNLOs (0, 1-4, 5-10, >10). RESULTS: The most prevalent MNLOs related to the performance of radiographs: bite-wings with overlapping teeth (90%), overturned film (30%), film over-exposure (48%), faulty film development (84%) and exposure of the same side of film twice (32%). Other MNLOs were drilling an intact tooth (37%), misdiagnosing existing radiographic caries (63%), anaesthetising the wrong tooth (49%), accidental incision of the cheek/lips during treatment (73%), administering an incorrect dose of antibiotic (49%) or analgesics (24%), extracting the wrong tooth (15%), documenting the wrong tooth in the patient's file (63%), and a child swallowing an instrument (33%) or clasp (15%). Prevalent MNLOs included administering sedation to a child who had not fasted (32%), sedating without monitoring (9%), treating children without receiving signed parental consent (15%) and losing a radiograph (64%). CONCLUSIONS: MNLOs occur commonly during various operative dental treatments. Means to raise awareness and to implement regulations should be addressed to limit these mistakes.