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*What is Dental Negligence? (‫ إه ل‬: )

When you go to the dentist you expect to receive a professional

service and treatment. However, sometimes injuries and
suffering are caused through the negligence of these
professionals.

Dental Negligence is basically any injury or suffering caused by

Dentists failure to meet their 'duty of care' towards the patient,
or can be claimed when careless or incorrect dental work
leading to personal injury.

* Now, what are the situations that can be arise dental

negligence?
For example:

1- Nerve injuries that affected a patient’s ability to taste, or that

caused permanent numbness in the tongue (or even just part of
the tongue); that result from incorrect local anesthesia that
may traumatized or cutting the lingual nerve.

2- Complications arising from negligently completed crowns

and bridges ; this is very important, when you are doing
complete crown & bridge preparation you must prepared tooth
to fabricated for crown & bridge, & the problem in our
country that we decrease the visits & this is very painful to the
patient. Or; if the dentist don’t learn any thing about tooth
preparation & he doing over preparation & reach to the pulp
of the tooth, this is a problem!!

3- Dentists’ failures to take a patient’s relevant medical history

into account before acting; you should take a medical history &
this is a very protected part, for example; patient with heart

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failure, hemophelia …., you must deal with them carefully, &
you must deal with this part as routine situations - &this is
main thing to successful in your job.

4- Failure to detect oral cancer, periodontal disease, or other

diseases; that is what you are study in oral pathology & there
are important why? Because you are studying sequamous cell
carcinoma, apthus ulcer etc… & you can discovering the oral
cancer easily , but if you don’t know & the patient leave you
then discovered the cancer by other dentist that means end of
you, other thing important that is PDL diseases; many of our
clinics don’t have PDL probe & they don’t examine the patient
from periodontal disease , if the patient appear after many years
& he lost his teeth do to aggressive periodontitis & he going
back to the chart &the dentist don’t mention that, they will
convict the dentist, so if you cant do proper diagnosis you must
convert the patient to specialist.

5- Certain complications from anesthesia, even when releases

are signed:
For example; anterior dental block between 2 premolars, some
time you might giving anesthesia in wrong way & this is a
problem, & ethical back ground to you if you don’t know how
to giving the anesthesia in correct procedure you must be don’t
giving him especially when you are undergraduate .

6- Unnecessary extraction of multiple teeth; for many ways to

make an implant for the patient, & this is complicated either
from periodontal pulp diseases or from endodontic pulp
diseases , but the dentist didn’t know the correct procedure to
deal with this cases.

7- Extraction of wrong teeth (Oh, yes….it happens) ;(

Because the dentist is careless as simple as that, if you extract a
wrong tooth that is mean you are careless & this is happen.

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* Informed consent:

Is a process by which a patient is apprised (informed) of the

nature and risks of a proposed treatment that may be occur
during the treatment, including no treatment or observation
only, and then accepts a treatment plan (consents) .

That means the patient getting a paper to accept the plan of

treatment, & that is very important because you protect your
self from any complication may be occurs during the
procedure.

*Now; the types of patient concept;

1) Implied concept;

Provided the patient has the ability to give it, implied consent
is given when the patient agree to treatment, or at least does not
object. In dentistry; we have from our teaching the plan, for ex;
In surgery; we have a minor surgery such as getting impacted
lower 8, & in this procedure might be complication like
swelling & continuous pain, etc… all of this complication
should be written.
Or; another procedure such as general anesthesia especially in
children & the complication of this procedure also should be
written.

2) Written concept:

Written consent is a preferred means of obtaining &

documenting the patient’s consent & understanding of the
procedure, In dentistry, written informed consent usually is
obtained for anesthesia involving sedation or general anesthesia,
as it is for many other procedures , in certain countries that are
even cavity preparation include.

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Practitioners generally advise patients about both minor
common complications or even serious rare complications that
can occur with the proposed procedures;

*Now, What is the condition, that do not required an informed

consent in dentistry or in your clinic??!!!!

Emergency cases, but you must know how to deal with these
cases.

* Guidelines for Informed Consent:

1) Use simple words & phrases:

Very important because you might use a complex words your
patient doesn’t know what that is mean such as if you write:
after surgery procedure you may get a hyper plastic enlargement
tissue … , so you should use a very easy word to make the
patient understand that.

2) Avoiding technical terms, so that it may be easily understood.

3) Avoid overly broad statements such as “any and all

treatment:
To protect your self don’t ever written statements such that:
this procedure don’t have any complication at all.

4) When possible, this should occur on a day separate from the

treatment (question in exam): why? To become the patient leave
it & understand what you do
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( -"‫ا أ‬./" ‫ج‬1‫ا‬

5) To assist the patient in making an informed decision about

having the proposed treatment, the dentist should explain:
-The nature of the proposed treatment

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-The benefits of the proposed treatment, & the consequences of
not having the proposed treatment
-The most common & severe risks associated with the proposed
treatment
-Reasonable alternatives to the proposed treatment, including
the risks and benefits
(the doctor just read the slide)

*Now: Items appearing on a consent form for a minor:

1) Name & date of birth of pediatric patient, for every child

who enter to the clinic
2) Name, relationship to patient, and legal basis for adult to
consent on behalf of minor .
3) Treatment, alternatives, & risks; that means if you want to
do a very critical procedure for a child such a surgery you
should take a concept from his father or any some one legally
responsible on him.
4) Potential adverse sequelae specific to the procedure
5) An area for the patient or parent/guardian to indicate all
questions have been asked
6) Signature lines for the dentist, parent or legal guardian & a
witness.

*Informed Consent Should be;

Procedure specific, with multiple forms likely to be used

Updated or changed accordingly as changes in treatment plans
occur.

*When Written Consent Is Required ?

_ If new drugs are to be used

_ If experimentation or clinical testing is involved
_ If a patient’s identifiable photograph is used
_ If minor children are treated in a public program

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_If the treatment takes more than 1 year to complete ( question
in exam)
You need to have a concept

*Conclusion;
_The patient education & informed consent process plays an
important role in assuring realistic expectations, enhancing
your relationship with patients, & improving patient outcomes
_ Additionally, a well-established informed consent process may
assist in preventing & defending malpractice claims
_Take the time to consider whether your informed consent
process effectively educates patients and protects you from
potential malpractice claims

( the doctor just read this slide)

_ THE END_

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 Final Exam will be held on (Thursday
14/8/2008) at these halls 0n line:

Lab. 4 from no. 1 - no. 43 .1

Lab.8 from no. 44 – n. 84 .2
Lab. 10H2 from no. 85 – no. 155 .3
According to the list of names provided to you by
the your C.R.

Note; the lecture of dr. khansaa ababneh about;

(control of infection are include in the final exam)