Tag Archives | patient

Case Reports Serve a Place in Dentistry

An interesting article titled “CASE REPORTS HAILED” appears in JADA in September 2014, written by Enihomo Obadan, Elsbeth Kalenderian, and Rachel B. Ramoni. The article discusses an article in an earlier 2014 JADA article that featured an interesting case report. The authors state “Almost becoming a lost art in the biomedical literature, case reports still hold tremendous opportunities for learning in dentistry. In addition to the obvious learning potential for the individual dental professional, the entire professional body advances in giant strides when there is cross-organizational learning among dental clinics through information sharing.” The authors then discuss how adverse dental events being reported by dentists would help make dental treatments safer for all. The authors feels this helps promote a culture of safety, as long as there is no fear of retribution when the report occurs by the dentists. The authors describe how the identification of threats to patient safety is the first element of the patient safety initiative by the Agency for Healthcare Research and Quality in the U.S. The authors state “Ideally, there should be a national patient safety organization to which these events could be reported. This would provide dental clinicians, researchers and patients alike essential information […]

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How to Address a Patient who Had an Interrupted Treatment Plan

An interesting article titled “Following up with a patient whose treatment has been interrupted” appears in the November 2014, JADA, and written by Michael H. Halasz. The article discusses a patient who received a complex treatment from a military dentist. The treatment started but because of deployment of a large number of troops in Iraq the treatment was interrupted so that the dentists could attend to other troops. The article addresses if the patient was abandoned during this time. The American Dental Association Principles of Ethics and Code of Professional Conduct states “Once a dentist has undertaken a course of treatment, the dentist should not discontinue that treatment without giving the patient adequate notice and the opportunity to obtain the services of another dentist. Care should be taken that the patient’s oral health is not jeopardized in the process.” The article states that if the dentist felt he was going to resume the treatment of the patient after handling the deployed troops, then he acted reasonably. However, one could also argue that since the dentist did not know how long he would be tied up with the other troops, he had an ethical obligation to inform the patient to have […]

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Exploring the Alternative to Medical Injury Claims in New Hampshire

In a post last year I dicussed briefly the early offer system in New Hampshire see The Optional Alternative to Medical Injury Claims. This is the first of the kind system in the United States that is an alternative to the traditional medical malpractice system. An article in the 2013 issue 4 of the American Journal of Law and Medicine has explored this titled “Evaluating New Hampshire’s First-In-The-Nation Early Offer Alternative to Medical Malpractice Litigation,” and written by John W. Masland. The article states “Many states have enacted medical malpractice reforms, recognizing that their tort systems result in protracted litigation, high costs, and a large number of uncompensated victims. One proposed reform, an “early offer” system, allows a medical provider to make a financial offer covering an injured patient’s economic damages, which, if the patient accepts, precludes litigation…On June 27, 2012, the New Hampshire General Assembly overrode former Governor John Lynch’s veto and established the country’s first early offer payment system for medical malpractice claimants.  After a medical injury, patients may now request an early offer payment from their medical providers for economic damages.” The article goes into more specific details of the early offer program as implemented in New Hampshire. […]

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Dental Anxiety Associates with Pain During Dental Procedures

It is well known by dentists that some patients experience dental anxiety, with some patients have worse dental anxiety than others. In a review article titled “Dental Anxiety Is Considerably Associated With Pain Experience During Dental Procedures,” by Mike T. John, appearing in J Evid Base Dent Pract, 2013, issue 13, pp. 29-30, the issue of dental anxiety in dental patients is explored. The study reviews a study titled “Predictors of pain associated with routine procedures performed in general dental practice,” by Tickle M, Milsom K, Crawford FI, and Aggarwal VR, in Community Dent Oral Epidemiol, 2012 Aug;40(4):343-50. In the original study 508 patients who visit 38 different dentists in England participate. Dental anxiety was measured with the Corah Dental Anxiety Scale which resulted in a score between 4 and 20. This score was grouped into 4 different variables representing anxiety. The dental patients were asked to rate their intensity of pain on a scale of 0 to 10 during the procedure, after the procedure, and later after the procedure (not immediate). The researchers performed logistic regression and found that very anxious patients had a fivefold increased odds of experiencing pain during the dental procedure compared to patients who had […]

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Ethical Issues for Consent in Dentistry

An article appears in the Journal of Medical Ethics, vol. 39, pp. 59-61, January 2013, titled “Consent in dentistry: ethical and deontological issues,” written by Adelaide Conti, Paola Delbon, Laura Laffranchi, and Corrado Paganelli. The authors are from Italy and so the focus of the article is a discussion of some of the ethical issues in dentistry. I have previously discussed some ethical issues in medicine and dentistry. See for example, Attending to the Patient in the Informed Consent Process and Are Dentists Ethical or Scam Artists?. In the article the authors say “The right of patients to make decisions about their healthcare has been enshrined in legal statements: in Italy the National Constitution establishes that personal liberty is inviolable and that no one may be obliged to undergo any given health treatment except under the provisions of the law…In addition, the Charter of fundamental rights of the European Union and the Council of Europe’s ‘Convention on human rights and biomedicine’ establish the general rule of free and informed consent in the health field.” The authors touch on how it is possible that some treatment options provided by dentists may be considered a disfigurement in some cultures but a sign […]

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