Malpractice claims in orthodontics appear to be growing, fueled by poor communication, unmet patient expectations, and more, according to a review published on April 13 in International Orthodontics.
The keys to reducing liability are education, documentation, and transparency, the authors wrote.
“Overall, evidence suggests that both clinical complications and medico-legal shortcomings contribute to orthodontic litigation,” wrote the study's lead author, Dr. Giuseppe Varvara, PhD, of "Gabriele d'Annunzio" University of Chieti-Pescara in Italy.
To identify potential underlying causes of malpractice claims in orthodontics, a scoping review was conducted. Seven studies were analyzed.
The analysis revealed several recurring themes, most notably that periodontal complications, aesthetic dissatisfaction, and failures in documentation or informed consent were the most common drivers of lawsuits.
Biological and periodontal complications, including tooth injury (63%), recession (29%), and root resorption (6%), were reported as reasons for litigation. Meanwhile, treatment outcome dissatisfaction, specifically aesthetic expectations (36%), was another recurrent reason for claims.
Factors other than clinical problems also led to litigation. Lack of documentation accounted for about 22% and 29%, and insufficient or a lack of informed consent was reported in up to 30% of claims, according to the review.
The findings reveal that many factors may reduce orthodontic malpractice claims. Clear communication and a comprehensive informed consent process would help, as well as being upfront about the duration of treatment and ensuring patients are free of dental disease as treatment progresses, the authors wrote.
Nevertheless, the review had limitations. Most data used were derived from retrospective analyses of legal cases, which may underreport those disputes that were resolved informally, they wrote.
“Maintaining accurate and complete clinical records, ensuring consistent follow-up, and pursuing ongoing professional education in both orthodontic and medico-legal aspects of practice are equally important to reduce the likelihood of legal disputes,” Varvara wrote.
