Dental Negligence – A Double Edged Sword (Part 1)

In the era of modern dentistry and educated patients, dental practice needs to be more alarmed being more specific at the target and setting up goals with proper execution. Nowadays patients are not hesitant to pay when it comes to their need of treatment and demand quality dental work. Patient’s negligence in dental field may be because of his/her lack of interest regarding treatment needs. Most of the patients are fearful to meet dental management because of their peers' experience or their previous nightmares with dentists.

Dental negligence by patients may be because of the following reasons

1. Patient habitually not bothered about dental hygiene.
2. High cost factor in dental treatment
3. Pain associated fear factors during dental treatment
4. Negative responses from family members, peers and neighbors regarding dental treatment.

Negligence by the dentist in regards to the patients

1. Busy schedule of the dentist limits proper communication & counselling with patient.
2. Sometimes dentist just relieves acute symptoms thinking the patient’s condition may improve instead of suggesting an overall treatment plan.
3. Dentist may order the dental assistant to perform a procedure over a patient which may back fire.
4. A dentist may attempt a dental procedure on a patient which should have been supervised by a dental specialist due to his/her lack of experience/skill.

These are instances in dental practice were dentists and patients commit mistakes and both the parties are liable for compensation or punishment under Indian Penal Code. There are laws made in civil and criminal court procedures where either of the parties is responsible for their liabilities from each other. Since there are adequate laws exist to safeguard dental patient from either of their negligence, dentist must be aware of these distressing threats.

Ethics in dentistry is one of the gold standard means for any dentist to secure himself from any danger which he or she will encounter in near future. As the famous quote “prevention is better than cure”, ethics in dentistry prepares a dentist from doing any wrongful things to the patients. The ethical principles in dental profession are as follows:

• Autonomy: Dentist must allow the patients decision on deciding his/her treatment and he has to respect the patient’s vision. It doesn’t mean that patients should over power dentist in their decision making; here the dentist is in a position to explain the patient about their dental health and treatment needs. Dentists are also given the liberty to explain the patients with the newer techniques and procedures available for dental treatment and get the patients consent for his/her dental treatment.
• Sympathy and beneficence: The dentist needs to understand the patient’s condition and he/she needs to attend the patient at the time of emergencies or patients need. Dentist should work for the patient and he/she can refer the patient for higher dentist for patient’s benefits or if he thinks the patient condition is out of his/her way to handle.
• Competence: The dentist needs to be very well aware of his/her abilities and need to be at their best to arrive to a diagnosis and provide suitable dental treatment for the patient. They need to be updated about the newer treatment modalities and newer drug therapies available in dentistry.
• Integrity: Here dentists need to be transparent to the patient thereby explaining the patient about the positives and negatives with the rendered dental treatment. The dentist should act with utmost responsibility and truthfulness by this means showing a desire to help the patient with utmost clarity and ease.
• Justice: The dentist must be impartial when it comes to the treatment needs. Rich, poor, religion or different race and customs, dentist has to provide the best treatment available with affordable cost and serve humanity with integrity and truthfulness.
• Professionalism: In dentistry, professionalism is akin to a character associated with superior competency and skill in handling and treating dental patient with respect, honesty and dedication. Professionalism in dentistry and medical field goes hand in hand.
• Tolerance: Dentist must be aware of patient’s attitude and behavior. He/she needs to act very thoughtfully with different race, religions and ethnicities present in our country and treat them with love and affection.
• Veracity: Truthfulness is the basis of patient- dentist relationship. During any dental procedures, patient relies upon dentist’s honesty on rendering quality treatment and dentist will rely on patient's truthfulness while arriving to a diagnosis.

An absence of reasonable degree of care or skill during any dental procedure which may cause death or a serious injury to any patient amounts to the act of negligence in dental practice. On the other hand, negligence can be an act of charge by the dentist or can be an act of exception. In either way, it cannot be termed as a planned operation with an intention to do harm to either a patient or the dentist.

As medico legal cases against healthcare professionals are on the rise, we will analyze it in depth in Part 2 of this article.