title: An analysis of dental patient safety incidents in a patient complaint and healthcare supervisory database in Finland.
abstract: OBJECTIVE
  Few studies of patient harm and harm-prevention methods in dentistry exist. This study aimed to identify and characterize dental patient safety incidents (PSIs) in a national sample of closed dental cases reported to the Regional State Administrative Agencies (AVIs) and the National Supervisory Authority for Welfare and Health (Valvira) in Finland.
  
  
  METHODS
  The sample included all available fully resolved dental cases (n = 948) during 2000-2012 (initiated by the end of 2011). Cases included both patient and next of kin complaints and notifications from other authorities, employers, pharmacies, etc. The cases analyzed concerned both public and private dentistry and included incident reports lodged against dentists and other dental-care professionals. Data also include the most severe cases since these are reported to Valvira. PSIs were categorized according to common incident types and preventability and severity assessments were based on expert opinions in the decisions from closed cases.
  
  
  RESULTS
  Most alleged PSIs were proven valid and evaluated as potentially preventable. PSIs were most often related to different dental treatment procedures or diagnostics. More than half of all PSIs were assessed as severe, posing severe risk or as causing permanent or long-lasting harm to patients. The risk for PSI was highest among male general dental practitioners with recurring complaints and notifications.
  
  
  CONCLUSIONS
  Despite some limitations, this register-based study identifies new perspectives on improving safety in dental care. Many PSIs could be prevented through the proper and more systematic use of already available error-prevention methods.
authors.affiliation: a 1 Oral Public Health, Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki , Helsinki, Finland.|b 2 FINDOS Helsinki, Doctoral Programme in Oral Sciences, University of Helsinki , Helsinki, Finland.
authors.forename: Nora
authors.initials: N
authors.lastname: Hiivala
authors.affiliation: c 3 Public Health, Hjelt Institute, Faculty of Medicine, University of Helsinki , Helsinki, Finland.|d 4 Regional State Administrative Agency for Southern Finland , Helsinki, Finland.
authors.forename: Helena
authors.initials: H
authors.lastname: Mussalo-Rauhamaa
authors.affiliation: e 5 National Supervisory Authority for Welfare and Health , Helsinki, Finland.
authors.forename: Hanna-Leena
authors.initials: HL
authors.lastname: Tefke
authors.affiliation: a 1 Oral Public Health, Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki , Helsinki, Finland.
authors.forename: Heikki
authors.initials: H
authors.lastname: Murtomaa
mesh_terms: D000328:Adult; D019992:Databases as Topic / Q000706:statistics & numerical data*; D003727:Dental Auxiliaries / Q000706:statistics & numerical data; D003729:Dental Care / Q000706:statistics & numerical data*; D003756:Dental Hygienists / Q000706:statistics & numerical data; D003800:Dental Technicians / Q000706:statistics & numerical data; D003815:Dentists / Q000706:statistics & numerical data; D034462:Dissent and Disputes; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D008318:Malpractice / Q000706:statistics & numerical data; D008875:Middle Aged; D064406:Patient Harm / Q000145:classification / Q000517:prevention & control / Q000706:statistics & numerical data; D061214:Patient Safety / Q000706:statistics & numerical data*; D017149:Private Sector / Q000706:statistics & numerical data; D017150:Public Sector / Q000706:statistics & numerical data; D012308:Risk Management; D012737:Sex Factors
keywords: Degree of harm; dentistry; error prevention; incident type; malpractice