Patient Safety Incidents and Adverse Events in Ambulatory Dental Care: A Systematic Scoping Review.
There have been efforts to understand the epidemiology of iatrogenic harm in hospitals and primary care and to improve the safety of care provision. There has in contrast been very limited progress in relation to the safety of ambulatory dental care.



To provide a comprehensive overview of the range and frequencies of existing evidence on patient safety incidents and adverse events in ambulatory dentistry.



We searched MEDLINE and EMBASE for articles reporting events that could have or did result in unnecessary harm in ambulatory dental care. We extracted and synthesized data on the types and frequencies of patient safety incidents and adverse events.



Forty articles were included. We found that the frequencies varied very widely between studies; this reflected differences in definitions, populations studied, and sampling strategies. The main 5 PSIs we identified were errors in diagnosis and examination, treatment planning, communication, procedural errors, and the accidental ingestion or inhalation of foreign objects. However, little attention was paid to wider organizational issues.



Patient safety research in dentistry is immature because current evidence cannot provide reliable estimates on the frequency of patient safety incidents in ambulatory dental care or the associated disease burden. Well-designed epidemiological investigations are needed that also investigate contributory factors.
From the Centre of Medical Informatics.
Eduardo
E
Ensaldo-Carrasco
Centre for Population Health Sciences, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Scotland, UK.
Milton Fabian
MF
Suarez-Ortegon
Patient Safety Research Lead, Primary and Emergency Care Research (PRIME) Centre, Cardiff University, Wales; and Visiting Professor of Healthcare Improvement, Department of Family Practice, University of British Columbia.
Andrew
A
Carson-Stevens
Kathrin
K
Cresswell
Professor and Head Centre for International Child Oral Health. King's College London Dental Institute at Guy's, King's College and St Thomas's Hospitals, Division of Population and Patient Health, King's College London, UK.
Raman
R
Bedi
Professor of Primary Care Research & Development and Co-Director, Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Scotland.
Aziz
A
Sheikh
D003729:Dental Care; D006761:Hospitals; D006801:Humans; D019300:Medical Errors; D061214:Patient Safety; D011320:Primary Health Care