Adverse incidents - including erroneous extractions, like the one we describe below - are unfortunate for patients and dental professionals alike. But depending on the circumstances, it may be that they can still be managed well by the dental team, so that a subsequent complaint or claim is avoided.

Making a plan

It's important to know what to do when something goes wrong, and that means having the right plans, procedures and practice policies in place.

Make sure that any adverse incident is thoroughly investigated, and, when necessary, appropriately reported. An investigation of any adverse incident should look at what happened, why it happened and what can be done to help prevent a similar situation arising in future.

This should be carried out in a no-blame way and the findings should be shared with the whole team, as it might mean a similar situation doesn't happen to someone else. It can also be worthwhile to go through a similar investigation when there has been a 'near miss', which might help prevent a difficult situation arising in future that could result in someone else suffering harm.

When considering what happened and why, take into consideration all relevant factors. For example, were the correct records available? Were they up to date and accurate? Were there any factors that might have led to a lapse in concentration? This is not an exhaustive list, but are still good examples of some of the factors you might need to consider.

Avoiding a complaint

Although the extraction in this case did result in a complaint, there are steps you can take to help prevent a patient from being dissatisfied with their treatment. If the patient is undergoing orthodontic treatment, as in this example, it's sensible to liaise with an orthodontist at the earliest opportunity to see if the treatment plan can be amended so the patient gets a good result with the minimum of disruption.

If the erroneous extraction was not part of an orthodontic treatment plan, arrange for the patient to have a further assessment so all appropriate treatment options can be explored. Think carefully about involving other clinicians in this assessment, as the patient might now lack confidence in your abilities.

Make sure that you tell the patient of any developments, so they're kept up-to-date with your attempts to arrange their ongoing care. Keep good records of all your discussions with the patient, and with anyone else who might be involved in helping you arrange care for the patient.

As with so much of dental practice, rectifying an inadvertent error and achieving a good result for the patient involves good communication, and having reliable practice procedures in place. When the dental team work well together, it is often possible to achieve an outcome that the patient is happy with.