Legal liability facing COVID-19 in dentistry: Between malpractice and preventive recommendations.

The dental profession is considered at high potential risk of exposure and transmission of SARS-Cov-2. Thus, dentists should implement special safety measures in order to prevent any possible contamination during dental sessions and should be aware of the legal implications of their act in order to avoid malpractice leading them to be a causative agent of transmission of this virus. This paper aimed to provide a global review on COVID-19 preventive recommendations at dental clinics and discussed the legal values of such procedures, the dentist criminal and civil liability arising from transmitting this virus to a patient, the obligation of care under COVID-19 and the possible solution to this dilemma. The review concluded that dentists should follow all modern scientific procedures which are in their interest and in the interest of patients to maintain their safety and advised dentists to document all steps taken during the period of COVID-19 outbreak, because any undocumented action is considered not to have taken place, and they shall be bound by the burden of proof.

Telemedicine services in the work of a doctor, dentist, nurse and midwife - analysis of legal regulations in Poland and the possibility of their implementation on the example of selected European countries.

INTRODUCTION AND OBJECTIVE: The aim of the study is to discuss the legal framework for telemedicine services in Poland, and to present telemedicine solutions used in selected European countries. MATERIAL AND METHODS: The analysis of legal cts was chosen as a research method in order to determine legal possibilities for medical professionals to use telemedicine services. A literature review was undertaken to demonstrate the possibilities of telemedicine as used in the United Kingdom, Germany, Norway, The Netherlands and Sweden. RESULTS: The Act on the professions of a doctor and a dentist states that the doctor and the dentist can perform their profession via ICT systems or communication systems. The doctor is obliged to practice in accordance with current medical knowledge and available methods. 'Available methods' include considering information and communication measures that may allow prevention, recognition or treatment. The Act on the profession of a nurse and a midwife states that the nurse and midwife perform the professions using current medical knowledge and the mediation of ICT systems or communication systems. Thus, the legislator has clearly authorized persons performing these professions to provide services in the field of telemedicine. However, despite the existence of a legal basis for using telemedicine, its development in Poland is not as high as in the United Kingdom, Germany, Norway, The Netherlands or Sweden. CONCLUSIONS: The legislator gradually introduces legal solutions necessary for the development of telemedicine services, although the pace of these changes, as well as building the technical infrastructure that is the basis for the proper provision of telemedicine services, are too slow.

Medical grounds for suspending the professional licence of physicians and dentists by Regional Medical Councils between 1990 and 2014. / Przyczyny zdrowotne zawieszenia prawa wykonywania zawodu przez okregowe rady lekarskie w latach 1990­2014.

OBJECTIVES: The professions of physician and dentist are associated with multiple health risks. The aim of this study was to identify the medical conditions that caused limitation or suspension of the professional license of Polish physicians and dentists, and to assess their return to professional activities. METHODS: We analyzed documentation of Regional Medical Registers concerning the procedure for suspending medical licences or limiting certain medical activities, and decisions of Regional Medical Councils in 1990-2014. RESULTS: The data on 65 decisions suspending the professional license, 8 decisions limiting the license and 1 revoking the right to practice have been obtained from 8 Councils. The most frequent cause of limiting or suspending the professional license was drug and alcohol dependence (54.1%). There was no correlation between the underlying medical condition and gender or profession (physician/dentist). Among doctors aged 42-57 and 58-67 whose licence had been suspended or limited, more than 60% suffered from substance use disorder (SUD). In the group of doctors aged 41 and younger, no such case was found. Among doctors older than 67, addiction was the cause of 37.5% of decisions suspending or limiting the professional license. In no case the medical condition causing limitation or suspension of the licence was an occupational disease. SUD was more frequent in surgical than nonsurgical specialties (76.5% vs. 46.9%, p < 0.05). The doctors suffering from addictions were more likely to return to their practice (57.5%) than those suffering from other illnesses (20.5%, p < 0.05). CONCLUSIONS: The most common medical ground for limiting or suspending the professional licence was substance abuse. Number of decisions suspending or limiting the licence is relatively small and indicates a need for more efficient procedures for identification of doctors and dentists incapable of practicing due to health problems and assessment of the capacity to practice in the case of individuals who do not undertake treatment themselves and therefore are unable to assure sufficient quality of care to their patients. Moreover, although few decisions were issued, there is a need for an active addiction prevention, particularly among surgical specialists.

The Indian dental litigation landscape: An analysis of judgments on dental negligence claims in Indian Consumer Redressal Forums.

INTRODUCTION: Dental malpractice/negligence litigations against dentists in India is not widely studied. The aim of this study is to report the Indian dentist related litigation landscape in consumer redressal forum (CRF) and to understand more of the nature of the same. MATERIAL AND METHOD: 111 cases of judgments of dental malpractice in Indian CRF were collected. Useful information was extracted, reported in a grid and statistically analyzed. Data was compared by claim, specialty, treatment offered, days lapsed and compensation awarded. P ≤ 0.05 was taken as statistically significant. RESULTS: In all, 44 (39.63%) dentists were found guilty. Thirty dentists had produced at least one evidence in their favor. Among them, 23 outcomes were in dentist's favor.(P = 0.02) The mean wait for final judgment was 1945 ±â€¯1286(193-6762) days. The mean compensation claimed was INR 577287 ±â€¯905898. Presence of evidence (dentists/patients) had an impact on the days to reach a judgment as well as compensation. CONCLUSION: Indian dental litigation landscape CRF has been described for the first time. We identified that CRF litigation of dental malpractice are few, as compared to number of procedures performed in India. Oral surgical procedures were often involved and 40% of instances, dentists were guilty and mean compensation awarded was INR 103998 ±â€¯158976.

A 15 years survey for dental malpractice claims in Rome, Italy.

INTRODUCTION: In recent years, dental malpractice claims seems to have increased dramatically worldwide without a clear explanation. The aim of our work is to shed more light on this phenomenon to better understand its magnitude and trend, and to point out possible critical factors that, if changed, can mitigate it. MATERIAL AND METHOD: 458 cases of dental malpractice sentenced by the civil court of Rome, Italy, from 2001 to 2015, were collected. Useful information was extracted, reported in a grid and statistically analyzed. Data was compared between years and overall evaluated. RESULTS: Multiple information were obtained, among which: the number of dental malpractice claims has decreased in most recent years; Dental professionals are found guilty in 74% of cases; the average compensation granted is 18.820,15 €; only 47,7% of the insured dentist found guilty was fully covered by their insurance. CONCLUSIONS: Contrary to what we expected, dental malpractice claims in court have decreased in recent years. The limit liability of dental professional insurances is high compared to the average compensation granted and the insurance doesn't always cover all the expenses for the presence of peculiar clauses in the contract.

Competency model for dentists in China: Results of a Delphi study.

OBJECTIVE: With the increasing awareness of the importance of oral health, patients have an increasing need for integrated care from dentists. In China, the dentistry examination consists of two parts: a practical skills examination and a comprehensive medical examination; to date, no assessment methods that are based on specialized dentistry competencies, unlike the United States, Canada, and other countries, have been established. Therefore, the purpose of this study was to construct a competency model for dentists in China in order to guide the development, admission, training and assessment of dentists. METHODS: Using a literature review, focus group interviews and in-depth personal interviews, a dentist competency index was developed with an expert consultation questionnaire. A panel of 20 specialist experts was chosen from ten national medical universities to carry out two rounds of Delphi expert analysis, using the boundary value method to filter the indicators and the Analytic Hierarchy Process to calculate the weights of the primary indicators. RESULTS: Two rounds of Delphi results showed that the expert authority, enthusiasm, and coordination coefficients were high. Constructs of the competency model that included seven primary indicators and 62 secondary indicators determined the weight of each index. The seven primary indicators included the following: clinical skills and medical services, disease prevention and health promotion, interpersonal communication skills, core values and professionalism, medical knowledge and lifelong learning ability, teamwork ability and scientific research ability. CONCLUSION: In conclusion, the use of the Delphi method to construct an initial model of Chinese physician competency is scientific and feasible. The initial competency model conforms to the characteristics and quality requirements of dentists in China and has a strong scientific basis. The dentist competency model should be used in the National Dental Licensing Examination in China.

Establishment of a dental license regulation authority is required in Korea: results of the Delphi technique.

PURPOSE: In addition to dental education, a system for the evaluation and management of dental licensing and certification is required to meet the growing societal demand for more competent dentists. In this study, the Delphi technique was used to gather opinions from a variety of professionals on the problems of and remedies for the dental license management system in Korea. METHODS: Delphi surveys were conducted from April 2016 to October 2016 in South Korea. A variety of dental professionals were included and categorized into 3 groups according to their expertise as follows: the basic dentistry group, the clinical dentistry group, and the policy group. The Delphi technique was conducted in 3 rounds of e-mail surveys, each with different questions that probed with increasing depth on the dental license management system. In each successive round, the responses were categorized, scored on a Likert scale, and statistically analyzed. RESULTS: After categorizing the results of the first survey and ranking the results of the second survey using the Delphi technique, regulation by a licensing authority was found to be the most critical issue. This was followed by the license renewal system, continuing education, a tiered licensure system, improvement of foreign license approval, and utilization of retirees, in decreasing order of importance. The third Delphi survey showed a similar ranking, with regulation by a licensing authority being the major concern. Opinions regarding the dental license management system were provided as open-ended responses. The responses of the 3 groups showed statistically significant differences in the scores for the issue of regulation by a licensing authority. After re-grouping into the dentistry group and the policy group, the issue received a significantly higher score in the dentistry group. CONCLUSION: The quality of dental treatment should be managed to protect patients and dental professionals. For this purpose, the establishment of an independent license regulation authority along with legislative changes is required.

No longer 'written off' - times have changed for the BBV-infected dental professional.

There is a recognised potential risk of transmission of blood-borne viruses (BBVs) from infected healthcare workers to patients during exposure prone procedures (EPPs). The restrictions placed on performance of EPPs by infected clinicians in the UK have had a particularly significant impact on dentists because of the exposure-prone nature of most dental procedures and the difficulties in identifying alternative career pathways in the profession that do not involve EPPs. More recently, the significant positive impact of antiviral drugs on viral load, together with a re-categorisation of EPPs in dentistry have resulted in evolution of the guidance with a consequent significant improvement to the career prospects of dentists infected with BBVs. This paper provides an update for practitioners on the progress that has been made and outlines the current position with respect to practice restrictions.

Indenizações e processos jurídicos em Implantodontia: uma revisão no Brasil entre 2006 e 2016 / Compensation and legal processes in Implant Dentistry: a Brazilian review from 2006 to 2016

Objetivo: o presente estudo teve como objetivo averiguar as características dos processos cíveis de reparação de danos contra cirurgiões-dentistas, bem como o montante dessas reparações. Material e métodos: uma busca eletrônica foi realizada com o termo "implante dentário" em sites oficiais do Tribunal de Justiça de Santa Catarina, Superior Tribunal Federal e Supremo Tribunal Federal, entre 2006 e 2016. Os principais desfechos investigados foram: 1) pertinência dos processos contra cirurgiões-dentistas; 2) evolução dos processos; 3) sexo do reclamante; 4) personalidade jurídica do réu; 5) condenação ou absolvição; 6) tipo de decisão; e 7) valor das indenizações. Resultados: dos processos analisados neste estudo, 63% eram reclamações contra cirurgiões-dentistas. Dos autores das ações, 80% eram do sexo feminino. A maioria dos réus era pessoas jurídicas. Os profi ssionais de Odontologia foram condenados na maior parte dos processos. A decisão monocrática foi maioria ampla no tipo de decisão. O valor médio das indenizações foi R$ 20.123,07 para danos morais e R$ 15.020,55 para danos materiais, totalizando R$ 35.143,62. Conclusão: o crescimento do número de reclamações contra cirurgiões-dentistas nos últimos anos nos leva a tomar atitudes para evitar que esses processos resultem na condenação do profissional, entre elas: a melhora das relações paciente/profissional e a importância de um constante aperfeiçoamento profissional. Além disso, demonstra a necessidade do termo de consentimento livre e esclarecido, detalhado e bem explicado, com planejamento, riscos, possíveis mudanças, preços e alternativas de tratamento.

Objective: the present study aims to investigate the characteristics of civil damage repair against dental surgeons, as well as the amount of these reparations. Material and methods: an electronic search using the "dental implant" as key word was performed at official sites of the Court of Santa Catarina, Superior Court and Federal Supreme Court between 2006 and 2016, resulting in data about whether the processes are against dental surgeons, progress of process, gender, defendant's legal personality, conviction or acquittal, type and value of the claims. Results: about the processes ana lyzed in this study, 63% were complaints against surgeons and these processes have grown in recent years. The authors of the actions were represented by a percentage of 80% women. Most of the defendants were legal entities. Dental professionals were condemned in most cases. The monocratic decision was most extensive in the kind of decision. The average value of claims was in R$ 20,123.07 for moral damage and R$ 15,020.55 to property damage, totaling R$ 35,143.62. Conclusion: the increase in the number of complaints against surgeons in recent years leads us to take action to prevent these processes resulting into professional conviction, including the improvement of patient-professional relationship and the importance of constant professional improvement. In addition, it demonstrates the need for using of an informed consent form, detail

Civil liability: characterization of the demand for lawsuits against dentists.

In light of the fact that dentists may be held civilly liable for their practice, it is important to understand the current situation of lawsuits filed against these professionals by studying current legal decisions and the literature. The objective of this study was to analyze the case law of the Court of Justice of São Paulo, Brazil, relative to the profile of patients and professionals, the most commonly involved specialties, the amounts litigated and the court decisions pertaining to civil liability lawsuits against dentists. In an inductive approach, a single researcher screened and collected civil liability rulings by accessing the Court's website, and following a statistical-descriptive procedure and an indirect observation technique. The most frequently involved specialty was prosthodontics. However, oral and maxillofacial surgery was related to a higher incidence of damages awarded to settle claims and to higher damage amounts. The dentist was found guilty in 44.32% of the cases researched. Pecuniary damages ranged between R$ 485.50 and R$ 12,530.00, and non-pecuniary damages ranged between R$ 2,500.00 and R$ 70,000.00. Most lawsuits were filed by women against male dentists. An increase in the relative number of lawsuits against companies versus individuals was observed.

[The allocation of tasks and responsibilities in oral healthcare: basic terms]. / Toedeling van taken en verantwoordelijkheden in de mondzorg: kernbegrippen.

Oral healthcare is to an ever-larger extent delivered by a team or network. Members of such a network often seem to be unsure about the rules that govern the distribution of tasks. The Individual Healthcare Professions Act (Dutch: Wet BIG) in which this distribution is defined, makes use of very specific terms. Clarity concerning these terms is a prerequisite to be able to reflect, in a subsequent contribution, on the realisation of the prerequisites that are applicable to working in a team or network.

Civil liability: characterization of the demand for lawsuits against dentists

Abstract In light of the fact that dentists may be held civilly liable for their practice, it is important to understand the current situation of lawsuits filed against these professionals by studying current legal decisions and the literature. The objective of this study was to analyze the case law of the Court of Justice of São Paulo, Brazil, relative to the profile of patients and professionals, the most commonly involved specialties, the amounts litigated and the court decisions pertaining to civil liability lawsuits against dentists. In an inductive approach, a single researcher screened and collected civil liability rulings by accessing the Court's website, and following a statistical-descriptive procedure and an indirect observation technique. The most frequently involved specialty was prosthodontics. However, oral and maxillofacial surgery was related to a higher incidence of damages awarded to settle claims and to higher damage amounts. The dentist was found guilty in 44.32% of the cases researched. Pecuniary damages ranged between R$ 485.50 and R$ 12,530.00, and non-pecuniary damages ranged between R$ 2,500.00 and R$ 70,000.00. Most lawsuits were filed by women against male dentists. An increase in the relative number of lawsuits against companies versus individuals was observed.