Diş Hekimliğinde Malpraktis: Hasta Güvenliği, Hukuki ve Etik Boyutlar, Branşlara Özgü Risk Yönetimi
Özet
Diş hekimliğinde malpraktis, yalnızca teknik uygulama hatalarıyla sınırlı olmayan; tanı, tedavi planlaması, iletişim, aydınlatılmış onam, kayıt tutma ve komplikasyon yönetimini de kapsayan çok boyutlu bir hasta güvenliği sorunudur. Ayaktan diş hekimliği hizmetlerinde olayların özellikle tanı ve muayene, planlama, iletişim ve prosedürel süreçlerde yoğunlaştığı; yabancı cisim aspirasyonu veya yutulması gibi durumların da önemli risk alanları oluşturduğu bildirilmektedir. Branşlara göre malpraktis riskleri farklılık göstermekle birlikte, risk azaltımının temel ilkeleri ortaklık göstermektedir. Bu ilkeler; standart bakıma uyum, etkili hasta-hekim iletişimi, prosedüre özgü ve anlaşılır aydınlatılmış onam, eksiksiz ve kronolojik klinik kayıtlar ile komplikasyonların zamanında ve uygun biçimde yönetilmesidir. Ayrıca malpraktis korkusu ve savunmacı uygulamaların klinik karar süreçlerini etkileyebildiği, bu nedenle güvenli bakımın yalnızca bireysel dikkatle değil, aynı zamanda eğitim, raporlama kültürü ve sistem temelli önleyici yaklaşımlarla desteklenmesi gerektiği anlaşılmaktadır.
Malpractice in dentistry is a multidimensional patient safety problem that extends beyond technical errors and includes diagnosis, treatment planning, communication, informed consent, documentation, and complication management. In ambulatory dental care, patient safety incidents are reported most frequently during diagnostic, planning, communicative, and procedural stages, while events such as aspiration or ingestion of foreign objects constitute additional critical risk areas. Although malpractice risks vary among dental specialties, the core principles of risk reduction remain largely consistent. These include adherence to standards of care, effective dentist-patient communication, procedure-specific and comprehensible informed consent, complete and chronological clinical records, and timely, appropriate management of complications. In addition, fear of malpractice and defensive clinical behaviors may influence professional decision-making, indicating that safe dental care should be strengthened not only through individual diligence but also through education, reporting culture, and system-based preventive strategies.
Referanslar
Wulandari P, Hidayat R. Legal Review of Physician Malpractice Cases: A Narrative Literature Review. Open Access Indonesia Journal of Social Sciences. 2022;5(6).
Khare A, Saxena V. Acuity of Morality in Dental Practice Management. J Dent Res Rev. 2018;5(1):3-6.
Vashist V, Parhar S, Gambhir RS, Sohi R, Talwar P. Legal modalities in dental patient management and professional misconduct. SRM J Res Dent Sci. 2014;5(2):91-96.
Ensaldo-Carrasco E, Suarez-Ortegon MF, Carson-Stevens A, Cresswell K, Bedi R, Sheikh A. Patient Safety Incidents and Adverse Events in Ambulatory Dental Care: A Systematic Scoping Review. J Patient Saf. 2021;17(5):381-391.
Annandale EC. The malpractice crisis and the doctor-patient relationship. Sociology of Health & Illness. 1989;11(1).
Eser Misir S, Ugrak U, Topsakal KG, Dalgali P, Duran GS, Gorgulu S. Evaluation of dentists' malpractice fears and defensive dentistry attitudes: a scale development. BMC Oral Health. 2025;25:730.
Aldahmashi A, Alkattan A, Al-aydaa F. Awareness of Health Professional Regulations, Associated Factors, and Malpractice Consequences among Dentists. Saudi J Health Syst Res. 2024;4:28-36.
Tahani B, Tashakor A, Mousavi SA. Professional legislation knowledge of dentists and psychological effects of negligence. J Forensic Leg Med. 2021;81:102199.
Ramaswami SV, Franco A, Manica S. An Integrative Literature Review on Dental Ethics and Malpractice - An Exploratory Study. Rev Bras Odontol Leg (RBOL). 2024;11(2):96-110.
Alrahabi M, Zafar MS, Adanir N. Aspects of Clinical Malpractice in Endodontics. Eur J Dent. 2019;13:450-458.
Misra SR, Mishra L, Kumar M, Niyogi S, Priyadarshini S. Dental Malpractice, The Odds in Dental Treatment. Indian J Public Health Research & Development. 2018;9(12):2426-2429.
Mustafa L, Darmawan ES. Strengthening Legal Frameworks and Patient Safety: A Narrative Review of Medical and Dental Malpractice in Indonesia. Jurnal ARSI. 2025.
Pour H, Subramani K, Stevens R, Sinha P. An overview of orthodontic malpractice liability based on a survey and case assessment review. J Clin Exp Dent. 2022;14(9):e694-e704.
JKDA. Dental disputes/malpractice overview. JKDA. 2015;53(2):82.
Wu K-J, Hsieh S-C, Yang C-N, Chen Y-W, Lai C-L, Lai T-J, Kuo MY-P. Endodontic malpractice litigations in the United States from 2000 to 2021. J Dent Sci. 2023;18:374-381.
Nassani MZ. Aspects of Malpractice in Prosthodontics. J Prosthodont. 2017;26:672-681.
Referanslar
Wulandari P, Hidayat R. Legal Review of Physician Malpractice Cases: A Narrative Literature Review. Open Access Indonesia Journal of Social Sciences. 2022;5(6).
Khare A, Saxena V. Acuity of Morality in Dental Practice Management. J Dent Res Rev. 2018;5(1):3-6.
Vashist V, Parhar S, Gambhir RS, Sohi R, Talwar P. Legal modalities in dental patient management and professional misconduct. SRM J Res Dent Sci. 2014;5(2):91-96.
Ensaldo-Carrasco E, Suarez-Ortegon MF, Carson-Stevens A, Cresswell K, Bedi R, Sheikh A. Patient Safety Incidents and Adverse Events in Ambulatory Dental Care: A Systematic Scoping Review. J Patient Saf. 2021;17(5):381-391.
Annandale EC. The malpractice crisis and the doctor-patient relationship. Sociology of Health & Illness. 1989;11(1).
Eser Misir S, Ugrak U, Topsakal KG, Dalgali P, Duran GS, Gorgulu S. Evaluation of dentists' malpractice fears and defensive dentistry attitudes: a scale development. BMC Oral Health. 2025;25:730.
Aldahmashi A, Alkattan A, Al-aydaa F. Awareness of Health Professional Regulations, Associated Factors, and Malpractice Consequences among Dentists. Saudi J Health Syst Res. 2024;4:28-36.
Tahani B, Tashakor A, Mousavi SA. Professional legislation knowledge of dentists and psychological effects of negligence. J Forensic Leg Med. 2021;81:102199.
Ramaswami SV, Franco A, Manica S. An Integrative Literature Review on Dental Ethics and Malpractice - An Exploratory Study. Rev Bras Odontol Leg (RBOL). 2024;11(2):96-110.
Alrahabi M, Zafar MS, Adanir N. Aspects of Clinical Malpractice in Endodontics. Eur J Dent. 2019;13:450-458.
Misra SR, Mishra L, Kumar M, Niyogi S, Priyadarshini S. Dental Malpractice, The Odds in Dental Treatment. Indian J Public Health Research & Development. 2018;9(12):2426-2429.
Mustafa L, Darmawan ES. Strengthening Legal Frameworks and Patient Safety: A Narrative Review of Medical and Dental Malpractice in Indonesia. Jurnal ARSI. 2025.
Pour H, Subramani K, Stevens R, Sinha P. An overview of orthodontic malpractice liability based on a survey and case assessment review. J Clin Exp Dent. 2022;14(9):e694-e704.
JKDA. Dental disputes/malpractice overview. JKDA. 2015;53(2):82.
Wu K-J, Hsieh S-C, Yang C-N, Chen Y-W, Lai C-L, Lai T-J, Kuo MY-P. Endodontic malpractice litigations in the United States from 2000 to 2021. J Dent Sci. 2023;18:374-381.
Nassani MZ. Aspects of Malpractice in Prosthodontics. J Prosthodont. 2017;26:672-681.
