Cullingham P, Saksena A, Pemberton M N
Locum Consultant in Oral Surgery, Royal Liverpool University Dental Hospital, Oral Surgery Department, Brunswick Place, Liverpool, L3 5PS.
Oral Surgery, University Dental Hospital of Manchester, Manchester, M15 6FH.
Br Dent J. 2017 May 26;222(10):759-763. doi: 10.1038/sj.bdj.2017.448.
Over recent years there has been an increased emphasis on improving patient safety in all branches of medicine, with reducing wrong tooth extraction being a priority in dentistry. The true incidence of wrong tooth extraction is unknown but it is considered an avoidable harm and is a significant source of dental litigation. Interventions to reduce wrong tooth extraction include educational programmes encompassing human factor training, patient assisted identification, the use of checklists, marking of surgical sites and implementation of patient safety guidelines. Identified risk factors which make wrong tooth extraction more likely include; suboptimal checks and/or cross checking of relevant clinical information, unclear diagnosis, unclear documentation, ambiguity regarding notation of molar teeth, orthodontic extractions, and extractions where there are multiple carious teeth and extractions in the mixed dentition. Accurate and timely reporting of wrong tooth extraction incidents followed by analysis and sharing of findings together with implementation of improved practice will help to minimise risks of wrong tooth extraction.
近年来,医学界各领域都越来越重视提高患者安全,减少误拔牙齿成为牙科领域的首要任务。误拔牙齿的真实发生率尚不清楚,但被视为一种可避免的伤害,也是牙科诉讼的重要源头。减少误拔牙齿的干预措施包括涵盖人为因素培训、患者辅助识别、使用检查表、标记手术部位以及实施患者安全指南的教育项目。已确定的使误拔牙齿更易发生的风险因素包括:对相关临床信息的检查和/或交叉检查不充分、诊断不明确、记录不清晰、磨牙标记含糊、正畸拔牙、存在多个龋齿时的拔牙以及混合牙列期拔牙。准确及时地报告误拔牙齿事件,随后进行分析并分享结果,同时实施改进措施,将有助于最大限度地降低误拔牙齿的风险。