‘I learnt about dentistry from that’ – first steps in developing an open reporting culture in dentistry

The November 2017 publication of ‘Lessons for dentistry from the flightdeck’¹ has stimulated thought, as evidenced by the Dental Update Study Day into how dentistry can learn from the aviation industry. In aviation, a pilot's continued professional competence is formally assessed every six months during simulator checks and, alongside that, targeted training aims to develop competencies. Outside formal assessments, aviation aims to create a culture that encourages the open reporting and sharing of information in a way that identifies where mistakes have been made but, more importantly, focuses on how that information can be used to learn lessons and strive for continuous improvements in safety and standards.

UK dentistry has been in a spiral of increased litigation against dentists, with the General Dental Council, until recently, joining in by virtue of its increased case load of cases against supposedly miscreant dentists. This is in stark contrast to the ‘Just Culture’ that is promoted within aviation, where the aim is to encourage open reporting without fear of unfair retribution. Of course, the situations are different. In aviation, a mistake by a pilot could cost many lives, whereas in dentistry a mistake by a dentist could cost a tooth, with the patient suing the dentist as a result or, in situations reported in our November 2017 ‘Risk Issue’, death. Apart from the, thankfully, relatively rare significant incidents in aviation though, there are many more much less significant ‘near misses’ or situations where things might have gone wrong had actions, procedures, equipment performance or circumstances been different.