Human factors in dentistry: Part 2. Whose fault is a mistake?

It is the author's opinion that all clinicians make mistakes. We are all human beings and therefore, mistakes are inevitable. However, this is not something the dental profession ever feels comfortable acknowledging or discussing with our patients or colleagues when things do go wrong. A dentist who accidentally extracted the wrong tooth or made any error will tell you that they never intended to cause harm or distress to the patient. And yet, it happened. A highly respected restorative consultant once told me, ‘if you haven't made a mistake in dentistry, you haven't seen enough patients.’ And yet, the common misconception in dentistry is that mistakes happen to someone else/inexperienced clinicians, or even that mistakes only happen to ‘bad’ dentists; a statement that is completely untrue.

One approach could be to always be prepared, waiting in expectation for the next error to occur. This is not feasible because mistakes are few and far between, thankfully. In Part 1 of the series it was discussed that the use of written standard operating procedures (SOP) checklists for certain complex procedures that are known to carry more risk, such as implant surgery, can help us anticipate and plan appropriately to avoid or minimize the impact of any errors, to a certain degree. Interestingly, we are usually more vigilant when we are doing more complex procedures, such as implant surgery, because they require more focus. Unsurprisingly, we are probably less vigilant when doing something we consider more straightforward, such as a filling or routine extraction, because we have done thousands of these procedures and we often become more complacent, which is one of Dupont's dirty dozen reasons for errors,¹ discussed in Part 1 of the series.