No matter how skilled or experienced you are, complications happen in dentistry. Even the best clinicians will eventually face a case that does not go as planned. When that happens, the difference between a manageable complication and a board complaint or dental malpractice case often comes down to preparation, communication, and documentation.
In this Dental Practice Heroes episode, Dr Paul Etchison sits down with Dr Tahir Dune to discuss how dentists can protect themselves, their patients, and their practices when the unexpected occurs. This conversation highlights real-world lessons on dental malpractice prevention, informed consent in dentistry, and how to avoid turning complications into legal nightmares.
Why Dental Complications Can Turn Into Legal Problems
Clinical complications alone rarely cause lawsuits. What usually triggers a board complaint or legal case is how the situation is handled after something goes wrong.
In high-risk procedures such as implants, wisdom teeth removal, full-arch cases, and advanced restorative dentistry, complications are a known risk. However, many dentists underestimate how quickly a breakdown in communication or documentation can escalate into a serious legal issue.
Protecting your dental practice starts long before a complication occurs. It begins with setting expectations, documenting conversations, and having systems in place for when things do not go perfectly.
The Role of Informed Consent in Dentistry
One of the strongest protections against dental malpractice claims is a thorough and well-documented informed consent process. Verbal consent alone is no longer enough.
Informed consent in dentistry should include:
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Written consent forms that are signed and dated
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Clear documentation of risks, benefits, and alternatives
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Proof that all treatment options were discussed
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Confirmation that the patient had the opportunity to ask questions
For complex or high-dollar cases, many dentists are now recording consent conversations. This creates an additional layer of protection and provides clarity if a patient later claims they were not informed of certain risks.
Documentation Is Your First Line of Defense
Poor documentation is one of the fastest ways to lose credibility in a legal or board review. Even when care is clinically appropriate, missing or incomplete records can make a dentist appear negligent.
Best practices for dental documentation include:
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Completing progress notes the same day or shortly after treatment
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Never altering records after a complication
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Clearly documenting follow-ups and patient communications
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Keeping records of referrals and correspondence with specialists
If a case is ever reviewed, strong documentation shows that you acted thoughtfully, professionally, and within the standard of care.
Why Specialist Relationships Matter More Than You Think
Many dentists underestimate the importance of having established relationships with specialists they refer to. When a complication requires referral, sending a patient to a provider who does not know you or your treatment philosophy can create unnecessary risk.
Building professional relationships with oral surgeons, endodontists, periodontists, and orthodontists helps ensure:
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Better continuity of care
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Clear communication between providers
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Reduced assumptions or conflicting treatment decisions
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A unified front if complications arise
Strong referral relationships are an often-overlooked part of dental practice risk management.
Understanding the Candor Process in Dental Malpractice Prevention
One lesser-known but powerful tool in dental malpractice prevention is the candor process. When initiated early, before a formal demand is made, this process allows for open discussion between providers, legal teams, and insurers in a protected setting.
When used appropriately, the candor process can:
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Resolve disputes without litigation
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Prevent cases from being reported to the board
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Avoid reporting to national practitioner databases
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Reduce emotional and financial strain on the dentist
Knowing when and how to involve your malpractice carrier is critical when protecting your dental practice.
Presenting All Treatment Options Protects You Legally
Dentists are expected to present all reasonable treatment options, even those they do not personally recommend. Failing to do so can create legal exposure, even when the chosen treatment is successful.
To reduce risk:
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Document alternative treatment options
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Explain why certain options may or may not be ideal
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Allow patients to participate in the decision-making process
This approach not only protects you legally but also builds trust with patients.
How Better Communication Prevents Board Complaints
Many dental board complaints begin not with anger, but with confusion. Patients who feel abandoned, uninformed, or ignored are far more likely to seek outside advice from attorneys or boards.
Key communication strategies include:
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Proactive follow-up after complex procedures
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Clear explanations when complications occur
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Empathy without admitting fault
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Documenting every meaningful patient interaction
Strong communication does not eliminate risk, but it dramatically reduces escalation.
Final Thoughts on Protecting Your Dental Practice
You cannot eliminate complications from dentistry, but you can control how prepared you are when they happen. Protecting your dental practice requires more than clinical skill. It requires systems, documentation, communication, and professional relationships that support you when things go wrong.
By improving informed consent processes, strengthening documentation, building specialist relationships, and understanding legal tools like the candor process, dentists can dramatically reduce their exposure to board complaints and malpractice cases.
Dentistry will always involve risk. The goal is not to avoid it entirely, but to manage it intelligently so one complication does not define your career.
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