Clinical Dental Iatrogenesis: A Scoping Review

Abstract

Background Iatrogenesis, which refers to the unintended harm caused by medical or dental interventions despite the well-intentioned actions of healthcare providers, is a significant issue in healthcare. While the medical field has extensively documented iatrogenesis, the dental field lacks comprehensive research on the causes, extent, and prevention of these harms. Understanding iatrogenesis in dentistry is crucial for improving patient safety. Aims The aim of this scoping review was to provide a comprehensive understanding of iatrogenesis in clinical dentistry. The review sought to identify the nature and causes of iatrogenic injuries, evaluate their impact on patient safety, and explore potential policy implications to minimise their occurrence. Methods A scoping review was conducted. Relevant studies were identified through a systematic search of the MEDLINE database, focusing on literature published between 2000 and 2024. Studies were chosen based on specific criteria. The data extracted from these studies were synthesised to map the different aspects of dental iatrogenesis. Results The review identified fifty studies of different designs that met the eligibility criteria, revealing a wide range of iatrogenic injuries across various dental specialities. These injuries were related to preoperative procedures such as inadequate staff-patient communication, errors in diagnosis, inadequate documentation of patient history and treatment plans, and suboptimal treatment planning that fails to consider all patient-specific factors. Intraoperative and postoperative complications encompassed damage to both soft and hard tissues, and technical failures causing minor infections to severe, life-threatening conditions. The occurrence of these injuries was influenced by various factors, including the clinician's experience, patient-specific characteristics such as age, medical history, and anatomical variations, as well as the inherent risks associated with the procedures. Conclusion The findings of this review highlighted the need for additional empirical longitudinal research to understand the long-term impact of dental interventions, the nature and causes of iatrogenic injuries, and to develop standardised guidelines aimed at reducing such injuries. Enhancing professional development, adhering to evidence-based practices, and fostering a patient-centred care approach are critical to improving patient safety in dental settings.