Extracting the Wrong Tooth

The following is an article from The Annals of Improbable Research.

Gaping holes in the practice of dentistry
compiled by Bertha Vanatian, Improbable Research staff

The Case of the Wrong Tooth (1991, by Jerrold)
“The Case of the Wrong Tooth,” Laurance Jerrold and Mary Romeo, American Journal of Orthodontics and Dentofacial Orthopedics, vol. 100, no. 4, October 1991, pp. 376–81. The authors, in Massapequa, New York, write:

Without breaking stride, the patient was told that an important personal call had to be made and we would be with her momentarily. A call was placed to the surgeon. He was informed of the situation and asked in Anglo Saxon verbiage how he could have done what he did since he was familiar with our office routine and with the extraction forms that we use....

[He said that] was that the patient was fairly certain that the premolar he removed was indeed the intended sacrificial odontome. He said he asked her if she knew which one it was and she responded “I think this one.” He asked if she was sure, and she responded “pretty sure.” Unbelievable! He was told that it might be a wise idea for him to notify his malpractice carrier of the incident as there were no easy solutions to this problem.

Wrong Tooth Extraction: Ethics (1998, by Jerrold)
“Ethics Case Analysis: The Extraction of the Wrong Tooth,” Gary Chiodo, Susan Tolle, and Laurance Jerrold, American Journal of Orthodontics and Dentofacial Orthopedics, vol. 114, no. 6, 1998, pp. 721–3.

Withholding the fact that the wrong tooth was extracted encumbers the family’s decision about how to proceed with their future care.

Wrong Tooth Extraction: Education (2004, by Chang)
“Effectiveness of an Educational Program in Reducing the Incidence of Wrong-Site Tooth Extraction,” Hao-Hueng Chang, Jang-Jaer Lee, Shih-Jung Cheng, Puo-Jen Yang, Liang-Jiunn Hahn, Ying-Shiung Kuo, Wan-Hong Lan, and Sang-Heng Kok, Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, vol. 98, no. 3, 2004, pp. 288–94. The authors, at National Taiwan University Hospital and National Taiwan University, explain:

In view of the complex therapeutic and medicolegal problems associated with erroneous extraction, this complication deserves more attention. The actual incidence of wrong-site tooth extraction is unknown.

Wrong Tooth Extraction: Root Cause Analysis (2010)
“Wrong Tooth Extraction: Root Cause Analysis,” Oren Peleg, Navot Givot, Tali Halamish-Shani, and Shlomo Taicher, Quintessence International, vol. 41, no. 10, November–December 2010, pp. 869–72. The authors, at Tel Aviv University and the Medical Risk Management Company, Tel Aviv, Israel, report:

A total of 54 insurance claims for wrong tooth extractions were reported and evaluated by Medical Consultants International from 1993 to 2004. Data were collected and analyzed...

Results: General practitioners performed 72% of the extractions, 49% of the referring clinicians were orthodontists, 74% of the errors were made during extraction, and 77% of the errors were made in polyclinics.

Conclusions: Errors during treatment and poor communication among clinicians led to extraction of the wrong teeth. This can be avoided by greater caution on the part of the extracting clinician when following the treatment plan.

Wrong Tooth Extraction: Experience (2011, with a nod to Chang)
“Experience of Wrong-Site Tooth Extraction Among Nigerian Dentists,” Wasiu L. Adeyemo, Olabisi H. Oderinu, Akanbi C.O. Olojede, Azeez A. Fashina., and Adeshina O.S. Ayodele, Saudi Dental Journal, vol. 23, no. 3, 2011, pp.153–6. The authors, at the University of Lagos, Nigeria, report:

In the present study, 13% of the respondents reported having extracted a wrong tooth. However, 55% of these respondents were aware of a colleague who had extracted a wrong tooth. This implies that wrong-tooth extraction is not an uncommon event in the studied environment....

While some authors believe experience may play a role in the incidence of wrong-site surgery (Chang et al., 2004), others (Lee et al., 2007) believe otherwise.

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The article above is from the January-February 2015 issue of the Annals of Improbable Research. You can download or purchase back issues of the magazine, or subscribe to receive future issues. Or get a subscription for someone as a gift!

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