20 COMMON CAUSES OF ERRORS IN CLINICAL DENTAL PRACTICE

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  1. LACK OF SUFFICIENT COMMUNICATION:  For a good clinician , adequate hold on communication is very necessary otherwise there is a dual loss . First is important and relevant info helpful in reaching a diagnosis go unheard and secondly a lot about patients expectations go unnoticed, resulting in overall unsatisfied and unhappy patients.
  2. LACK OF MOTIVATION: Inability to motivate your patients properly results in rejection of Rx plan and adoption of alternate therapy which may not yield adequate results.
  3. POOR DIAGNOSTIC SKILLS : "Doing the right diagnosis is like half Rx done". Experience and proper knowledge of the subject are the few key things that ultimately help you to arrive at a diagnosis. Poor diagnosis and hasty decision making results in inability to cure the disease thereby unhappy patients.
  4. IMPROPER STERILISATION:  A lot is talked about sterilisation in all Dental schools but in Private practice more than 50 % dentists are not following proper sterilisation techniques  resulting in post operative infections and recurrences. Therefore it is must for all practicioners to follow proper sterilisation procedures.
  5. NOT FOLLOWING PROPER TECHNIQUES: A variety of errors occur due to use of inadequate techniques . e.g. Dislogedment of filling due to lack of prepration or overtapering of crown prepration leading to crown dislogement.
  6. ISOLATION: Again due to lack of isolation and non-use of rubber dam, variety of errors occur and reoccur. The best e.g here is dislodgement of composite fillings, reinfection in RCT paients after obturation.Moreover saliva contamination drastically effects mechanical properties of lot of filling materials.
  7. HIGH POINTS: Unchecked high points after fillings and crown placements lead to post operative pain and senstivity .

  8. OVER CUTTING AND OVER PREPARATIONS: Over cutting and over preparations lead to near pulpal  exposure and opening of dentinal tubules leading to senstivity and in some cases pain.
  9. NOT DISCARDING OLD RCT INSTRUMENTS: Unchecked use of files and broaches with open flutes may result in breakage of RC instrument within the canals , causing patients more severe a problem than with the one he came to you.
  10. PERFORATIONS: Every Root Canal case should be treated as a new and different case . Overconfidence and overcutting results in perforations.
  11. EXCESSIVE FORCE: Excessive use of force and improper extraction techniques results in root breakage and extended chair time for patients plus more post operative complications.
  12. IMPROPER POST EXTRACTION INSTRUCTIONS: Do not forget to give complete post operative instructions.These few instructions can help patient a lot to overcome his fears and anxieties.
  13. SHADE MISMATCH: Poor shade selection occurs mainly due to shade matching in presence of artificial light and sometimes even under yellow chair light. As recommended for proper shade matching it should be done under natural light.
  14. MEDICAL COMPLICATIONS: All medical complications can be avoided by proper history taking and necessary advise of the physician concerned.e.g . Monitoring B.P before extraction should be made mandatory in your operatory.
  15. JAW FRACTURES: Due to excessive force during extraction.
  16. OVER INSTRUMENTATION: Most common cause of Inbetween appointments pain in patients undergoing root canal treatment.Performing RCT without proper use of radiographs is inviting such troubles .
  17. RADIOGRAPHS: Lack of use of radiographs to establish diagnosis also results in some common errors which could have been easily avoided.
  18. BLIND USE OF ROTARY : Blind use of rotary endodontics results in perforations, ledging and variety of other errors.Rotary endo instruments should be used with caution and avoided in curved canals.
  19. UNCONTROLLED USE OF CHEMICALS: Chemical solutions like Sodium hypo , hydrogen peroxide and caustinerf may lead to mucosal burns and should be use with caution.
  20. NEW TECHNOLOGY: Running after new technology and forgetting your basics will only help you to deteriorate your practice . Sticking to basics and adequate use of technology only where necessary is the key and the demand of the day.

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