REDUCING IATROGENIC ERRORS IN ENDODONTICS: USING THE BRITISH ENDODONTIC CASE ASSESSMENT TOOLKIT

Background: Endodontics is supposed to be specific and require high dexterity, errors occur which include perforation, ledge formation or missed canals, which in turn influence the treatment outcome and patients’ confidence. In hospitals, where multitudes of dentists, regardless of their experience, work in, proper case type and skill set alignment is influential. The British Endodontic Case Assessment Toolkit (BES) is used for evaluating the difficulty of cases, provides a system that will assist in categorizing cases based on the competent professional. This research aims at identifying the potential of using BES Toolkit to minimize the rate of errors, enhance care. Methods: This study was conducted as a cross-sectional analysis aimed at evaluating the effectiveness of the British Endodontic Case Assessment Toolkit (BES Toolkit) in minimizing iatrogenic errors in endodontics. The study was carried out at Khyber College of Dentistry over six months, assessing 100 root canal treatment cases that had documented errors. Each case was scored using the BES Toolkit to determine difficulty levels: 17 Low (1 – 12) Medium (13 – 16) High (17 – 24) and High+ (>25) Ø Collected data included patient data, completion difficulty scores, practitioner type, and error characteristics. Outpatients, patients referred to the hospital from other hospitals, patients under 18 years of age and pregnant patients who refused X-ray examination in the hospital were excluded. Results: A breakdown of the results also showed that 40% of errors made were in average cases and another 40% were in the high-risk ones. Majority of errors were committed whenever GDPs practiced in areas which they were not properly conversant with especially when the score exceeded 16. For example, stronger team communication was observed when complex cases were attended by senior staff like Dentists with Enhanced Skills (DwESEs) or senior and more experienced members of the team. Conclusions: The BES Toolkit also assists in proper docketing of the case in the right practitioner depending on the level of difficulty in a way that reverses any mistakes and increases the patient’s quality of life. When this tool is integrated into practice as a common practice in hospitals then delivery of safe and effective patient care will be enhanced.