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I feature _ interview Yes. Another consequential damage, of which I only recently learnt, is loss of sense of smell. Patients whose sinus has been injured often lose their ability to smell. Sometimes, they may not even realise it initially, because the sinus runs on both sides of the face and the unaffected side often functions normally. Imagine losing your sense of smell completely owing to a defec- tive bilateral sinus lift procedure—that would be a fairly serious impairment of a person’s quality of life. _Have malpractice incidents become more common over the last decades? Iwouldsayso.Atleast,litigationhasincreased. Of course, there have always been cases of mal- practice, but patients tend to go to court more often nowadays. Perhaps you could call it an “Americanisation” phenomenon: almost every problem is taken to court, with the result that dentists are paying increasingly higher insurance feesbecausethetreatmentrisksaresohightoday. _How common is legal action in dentistry and whatisthecompensationamountpaidcompared with other medical disciplines? It is perhaps comparable to plastic surgery. Therearemanycomplaintsfiledforcasesinwhich the result was not what the patient expected it to be. Compensation payments range from US$10,000 to 100,000, which is much lower than those in other medical disciplines. _Do more cases of overtreatment or cases of error on behalf of the dentist end up in court? These cases have an almost equal occurrence. Of course, overtreatment leaves the dentist in a bad position. It raises the question of why he or she treated the patient unnecessarily in the first place and did so poorly in the second; it leaves him or her doubly guilty. If a mistake occurred after a reasonable treatment plan had been formulated, it is comparatively less bad. Sometimes, even if a patient dies while under- going therapy, this does not need to involve a distinct fault of the clinician. _An American dentist was recently charged because his patient died after he extracted 20 teeth in one procedure. I have performed such extensive treatment in thepast;itdependsontheneedforthetreatment and how it is done. Probably, that case in the US was the result of a combination of many things. For instance, did the dentist act in accordance with state-of-the-art practice? If not, he is at fault. If he did, one has to remember that dentists cannot rise above today’s level of knowledge and technology. Let us say an impaired patient files charges for something that happened to him 20 years ago that would have been preventable with the latest medical treatment. He can, of course, make a claim, but the dentist could not be sued for it if he or she treated the patient according to the best knowledge available at that time. That is a very important aspect when writing expert reports on dental malpractice: did the dentist act to the best of his or her ability and according to the current knowledge or with gross negligence? That is what makes the difference. _Whatcanmedicalprofessionalsdotoprotect themselves against legal disputes arising from high-risk procedures they intend to perform? Patients should not only be warned of the possible consequences of a certain procedure, but also be advised of the alternatives—and one of those alternatives is not proceeding with treatmentatall.Inmyopinion,thepatientshould always understand both options: the risks of a particular treatment and what could happen Bilateral mental and labial paraesthesia in a 62-year-old female patient due to bilateral mandibular canal perforation. (© Dr Andy Wolff) 10 I CAD/CAM 4_2015 CAD0415_06-11_Wolff 06.11.15 11:56 Seite 3 CAD0415_06-11_Wolff 06.11.1511:56 Seite 3

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