Presentations 2020: Ortho&Paeds

352 - Extraction of Teeth for Orthodontic purposes secondary care.

C HENEIN, T ROBERTS, S ROGERS
Presented by: Claudy Henein
Cardiff Dental Hospital

Introduction Erroneous tooth extractions is the most common serious patient safety incident in dental practice. It is wrong site surgery therefore a ‘never event’. Around 50% occur during orthodontic treatment. The British Orthodontic Society states it is one of the most common reasons for legal action with orthodontic treatment. Aim Establish improvements to the way patients are referred for orthodontic extractions. Objectives Assess compliance with BOS risk management guidelines: extraction referrals are written in 2 formats; one format in notation and the other in words and a description in words is used for extraction of supernumerary teeth. Method Retrospective data was collected for a three-month period, Oct-Dec 2017. Post-implementation of findings, prospective data was collected for the second audit cycle for three months, Nov-Jan 2020. The standard was set that 100% of external referral letters requesting orthodontic extractions are written in 2 different formats. Results First cycle (n=16) revealed that 62.5% (10/16) referral letters were written in 2 different formats and 37.5% (6/16) in one. Following the first cycle, an easily accessible computer template for palmer notation was created. Second cycle (n=57) results showed that 75% (43/57) of external referral letters were written in 2 different formats. 3% (2/41) of the registrar referral letters were written in one format. In comparison to 75% (12/16) of the consultant referral letters. This appears to be because registrars are using the template while the consultants are dictating letters. One referral requested the extraction of a supernumerary tooth and a description in words was used. Conclusion Access to electronic palmer notation templates that are easily inserted into referral letters has proven to be successful in improving compliance with BOS risk management guidelines. Further engagement is needed with secretaries and continued staff education with focus on staff failing to meet standards.
Consent Statement: There are no details on individual patients reported within the abstract.

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