Due to the increasing public concern regarding oral cancer, it is important for dentists to be aware of proper patient assessment and documentation procedures so that they may provide timely and proper treatment to their patients. This article will provide some insight into potential claims and also provide risk management advice to help avoid these problems.
Oral Cancer Statistics
The U.S. Department of Health and Human Services states that oral pharyngeal cancers affect around 30,000 people per year in the United States, with around 8,000 of those cases resulting in death. Most cases which result in death occur in people over 40 years of age and those with a history of smoking, regular alcohol use, or both. Men are more likely than women to develop oral cancer. A good deal of malpractice claims against dentists in the United States involve oral cancer cases. The complaints range from failure to diagnose to improper post-treatment dental care.
Correct Patient Assessment
When assessing a patient and planning a treatment strategy, dentists should first carefully review the patient’s medical history to note any predisposing oral cancer factors. Next, a comprehensive oral evaluation should be completed. This includes careful intraoral and extraoral examinations, including all parts of the tongue, floor of the mouth, the hard and soft palates, and palpitation of the nodes.
This full examination should be followed with a review of oral radiographic images in order to note any potential abnormalities in the bones and dentition of the patient. The dentist should be sure to carefully and clearly document each area examined in the patient’s permanent record. All abnormalities should be noted along with notation of all normal areas, as well.
If an abnormality or suspicious lesion is found during the examination, the dentist should either properly refer the patient to a specialist for further examination and diagnosis or schedule the patient for a re-evaluation. Failure to do one of these two procedures in a timely manner can result in more severe medical or dental consequences for the patient.
In order to satisfy the basic standard of care, all dentists are required to perform these evaluations and note all the results from the examination in the patient’s permanent record.
The dentist should further understand the need to take special precautions throughout treatment for certain medical conditions, including oral cancer. This includes before, during, and after treatment of the patient. When dealing with oral malignancies, these precautions may relate to the surgery, chemotherapy, or radiation therapy which a patient might be undergoing.
In cancer cases, it is crucial that a treating dentist contact the patient’s oncologist to determine if any special precautions should be taken for the patient before and after undergoing medical treatment, such as chemotherapy. It is also essential that the medical history dictated in the patient’s record include information regarding whether or not the patient has undergone such medical treatment. This record should also note any necessary precautions that should be taken in regard to the patient’s dental care. Failure to take into account the patient’s medical condition and the necessary precautions because of the patient’s medical condition when providing treatment can result in complications involving both the dental and the medical care of the patient. This, in turn, could provide a basis for a malpractice claim against the dentist.
Dentists must carefully follow all procedures in the practice in order to help them avoid legal pitfalls. Properly assessing and examining the patient and documenting the patient’s record will not only keep the dentist out of legal trouble, but it will also provide the patient with positive dental care service. In the case of oral cancer, following the proper procedures may allow a dentist to observe the abnormality in a timely manner, thus creating a better prognosis for the patient.
Stuart J. Oberman, Esq.
Stuart J. Oberman is the founder and President of Oberman Law Firm. Mr. Oberman graduated from Urbana University and received his law degree from John Marshall Law School. Mr. Oberman has been practicing law for over 28 years, and before going into private practice, Mr. Oberman was in-house counsel for a Fortune 500 Company.
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