Dental Closed Claims Study: Leveraging Data to Enhance Clinical Judgment and Patient Safety

In the world of dentistry, where many clinicians operate independently, the true incidence of adverse events can be obscured. By systematically analyzing a group of closed malpractice claims, researchers can identify significant trends and underlying risk factors that may otherwise go unnoticed. This study draws on the distinctive dataset provided by The Doctors Company to conduct a comprehensive review of dental malpractice claims, offering evidence-based insights to support targeted improvements in patient safety and clinical outcomes.

Study Design

This was a descriptive, exploratory analysis using an evidence-based taxonomy.¹ The Doctors Company’s analysts studied dental malpractice claims with a loss year of 2010 through 2024. Claims data were aggregated and de-identified.

The study criteria included the major responsible service of dentistry, major allegation, major injury, patient’s gender and age, injury severity, procedures involved (if any), contributing factors (issues leading to patient harm), disposition of claim (indemnity vs. no indemnity), and average indemnity paid (if any).

Results

The study findings included:

• Improper performance of a treatment or procedure was the top major allegation, appearing in 60 percent of claims.
• Among claims for improper performance, almost 30 percent resulted in an indemnity payment, with an average payment of $86,000.
• Overall, 35 percent of claims studied closed with an indemnity payment, averaging $116,000 per claim. The median indemnity payment was $50,000 per claim.
• Extraction of teeth and/or prosthetic implants were the procedures involved in the claims that were likeliest to result in an indemnity payment (46 percent of implant-related claims; 59 percent of extraction-related claims). These procedures also had the highest mean indemnity payments: $115,000 for implants and $150,000 for extractions.
• Although the proportion of high-severity dental claims was low (3 percent), all high-severity dental claims resulted in an indemnity payment, averaging over $400,000 per claim.
• Almost one in four patients sought care from another practitioner due to dissatisfaction and poor communication about expectations.
• Medical emergencies can occur with any dental patient, regardless of sedation.

Conclusion

Many adverse events in dentistry are preventable, and adopting proactive risk mitigation strategies can significantly improve patient outcomes while reducing the risk of malpractice claims. This analysis highlights the importance of clear, patient-centered communication. To minimize misunderstandings, providers should use plain language, avoid medical jargon, and apply tools such as Ask Me Three and the teach-back method to confirm patient understanding.

The findings also emphasize the need for heightened awareness around scope-of-practice boundaries. Further, since medical emergencies can arise at any time, it is essential to ensure that all staff receive regular training to maintain competency in both routine and emergent situations.

In addition, implementing structured safety measures—such as checklists, time-out procedures, emergency protocols, and regular drills—is vital to fostering a culture of safety and preparedness.

We hope the insights and strategies presented in this study support dental professionals in enhancing patient safety and minimizing risks to both patients and practices.

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