Sir, it is pleasing to note that the Healthcare Safety Investigation Branch have removed extraction of the wrong tooth from the Never Event list due to 'strong and systemic safety barriers' not being in place.1 However, it is also good news in terms of training undergraduates. Fear of failure is a significant issue with the dental undergraduates and our future dental professionals. Indeed, the Good Childhood Report (2020) has reported that British teenagers have the lowest life satisfaction in Europe, in part due to fear of failure.2 As highlighted by the NHS Leadership Academy (2020) 'the word "never" can imply that someone has done something wrong and implies blame and liability. For staff it can lead to a feeling that they are to blame and can cause moral injury'.3

We all strive for the highest possible standards of patient care, and as such teach students to follow national and local guidance and welcome that any wrong site tooth extraction would still be considered by LocSSiPs.4 However, even the previous terminology and investigation processes created unintended consequences. Attempting to learn whilst in the heightened levels of anxiety caused by undertaking a potential Never Event procedure, can lead to avoidance behaviour and a reluctance to develop skills further. Therefore, the human factors involved in undertaking such procedures should be examined, and rather than Never Events, perhaps we should encourage a more positive culture to empower staff to ensure that following the relevant National Safety Standards are 'Always Events'.