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Patient safety: reducing the risk of wrong tooth extraction

Key Points

  • Raises awareness of the factors increasing the risk of wrong tooth extraction.

  • Provides a summary of processes that can be implemented to minimise risk of wrong tooth extraction.

  • Highlights the incidence of wrong tooth extraction.


Over recent years there has been an increased emphasis on improving patient safety in all branches of medicine, with reducing wrong tooth extraction being a priority in dentistry. The true incidence of wrong tooth extraction is unknown but it is considered an avoidable harm and is a significant source of dental litigation. Interventions to reduce wrong tooth extraction include educational programmes encompassing human factor training, patient assisted identification, the use of checklists, marking of surgical sites and implementation of patient safety guidelines. Identified risk factors which make wrong tooth extraction more likely include; suboptimal checks and/or cross checking of relevant clinical information, unclear diagnosis, unclear documentation, ambiguity regarding notation of molar teeth, orthodontic extractions, and extractions where there are multiple carious teeth and extractions in the mixed dentition. Accurate and timely reporting of wrong tooth extraction incidents followed by analysis and sharing of findings together with implementation of improved practice will help to minimise risks of wrong tooth extraction.

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Correspondence to P. Cullingham.

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Cullingham, P., Saksena, A. & Pemberton, M. Patient safety: reducing the risk of wrong tooth extraction. Br Dent J 222, 759–763 (2017).

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