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Yansane A, Tokede O, Walji MF, et al. J Patient Saf. 2021;17:e1050-e1056.
Clinician burnout is a known threat to patient safety. This survey of a national sample of dentists found that approximately 1 in 10 respondents reported high levels of burnout and 50% of respondents reported a perceived dental error in the last 6 months. Efforts to minimize burnout among dentists may help improve patient safety.
Weenink J-W, Wallenburg I, Leistikow I, et al. BMJ Qual Saf. 2021;30:804-811.
This qualitative study explored the impact of published inspection frameworks on quality and safety in nursing home care, dental care, and hospital care. Respondents noted the importance of the inspection framework design, the role of existing institutional frameworks, and how the frameworks can influence quality improvement across various organizational levels.
Chua K-P, Brummett CM, Conti RM, et al. Pediatrics. 2021;148:e2021051539.
Despite public policies and guidelines to reduce opioid prescribing, providers continue to overprescribe these medications to children, adolescents, and young adults. In this analysis of US retail pharmacy data, 3.5% of US children and young adults were dispensed at least one opioid prescription; nearly half of those included at least one factor indicating they were high risk. Consistent with prior research, dentists and surgeons were the most frequent prescribers, writing 61% of all opiate prescriptions.
Bailey E, Dungarwalla M. Prim Dent J. 2021;10:89-95.
Research into patient safety culture in primary dental care remains limited. This commentary provides an overview of patient safety in dentistry and tools to develop a robust patient safety culture, including human factors and supporting second victims.

Farnborough, UK: Healthcare Safety Investigation Branch; April 22, 2021.

Wrong-site surgery in dentistry is a frequent and persistent never event. This report examines a case of pediatric wrong tooth extraction to reveal how the application of safety standards is influenced by the work environment and discusses the use of forcing functions to create barriers to error in practice.
Wessels R, McCorkle LM. J Healthc Risk Manag. 2021;40:30-37.
The COVID-19 pandemic has disrupted healthcare delivery. This study reviewed data from a large medical professional liability company to explore guidance sought by physicians and dentists during the initial months of the pandemic. Providers’ questions and concerns primarily involved operations (e.g., access to personal protective equipment, liability coverage), patient care (e.g., guidance for screening patients), scope of practice, and use of telemedicine.    

Coulthard P, Thomson P, Dave M, et al. Br Dent J. 2020;229:743-747; 801-805.  

The COVID-19 pandemic suspended routine dental care. This two-part series discusses the clinical challenges facing the provision of routine dental care during the pandemic (Part 1) and the medical, legal, and economic consequences of withholding or delaying dental care (Part 2).  

Elsabeth Kalenderian, DDS, MPH, PhD is a professor at UCSF. Muhammad F. Walji, PhD is the Associate Dean for Technology Services and Informatics and professor for Diagnostic and Biomedical Sciences at the UT Health Science Center at Houston, School of Dentistry. We spoke to them about the identification and prevention of adverse events in dentistry.   

Katie J. Suda, PharmD, MS is a professor at the University of Pittsburgh School of Medicine in the Division of General Internal Medicine. She is a pharmacist by training with a specialty in infectious diseases and a research concentration in the area of dental antibiotic and opioid stewardship. We discussed antibiotic and opioid prescribing in dental care and challenges for implementing stewardship programs.

Obadan-Udoh E, Panwar S, Yansane A-I, et al. J Evid Based Dent Pract. 2020;20:101424.
Patient safety events are common in dentistry. A survey administered to adult dental patients found that a majority of them were concerned about their safety at the dental office but that those concerns were not routinely shared with dental providers or clinic staff. Efforts to improve patient engagement and speaking up behaviors can improve safety in dentistry.
Brown KW, Carlisle K, Raman SR, et al. Health Aff (Milwood). 2020;39:1737-1742.
Over the last decade, children have experienced a dramatic rise in hospitalizations and intensive care unit stays related to opioid use. Based on Medicaid claims in North Carolina, prescribers of opioids for children were most commonly physicians and dentists. More than 3% of children ages 1 to 17 years had at least one opioid prescription filled annually; 76.6 children per 100,000 experienced an opioid-related adverse event or other harm. Adolescents ages 15 to 17 years disproportionately experienced these harms compared to younger age groups. Black and urban children were less likely to fill opioid prescriptions or experience adverse events, but they were more likely to experience other opioid-related harm, such as abuse or dependence.   
Zhou J, Calip GS, Rowan S, et al. Pharmacotherapy. 2020;40:992-1001.
This study analyzed the association between potentially inappropriate prescribing involving opioids prescribed by dentists and emergency department visits and hospitalizations among older patients. Results indicated that a significant proportion of older patients prescribed opioids by their dentist have contraindications (such as psychotropic medication use) which places them at increased risk for 30-day hospitalizations.
Rooney D, Barrett K, Bufford B, et al. J Patient Saf. 2020;16:e126-e130.
This study reviewed adverse event reporting forms from 16 dental schools and found that the forms were not standardized in structure, organization, or content. Adoption of a standardized method for event collection and assessment would allow for quality improvement and increase patient safety.
Mann B. National Public Radio. 2020;July 17.
Despite efforts to reduce opioid prescribing for pain management, physicians and dentists still overprescribe these medications. This news story shares concerns regarding how engrained the reliance on medications for pain management is to the culture of care and its role in opiate dependence and abuse.
Sarasin DS, Brady JW, Stevens RL. Anesth Prog. 2020;67(1):48-59. 
This two-part series discusses anesthesia- and sedation-related medication errors and adverse events in healthcare and dentistry (part 1) and how these errors impact dentistry and approaches to address these issues within a dental anesthesia medication safety paradigm - the Dental Anesthesia Medication Safety Paradigm (DAMSP) - which offers four general guidelines for reducing anesthesia medication errors and adverse drug events in dentistry (part 2).
Perea-Pérez B, Labajo-González E, Acosta-Gío AE, et al. J Patient Saf. 2020;16.
Based on malpractice claims data in Spain, the authors propose eleven recommendations to mitigate preventable adverse events in dentistry. These recommendations include developing a culture of safety, improving the quality of clinical records, safe prescribing practices, using checklists in oral surgical procedures, and having an action plan for life-threatening emergencies in the dental clinic.
Farooqi OA, Bruhn WE, Lecholop MK, et al. Int J Oral Maxillofac Surg. 2020;49:397-402.
The over-prescribing of opioids is a recognized contributor to patient harm. This multidisciplinary panel developed six recommendations to manage pain after dental procedures while reducing harm to patients: (1) Offer alternatives to opioids after dental surgery to interested patients when clinically appropriate. (2) Avoid prescribing opioids after dental surgery if pain is comfortably management with over-the-counter medication. (3) Advise patients about non-pharmacological therapies (e.g., cold, heat, distraction). (4) Teach patients to maximize non-narcotic (over the counter) pain medication with scheduled dosing unless contraindicated. (5) Engage in shared decision-making with patients. (6) Consider factors such as medical contraindications, risk for addiction, and risk aversion when prescribing opioids.
Suda KJ, Zhou J, Rowan SA, et al. Am J Prev Med. 2020;58:473-486.
National guidelines published in 2016 recommend prescribing low-dose opioids for short durations when necessary, including in dentistry practices. This cross-sectional analysis of over 500,000 commercial dental patients over a five-year period (2011-2015) examined prescribing practices prior to the recommendations and found that 29% of prescribed opioids exceeded the recommended dose for management of acute pain and half (53%) exceeded the recommended days’ supply. The authors emphasize the importance of evidence-based interventions tailored to dentistry to curtail excessive opioid prescribing.