DEFENSIVE DENTISTRY FROM NORMAL MEDICAL PRACTICE TO SAFEGUARD FROM MALPRACTICE LITIGATIONS. NEW RULES IN COVID-19 PANDEMIC

C. Medar, C. M. Cristache, T. Mihut, E. C. Marcov, F. L. Furtunescu, M. Burlibasa, L. Burlibasa

Abstract: Defensive dentistry, defined as dental care provided by professionals, aiming primarily to prevent the risk of litigation, has become, more and more, a popular choice among practitioners, in their daily practice, over the past decade. Being divided in “positive”, when performing unnecessary diagnostic tests or prescribing unnecessary treatment and “negative”, when avoiding high-risk patients or risky procedures, defensive dentistry’s adverse effects raised the cost and lowered the quality of the healthcare provided for patients. COVID-19 pandemic has changed the current clinical scenario in all medical practices, including dentistry, increasing the risk for performing defensive dentistry. The aim of the present paper was to bring new insights into the field of defensive dentistry and to highlight the impact of COVID-19 pandemic on patient’s treatment. Pubmed/MEDLINE and Embase/SCOPUS databases have been revised for articles in English language using as key- words “defensive medicine”, “defensive dentistry”, and “Covid-19”, “SARS-CoV-2”, “Coronavirus” associated with “dentistry”. The selected papers were critically assessed and corroborated with the changes occurred in the last months due to the high contagiousness of COVID-19 and the inherent risks for dental professionals, requiring multiple precautions during patient care or postponing patients treatments. Defensive dentistry need to be recognized and avoid, as possible. Dental practitioners, their team, and patients, as well, need to adapt, based on evidence-based update of medical knowledge, to the new scenario created by the COVID-19 pandemic.
Keywords: defensive medicine, liability, SARS-CoV-2, pandemic.