Differentiation between Adverse Events and Non-adverse Events

Adverse Events

Non-adverse Events

Events that meet the criteria of dental adverse event definition.

Events that do not meet the criteria of dental adverse event definition.

Examples of adverse events:

1. Dry Socket

2. Peri-implantitis

3. Perforation of tooth due to endodontic treatment

4. Pain following extraction/Root Canal Treatment (RCT) without proper pain management

5. Wrong tooth extraction

6. RCT on wrong tooth

7. Paresthesia following a dental procedure

8. Death due to overdose of anesthesia

9. Tissue necrosis due to bleaching or rubber dam clamp

10. Allergic reactions to dental materials

11. Laceration of lip/tongue/cheek during dental procedure

Examples of non-adverse events:

1. Incorrect angulation of implant resulting in removal and re-implantation without any harm

2. Failure of implant that was placed 10 years ago

3. Fracture of grossly decayed tooth during extraction

4. Premature failure of composite restoration due to bruxism

5. Delayed wound healing with no pain/infection due to patient's smoking habit

Quality of care issues

"Quality of care issue" in dentistry is considered as an event resulting from an intervention by a dental practitioner that does not conform to the accepted standards of dental practices or standard of care.

Quality of care issues in the absence of harm are not adverse events.

Here are few examples of quality of care issues that can lead to potential AEs and may cause harm to patients:

Quality of care issue	Potential Adverse Event	AE type
Overhanging restoration	Periodontal tissue damage leading to loss of bone/tooth	Hard tissue injury
Crown preparation on grossly carious tooth that was incompletely excavated	Pulpitis leading to RCT/extraction	Hard tissue injury
Incomplete obturation of root canals	Peri-apical pain/abscess needing RCT/extraction	Pain, Infection, Hard tissue injury
Improper/poor orthodontic treatment	Periodontal tissue damage and root resorption leading to loss of tooth/teeth	Hard tissue damage
Ill-fitting night guard	Pain, soreness and tenderness of jaws	Pain, Hard tissue injury