Medico-legal considerations in endodontics

Abstract

A major aim of endodontic care is to successfully treat acute and chronic pulpal and periapical disease and prevent recurrence. Consequently, the tooth can be rendered free of pain and subsequently restored to function and aesthetics. However, each of the stages of the treatment - from diagnosis through to review - can be complex and compromise the intended outcome. Occasionally, this can lead to medico-legal challenges, especially where a valid consent process has not taken place or has not been properly recorded. This paper reviews the key stages in providing care with respect to the clinician's skillset, the expected standard and discusses how the consent process can mitigate the risk of medico-legal interventions.

Fig. 1

Plain film radiograph illustrating a large and small radius of curvature

Fig. 2

a) Probable canal bifurcation in the plane of the radiograph demonstrating a ‘fast break'. b, c) CBCT of tooth: fast break (i), canal bifurcation evident at mid-root level (ii). d) Completed RCT showing (obturated) bifurcated canal

Fig. 3

Position of the periapical lesion indicating the position of the portal of exit of the canal. a) Periapical radiolucency lateral to the radiographic apex of the root (i). b) Portal of exit of canal lateral to the radiographic apex and central relative to the periapical radiolucency (ii)