Assessment of the online presence and regulatory compliance of dental practice websites in France.

Objective: The aim of this study was to investigate the online presence of French dental practices that have a professional website. Secondly, the degree of compliance of practices' websites with the current regulatory framework was assessed. Methods: Open data was used to identify a 5% random sample of private dental practices in France (n = 1370 facilities). Then, a manual search was made on Google to find the website for each practice. When found, the website was analyzed using criteria. Results: Only 25.9% of dental practices have a functional and referenced website, allowing 28.9% of the dentists in the sample to have an online presence. Disparities exist depending on the geographical location of the facility and its type. The assessment of website content uncovered a lack of compliance with the existing regulatory framework, exhibiting variations based on the type of facility and the person who designed the website. Hiring a specialized web design provider for dentists enhances compliance with laws and guidelines, though it doesn't guarantee complete adherence. Conclusions: The online presence of dental practices and dentists in France is limited. Where they do exist, dental practice websites generally do not comply with legal requirements and guidelines for online communication. Efforts should be made to improve the information provided to patients.

Patient information in dentistry: the standard dental treatment form, a French health policy / Information du patient en odontologie : le devis dentaire, une politique de santé

INTRODUCTION: In France, the information provided to the patient by the dentist is ensured by the mandatory delivery of a standard dental treatment form (SDTF). This form has undergone a certain number of changes, in particular as a result of legislative interventions. More recently, the implementation of the 100% health reform has confirmed the place of the SDTF in the political ambition to improve access to dental care. PURPOSE OF RESEARCH: This article presents the issues and changes of the SDTF in France over a period of 25 years. The study is based on a literature review supplemented by a qualitative analysis using semi-directed interviews with actors involved in oral health policies. RESULTS: The ambition of a SDTF is the result of a common approach initiated by the dental profession and insurers at the end of the 1990s. Subsequently, lawmakers became involved in the design of the form, making it mandatory. Over the years, the SDTF become particularly exhaustive, making its application and understanding by patients complex. According to the public control authority, the rate of non-application of the SDTF by dental surgeons remains high. CONCLUSIONS: The SDTF now occupies an essential place in dental health services in France. However, this study highlights the difficulties for the actors involved in oral health policies to reach a lasting consensus allowing its full application, in the interest of patients.

Introduction: En France, l'information du patient par le chirurgien-dentiste est assurée, entre autres, par la délivrance obligatoire d'un devis type, le devis dentaire. Ce document a subi un certain nombre d'évolutions ces vingt dernières années, au gré notamment d'interventions du législateur. But de l'étude: Cet article présente les évolutions et enjeux du devis dentaire en France, sur une période de vingt-cinq ans. L'étude s'appuie sur une revue de la littérature complétée d'une analyse qualitative par entretiens semi-dirigés, réalisés auprès d'acteurs impliqués dans les politiques de santé du secteur dentaire. Résultats: L'ambition d'un devis type, standardisé, résulte d'une démarche commune initiée par la profession dentaire et les assureurs complémentaires à la fin des années 1990. Par la suite, le législateur s'est impliqué dans la conception du devis, en le rendant obligatoire. Au fil des années, le devis dentaire est devenu particulièrement exhaustif, rendant complexe son application et sa compréhension par les patients. Néanmoins, selon l'autorité publique de contrôle, le taux de non-application du devis type par les chirurgiens-dentistes reste élevé. Conclusions: Le devis type occupe désormais une place essentielle dans les prestations de santé dentaire en France. Toutefois, cette étude met en lumière les difficultés, pour les acteurs impliqués dans les politiques de santé bucco-dentaire, à dégager un consensus durable permettant sa pleine application, dans l'intérêt des patients.

Henri Léger-Dorez: The First Expandable Implant (1912).

In the early 1900s, various authors worked on "artificial roots" to replace missing teeth. E. J. Greenfield's pioneering works (1910-1913) are among the best-known today and are often cited in publications reviewing the history of oral implantology. Shortly after Greenfield's first communications in the scientific literature, a French dental surgeon, Henri Léger-Dorez, designed the first expanding dental implant, which he indicated was used successfully in cases of single tooth edentulism. Its aim was to obtain the best primary stability and thus avoid the use of dental splint during osseous healing process. Léger-Dorez's works give us a new angle on the research in oral implantology by the pioneers of the early 20th century.

Medicolegal issues of peri-anaesthetic dental injuries: A 21-years review of liability lawsuits in France.

BACKGROUND/AIM: Peri-anaesthetic dental injuries (PDI) represent a major source of potential malpractice claims against anesthesiologists. Studies about the medico-legal aspects of PDI have mainly focused on liability insurance cases thus not encompassing those cases brought to court. The aim of this study was to assess the medico-legal issues of PDI-related liability lawsuits in France. MATERIAL AND METHODS: A review of judicial decisions pertaining to PDI was conducted on a French legal database, spanning the period between January 2000 and October 2021. Characteristics of decisions, patients and anesthesiologists, peri-operative care, dental injuries, and convictions were collected when available for analysis. RESULTS: Twenty-four judicial decisions fulfilled the inclusion criteria and were analyzed. All cases of dental injuries took place during elective surgery, 16 in the private sector and 8 in the public sector. Most injuries concerned two or more teeth and the most predominant dental injuries were luxation or avulsion (70.8% of cases). Eight cases resulted in a final verdict in favor of the plaintiff, four in the private sector (conviction rate: 25%), and four in the public sector (conviction rate: 50%). The causes of conviction were either a lack of information (5/8), a breach in the standard of care or technical negligence (3/8). The average amount of indemnification for the plaintiff was 3614 Euros (3753 Euros in 2022 inflation-adjusted Euros) excluding legal fees. CONCLUSIONS: The analysis of PDI-related liability lawsuits shows that medico-legal issues differ from those of PDI-related insurance claims. Avulsion and luxation of multiple anterior teeth during elective surgery appear to be a risk factor for liability lawsuits. In addition, inadequacy of patient information about PDI-risk seems to be a risk factor for conviction. Lastly, dental injuries are less at risk of civil conviction than other anesthesia-related damages.

Inferior alveolar nerve injury following dental implant placement: A medicolegal analysis of French liability lawsuits.

AIMS: This study thus aimed to review and analyze liability lawsuits resulting from implant surgery-related inferior alveolar nerve (IAN) injury over a twenty-year period in France. MATERIALS AND METHODS: A retrospective descriptive study was performed to analyze judicial decisions pertaining to IAN injury from a legal database between 2000 and 2020. Inclusion criteria comprised all closed malpractice cases that involved an oral and maxillofacial surgeon or a dentist who performed a mandibular implant surgery resulting in IAN injury. The following data were recorded: judicial decision reference (including jurisdiction and date of final court ruling), timing between the incident and final court ruling, number of involved practitioners, patient's age and gender, practitioner's age and gender, implant type, number of implants, location of iatrogenic implant(s), allegation of IAN injury, alleged cause of injury, justification(s) for conviction, compensation amount and legal costs. RESULTS: Twelve judicial decisions from high civil courts relating to ten closed cases of liability lawsuits were included and analyzed. All of involved practitioners were dentists or oral surgeons, working in the private sector. Eventually, 85% of them were convicted. Mean indemnification was 17,340€ and highest indemnification was 42,828€ (inflation-adjusted in 2020 euros). Mean interval between the incident and final ruling was 87,1 ± 34,2 months. CONCLUSIONS: Permanent nerve injury following dental implant placement can result in legal action. In the event of lawsuit, the risk of being convicted is high. Practitioners performing oral implantology procedures should practice effective risk management to avoid time-consuming unwanted litigations and administrative proceedings.

Application of recommended preventive measures against COVID-19 could help mitigate the risk of SARS-CoV-2 infection during dental practice: Results from a follow-up survey of French dentists.

BACKGROUND: During the first-wave of the COVID-19 pandemic, dentists were considered at high-risk of infection. In France, to stop the spread of SARS-CoV-2, a nationwide lockdown was enforced, during which dentists suspended their routine clinical activities, working solely on dental emergencies. This measure has had an indisputable mitigating effect on the pandemic. To continue protecting dentists after suspension of nationwide lockdown, implementation of preventive measures was recommended, including adequate personal protective equipment (PPE) and room aeration between patients. No study has explored whether implementation of such preventive measures since the end of the first-wave has had an impact on the contamination of dentists. METHODS: An online survey was conducted within a French dentist population between July and September 2020. To explore risk factors associated with COVID-19, univariate and multivariate logistic regression analyses were performed. RESULTS: The results showed that COVID-19 prevalence among the 3497 respondents was 3.6%. Wearing surgical masks during non-aerosol generating procedures was a risk factor of COVID-19, whereas reducing the number of patients was a protective factor. CONCLUSIONS: Considering the similar COVID-19 prevalence between dentists and the general population, such data suggest that dentists are not overexposed in their work environment when adequate preventive measures are applied. IMPACT: Dentists should wear specific PPE (FFP2, FFP3 or (K)N95 masks) including during non-aerosol generating procedures and reduce the number of patients to allow proper implementation of disinfection and aeration procedures. Considering the similarities between COVID-19 and other viral respiratory infections, such preventive measures may also be of interest to limit emerging variants spread as well as seasonal viral outbreaks.