Risk Management Tips: Strategies for Avoiding Misdiagnosis of Oral Cancer

Oral cancer is aggressive, and dentists must be constantly vigilant during regular check-ups to assess their patients, particularly those at risk. Although somewhat rare, it’s increasing in prevalence, according to a report by the Oral Health Foundation and Denplan. Oral cancer can be fastmoving; therefore, a missed or delayed diagnosis may have serious consequences for the patient’s health. During COVID-19, people have skipped, delayed or rescheduled appointments, lessening dentists’ opportunity to evaluate suspicious sores or ulcers.

Here are some strategies to consider during routine examinations.

1. Identify at-risk patients by taking a thorough social and medical history.

Be sure to update your patients’ histories regularly. Tobacco and alcohol abuse are common causes of oral cancer. Smokeless tobacco and poor diet have also been linked to the disease. The patient’s history could change between appointments; therefore, it is recommended that this information be updated during each examination, especially for at-risk patients.

2. Ensure your knowledge of early oral cancer detection is commensurate with current standards of practice.

Dentists are the first line of defense against oral cancer. It is important to be able to identify early signs of the disease during regular check-ups. Make sure you are familiar with the latest best practices by completing related continuing education courses.

3. Seek a second opinion or investigate further if indicated.

If a diagnosis is unclear, refer the patient to a specialist for a second opinion. A delay in diagnosis for not acting on an early sign or symptom could lead to a claim of negligence.

4. Document all your examination findings.

Detailed documentation in the dental record of the appointments and findings is important to patient care and can decrease your exposure to claims of negligence should the patient’s clinical condition change between visits at your practice.

5. If you have a reasonable suspicion of a diagnosis of oral cancer, make an immediate referral to a specialist.

Make sure your office has established referral pathways in your geographic area, in the event you identify clinical findings that are suggestive of oral cancer.

6. Communicate thoroughly with the patient: explain your recommended plan of care, coordinate a referral and advise the patient to contact you if there is a delay.

It is important to maintain continuity of care as well as communication with the patient and the consulting dentist, so you are aware of any updates, delays or changes.

7. Follow up with the consulting dentist after the patient’s appointment.

Reliable and comprehensive communication between the referring and the consulting dentist is an integral part of providing good patient care and managing risk, especially when dealing with a serious diagnosis.

Dentists can be at risk for oral cancer-related lawsuits for failure to check the patient for oral cancer during a regular check-up, an inadequate assessment of a suspicious lesion or a delay in referral to a specialist. To keep your patients safe and to protect against allegations of negligence, it is essential to be vigilant and thorough in your patient examinations.

If you would like to read other information for dentists, visit our resources page. Policyholders also have access to MLMIC’s toll free 24/7 Legal Hotline: (855) FAKS-LAW (1-855-325-7529). Our experts are available to help you address any challenges that may arise.