Evaluation of Medical and Diagnostic Errors in Patients with Compliant without Physical Explanations Referred to Oral Medicine Department of Mashhad Dental Faculty in 2013-2017

The aim of this study was to evaluate the frequency of different types of medical errors in patients having complaints with no physical explanation, referred to Mashhad Dental Faculty Orofacial Pain Clinic. In this cross-sectional/descriptive-analytical study, records of patients referred to the Orofacial Pain Clinic of Mashhad Dental School from 2013 to 2017 were evaluated. A checklist consisting of the following was completed: type of complaint at the visit, method of treatment, diagnostic methods and referral pattern. All the patients had been examined by oral medicine specialists. Their complaints that could not be physically explained based on the history, clinical examinations and paraclinical tests had been evaluated, and the type of sensory disorder had been determined. Furthermore, all the patients had been interviewed by a psychiatrist to determine any psychiatric disorder. The frequency of different types of medical errors, diagnostic methods, psychiatric disorder and sensory impairment were determined and the possible connection was statistically analyzed. Data were analyzed with SPSS (α = 0.05), using frequency tables, graphs and means and standard deviations. ANOVA, t-test and chi-squared test were used to compare the subgroups. In addition, if necessary, non-parametric tests of Mann-Whitney and Kruskal-Wallis were used. The highest frequency of complaints at the time of visit was facial, mandibular or neck pain (74.8%), and the lowest frequency was the complaint about a dull pain in the whole mouth. The most common treatment error was medication errors (49%), followed by tooth extraction. The most common error in diagnostic methods was radiography (65.2%), followed by CT scan (24.1%), and the lowest error occurred in sonography (2.3%). Based on the findings of this study, when a patient with a complaint without any physical explanation is referred to the dental clinic, there is a high probability of diagnostic and therapeutic medical errors. Therefore, it is recommended that specific training programs be organized for dentists to identify complaints with a mental origin and their proper diagnosis or to consider referral of these patients.