Complaint trends of dental malpractice in Tehran, Iran: a retrospective study (2016-2022).

Abstract

This study aimed to evaluate the frequency and causes of dental malpractice complaints filed with the Forensic Medical Commission (FMC) of Tehran Province from 2016 to 2022. A retrospective cross-sectional study was conducted using 450 case files selected by simple random sampling technique. Data on plaintiffs' and defendants' age, gender, and education level, type of treatment, time between treatment and complaint, commission verdict, defendant specialty, and treatment location were extracted and analyzed using the Chi-square test, forward stepwise multiple logistic regression, and Joinpoint regression, performed in IBM SPSS Statistics version 26. (α = 0.05). A total of 450 dental malpractice complaints were reviewed, all of which met the inclusion criteria for final analysis. The majority of defendants (70.7%) were males aged 46 to 55 years, while 57.6% of plaintiffs were females. Among defendants, 82.7% were general dentists, and 12.9% were non-dentist operators.The annual distribution of complaints was 45 in 2016, 47 in 2017, 54 in 2018, 71 in 2019, 54 in 2020, 81 in 2021, and 98 in 2022. Dental clinicians were found guilty in 61.3% of cases (n = 276). The most frequent complaints were related to prosthetic treatments (20.4%), dental implants (17.8%), and extractions (14.4%). The highest malpractice rates were observed in endodontic and prosthetic crown treatments (85.2%), followed by endodontic (66.7%), implant (66.3%), aesthetic (66.1%), and fixed prosthetic (62.8%) procedures. Malpractice was confirmed in 64.5% of complaints by females and 57.1% by males. From 2016 to 2022, dental malpractice complaints in Tehran Province showed a clear upward trend, with defendants held liable in 61.3% of cases, most commonly involving prosthetic treatments, implants, and extractions. Non‑dentist operators faced higher odds of conviction than generalists or specialists, while general dentists accounted for the majority of complaints. Female plaintiffs were more likely to have confirmed malpractice than males, and combined endodontic‑crown procedures posed the highest risk. These results highlight the urgent need for targeted training and tighter regulation to enhance patient safety and curb litigation.