Rising dental litigation in India: what dentists need to know

Historically, patients have held doctors in high esteem, trusting and following their advice without question. However, that trust is now waning, with doctors being sued for negligence and malpractice at an alarming rate all across the globe. India is no exception, with approximately 5.2 million cases filed annually – a fourfold increase over the past decade. [1] Dentists, in particular, face growing scrutiny with claims that can amount to several lakhs.

This is a scenario that any dental practitioner may face and cannot be taken lightly, as the verdict has been going against the dentist in 40% of cases. [2] For the remainder against whom the claims are proved baseless, it is still a loss, as they face significant emotional distress, time loss, and financial costs.

Understanding the causes and costs of litigation is the first step in curbing this challenge.

Why patients are taking dentists to court

The days when a doctor’s decisions and actions were revered as noble are long gone. An increasing number of patients in India are now aware of the Consumer Protection Act (CPA) 1986, which includes dental services. A disgruntled patient filing a lawsuit can tarnish a practitioner’s carefully built reputation and drain their finances.

Common triggers for dental malpractice litigation often arise from routine procedures that unexpectedly go wrong. These include nerve damage during extractions or surgeries, complications from root canals or implants, failure to diagnose serious conditions like oral cancers, and patient dissatisfaction with cosmetic outcomes.

Four key factors are driving the trend:

• Increased patient awareness
  With stronger laws behind them and awareness about their rights, patients are in a position to take the dentist to court for perceived substandard treatment. A dentist in Tamil Nadu was recently ordered to pay ₹10 lakh compensation for a botched extraction in a patient who later died of complications.
• Complex and high-stakes procedures
  With the significant advances made in the diagnostic and therapeutic techniques in healthcare practice, patients’ expectations in care and attention from practitioners have risen. Dentistry is most often associated with malpractice claims in areas where treatments are both expensive and have high aesthetic significance. Advanced treatments, such as implants, maxillofacial surgeries, cosmetic dentistry, and orthodontics, carry higher risks of litigation.
• Incomplete communication on outcomes and possible adverse events
  The doctor-patient relationship has evolved – the latter has a major role in decision-making, which requires them to receive comprehensive information. Failure to clearly explain diagnosis, procedures, and outcomes can lead to patient dissatisfaction. Signed consent forms are crucial for documenting informed consent.
• Providing treatment beyond one’s expertise and training
  A dental practitioner, without specialisation, lacks the expertise to perform advanced procedures such as orthodontics, implantology, or maxillofacial surgery. Attempting these treatments without requisite training can result in complications and be considered malpractice or fraud. A dentist in West Bengal, who performed a tooth extraction during an orthodontic procedure on a young girl, was sued by her father. The doctor, lacking specialised training in orthodontics, lost the case and was ordered to pay Rs 3 lakh in compensation.

These factors are pushing more dentists into costly legal battles.

The hidden costs of litigation: A major professional setback

If a patient is unhappy with the treatment received, they may sue for “failure to provide service” under the CPA, which is the beginning of a legal battle for both the patient and the dentist.

• Outcomes of litigation
  An analysis of 56 dental malpractice cases in India between 2018 and 2022 revealed that private practitioners in urban areas were most frequently involved, with oral surgery and endodontics being the specialties most frequently implicated. [3] In another analysis, about 40% of 111 cases resulted in dentists being found guilty. [2]
• Compensation
  Claims averaged about INR 6 lakhs, with awarded amounts typically being around INR 1 lakh. [2]. Combined with legal defence costs, this can create a significant financial burden.
• Duration of lawsuit
  The time to reach a final judgment takes around 5 years, indicating prolonged legal processes, leading to burnout and strain. [2]
• Impact of evidence
  Not having clinical records and informed consent significantly influenced both the duration of litigation and the outcome, often leading to prolonged or unfavourable verdicts [2]

Aside from compensation amounts, the hidden cost of litigation is far more devastating.

The toll, beyond the court

Even winning can feel like losing when it comes to malpractice litigation. As with all legal suits, being taken to court will have a toll.

• Psychological distress: allegations can trigger anxiety and depression not only in the doctor but also in their family
• Loss in income: cases, even dismissed ones, can cost dentists hundreds of hours of lost practice time
• Reputational damage: the doctor stands to lose his reputation and patient trust, with a real danger of the practice collapsing

This emphasises why dentists must take proactive steps to avoid litigation.

Protecting your practice

The rising dental litigations in India represent a shift in healthcare dynamics that calls for immediate attention. Modern dental practice requires more than clinical excellence. It requires comprehensive risk management.

The question isn't whether litigation will continue to rise. It will. But will you be prepared when it does? In our next article, we'll explore practical strategies to safeguard your practice, from robust documentation systems to professional indemnity insurance options specifically designed for Indian dental professionals.

References

1. Rai S, Devaiah VH. The need for healthcare reforms: Is no-fault liability the solution to medical malpractice? Asian Bioeth Rev. 2019;11(1):81-93. doi:10.1007/s41649-019-00081-7
2. Thavarajah R, Saranya V, Priya B. The Indian dental litigation landscape: An analysis of judgments on dental negligence claims in Indian Consumer Redressal Forums. Journal of Forensic and Legal Medicine. 2019;68:101863. doi:10.1016/j.jflm.2019.101863
3. Vadde SVN, Reddy M, Jois H, Koneru M, Vedati P. Indian dental malpractice claims and lawsuits: a medico-legal analysis. J Int Soc Prev Community Dent. 2024;14(4):295-301. doi:10.4103/jispcd.jispcd_193_23

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