Dental Office Incident Reports: Why They Matter — and What They Should Include

Adapted and expanded from Stephanie Lica, “Dental Office Incident Reports: Why They Matter and What They Include,” June 10 2025, Berxi.

Dentistry’s Unique Risk Landscape

In the world of dental compliance, few topics are more misunderstood than incident reporting. Every dental practice — from solo providers to DSOs — must be prepared to document and, when necessary, report adverse events to their state board.

Medical errors are a major healthcare challenge — research cited by Yale identifies them as the third leading cause of death in the U.S. While hospitals dominate that conversation, dentistry faces its own risks. The National Practitioner Data Bank recorded more than 32,000 adverse action reports involving dentistry between 1990 and 2020 — about 1,400 to 1,500 per year from 2010–2019 (Berxi article).

Unlike large medical centers, most dental offices operate independently. That means you are your own risk manager — which makes a reliable incident-reporting process essential. Reminds me of a song, ‘I’m my own grandpa’. Both the song and the idea that a dentist is their own risk manager are profoundly absurd ideas. While some dentists are phenomenally successful risk managers many suffer from judgement impairment,

Hospitals hire risk managers (other people) to watch over and protect the hospital and physicians. Risk Management is generally not a DIY project; dentists should be proactive and get help BEFORE a risk becomes a problem. Most of what I do is proactive. I can tell you story after story of incidents mitigated by proactive risk management. I can also tell you countless stories of dentists who did not manage their risks and the risk manifested as serious problems (patient deaths, patient hospitalizations, serious employee injuries, and even dentist suicides) – each being preventable and none being acceptable.

Recording vs. Reporting in Dentistry

Not every event you record internally must be reported externally. Recording captures facts for internal accountability and safety improvement; reporting means notifying a regulatory authority (such as your state dental board) when specific thresholds are met.

Quick Reference Table

Note: This table is an educational summary. Always confirm reportability with your state dental board or legal counsel.

What a Dental Incident Report Should Include (Internal Use)

A complete internal report should document:

·         Date and time of the incident

·         Exact location (address and specific room or area)

·         Individuals involved — patient(s), staff, witnesses

·         Objective, chronological description (no opinions or blame)

·         Nature and extent of injuries or harm

·         Immediate actions taken and who was notified

·         Recommendations to prevent future incidents

Complete the report as soon as possible while details are fresh. Remember, an incident report is an administrative document, not part of the clinical chart (Berxi).

State Dental Board Reporting Requirements (Examples)

Below are examples from two states. Always verify with your own state’s dental board.

California

Requirement: Report within 7 days any patient death related to dental treatment and any unscheduled hospitalization or emergency removal of a patient who received oral conscious sedation, conscious sedation, or general anesthesia.

·         Statute: California Business & Professions Code § 1680(z) (link)

·         Form: Dental Board of California Courtesy Form (PDF)

Texas

Requirement: Dentist must report a patient death within 72 hours, and a hospitalization within 30 days, to the Texas State Board of Dental Examiners.

·         Rule: 22 TAC § 108.6

·         Form: TSBDE Self-Report Form (PDF)

The Toothcop’s Pro Tip: Even if your state doesn’t explicitly require reporting every event, treat any serious incident (hospitalization, death, sedation complication) as potentially reportable — and document everything carefully. When a report IS necessary, consider obtaining legal counsel to assist you, to protect your interests, and review your documentation. Legal counsel will often make the notification on your behalf while making sure to assist you with documentation of the incident assuming potential Board action or litigation is likely (CDA – Preparedness is Key).

Record Retention Guidance

Professional Recommendations (from Duane “The Toothcop” Tinker — not statutory unless specified):

1.    Keep incident reports for at least 7 years from the incident or final resolution of any related claim (whichever is longer).

2.    For minors, retain for 7 years past their 18th birthday.

3.    For employee injuries, follow OSHA/state labor requirements (typically the duration of employment plus 30 years).

4.    Store separately from clinical records, securely locked or encrypted, with restricted access.

5.    Periodically audit your incident-report file for completeness and timeliness.

Final Thoughts from The Toothcop

When an adverse event happens — whether a patient fall, equipment failure, or sedation complication — a thorough incident report does more than cover your bases. It shows your team acted responsibly, documented accurately, and learned from the event.

“If it’s worth remembering, it’s worth recording. If it’s reportable — don’t hurry but also don’t wait too long. Reporting at the ‘11^th’ hour is often the best strategy. Conversely, immediate reporting is often met with unnecessary issues – take your time.”

Compliance isn’t about paperwork — it’s about protecting people: your patients, your staff, and your license.

Disclaimer

This article is for educational purposes only and does not constitute medical, legal, or regulatory advice. Dentists should consult their state dental board and legal counsel for requirements specific to their jurisdiction.

Citation

Adapted and expanded from Stephanie Lica, “Dental Office Incident Reports: Why They Matter and What They Include,” June 10 2025, Berxi — https://www.berxi.com/resources/articles/dental-incident-reports/