Patient safety in hospital dentistry: A model for dentists without operating room privileges

Abstract

A lack of compliance with professional privileging and training requirements is the most common cause of dental malpractice. In hospital dentistry, some dental specialties are trained to treat patients in the operating room, whereas others, including restorative dentists, endodontists, prosthodontists, and periodontists, are occasionally required for dental management under general anesthesia, yet typically hold no operating room privileges. This creates a gap in standardized care and patient-safety compliance. To address this gap, this narrative review proposes a conceptual model that enables non-OR-privileged dental specialists to participate safely in the care of patients requiring multidisciplinary management in the Saudi Arabian healthcare context. The review was developed following the Scale for the Assessment of Narrative Review Articles (SANRA). The model was developed through thematic synthesis of the included literature and gray documents. It comprises four interdependent domains: Governance, Regulatory OR-Safety Requirements, Institutional Privileging, and Proficiency-based Training, collectively termed the GRIP model. These domains interlock through four shared patient-safety outcomes: improved OR efficiency, reduced inappropriate practice, monitoring of potential malpractice, and improved clinical effectiveness. By clarifying the competencies, documentation, and accountabilities of non-OR-privileged dental specialists, the GRIP model might enable their management with the same rigor as that applied to other medical staff, while maintaining efficient hospital-based dental services and patient safety. This conceptual model is intended to guide practice rather than prescribe a single protocol. Yet it can serve as an adaptable reference for health systems in countries seeking to promote patient-centered care across their healthcare settings.