{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T10:56:30Z","timestamp":1791284190920,"version":"4.1.0"},"reference-count":26,"publisher":"Istanbul University","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["eor"],"accepted":{"date-parts":[[2026,8,22]]},"abstract":"<jats:p xml:lang=\"en\">Purpose This study aimed to evaluate the impact of medical malpractice litigation and associated defensive medicine practices on the clinical decision-making of orthodontists. Materials and Methods This study was conducted between December 2025 and February 2026. Questionnaires were emailed to 2,526 orthodontists registered in the database of the Turkish Orthodontic Society (TOD), and 252 orthodontists completed the survey. Of the participants, 64.3% (n = 162) were female and 35.7% (n = 90) were male. In addition to demographic questions, participants completed the Fear of Medical Error Scale (FMS), the Defensive Medicine Practice Attitude Scale (DMPAS), and clinical preference questions specific to orthodontic practice. The level of statistical significance was set at p &lt; 0.05. ResultsOverall, 51.2% (n = 129) of the participants exhibited a high level of fear of medical malpractice. Orthodontists aged over 35 years had significantly lower FMS scores than younger orthodontists. According to the DMPAS, 53.6% of orthodontists exhibited a high level of defensive medicine behavior, while 15.5% exhibited a very high level. ConclusionOrthodontists\u2019 clinical decision-making appears to be influenced by concerns about legal repercussions. To mitigate the legal pressure experienced by physicians, education in health law should be strengthened for physicians and other healthcare professionals, and medical malpractice legislation should be revised to provide a more balanced framework that also safeguards physicians\u2019 rights.<\/jats:p>","DOI":"10.26650\/eor.20261905763","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T22:00:09Z","timestamp":1789768809000},"page":"352-363","update-policy":"https:\/\/doi.org\/10.26650\/iucrossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of malpractice fears and defensive approaches in orthodontists\u2019 clinical practice"],"prefix":"10.26650","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4699-1543","authenticated-orcid":true,"given":"G\u00f6n\u00fcl","family":"Din\u00e7","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/041jyzp61","id-type":"ROR","asserted-by":"publisher"},{"id":"https:\/\/www.isni.org\/0000000121646335","id-type":"ISNI","asserted-by":"publisher"}],"name":"Van Y\u00fcz\u00fcnc\u00fc Y\u0131l \u00dcniversitesi","place":["Van Turkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5846-3177","authenticated-orcid":true,"given":"H\u00fcseyin Melik","family":"B\u00f6y\u00fck","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/041jyzp61","id-type":"ROR","asserted-by":"publisher"},{"id":"https:\/\/www.isni.org\/0000000121646335","id-type":"ISNI","asserted-by":"publisher"}],"name":"Van Y\u00fcz\u00fcnc\u00fc Y\u0131l \u00dcniversitesi","place":["Van Turkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11192","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"1773752","doi-asserted-by":"crossref","unstructured":"Eser Misir S, U\u011frak U, Topsakal KG, Dalgali P, Duran GS, G\u00f6rg\u00fcl\u00fc S. Evaluation of dentists' malpractice fears and defensive dentistry attitudes: scale development. BMC Oral Health. 2025; 25(1): 730 [CrossRef]","DOI":"10.1186\/s12903-025-06103-1","type":"journal-article"},{"key":"1773753","doi-asserted-by":"crossref","unstructured":"Akta\u015f S, Sava\u015f N, Haj\u0131yeva G. Bir \u00dcniversite Hastanesinde \u00c7al\u0131\u015fan Hekimlerin Defansif T\u0131p Uygulama Durumu, Nedenleri ve Sonu\u00e7lar\u0131; Karma Ara\u015ft\u0131rma. Eski\u015fehir T\u00fcrk D\u00fcnyas\u0131 Uygulama ve Ara\u015ft\u0131rma Merkezi Halk Sa\u011fl\u0131\u011f\u0131 Dergisi. 2025; 10(3): 330-344 [CrossRef]","DOI":"10.35232\/estudamhsd.1662347","type":"journal-article"},{"key":"1773754","doi-asserted-by":"crossref","unstructured":"Kessler D, Mcclellan M. Do Doctors Practice Defensive Medicine? Q J Econ. 1996; 111(2): 353-390 [CrossRef]","DOI":"10.2307\/2946682","type":"journal-article"},{"key":"1773755","doi-asserted-by":"crossref","unstructured":"Costanza-Gugiu F, Cernega A, Pi\u021buru SM. Medico-legal implications and risk management strategies in orthodontic practice: an analytical literature review. Healthcare (Basel). 2025; 13(23): 3054 [CrossRef]","DOI":"10.3390\/healthcare13233054","type":"journal-article"},{"key":"1773756","doi-asserted-by":"crossref","unstructured":"Eijkman MAJ, Assink MHJ, Hofmans-Okkes IM. Defensive dental behaviour: illusion or reality? Int Dent J. 1997; 47(5): 298-302 [CrossRef]","DOI":"10.1002\/j.1875-595X.1997.tb00793.x","type":"journal-article"},{"key":"1773757","doi-asserted-by":"crossref","unstructured":"Ba\u015fer A, Ba\u015fer Kolcu M\u0130, Kolcu G, Tuncer \u00d6, Altunta\u015f M. Dentists' Views About Defensive Dentistry: A Crosssectional Study. The Journal of Tepecik Education and Research Hospital. 2014; 24(2): 103-109 [CrossRef]","DOI":"10.5222\/terh.2014.70288","type":"journal-article"},{"key":"1773758","doi-asserted-by":"crossref","unstructured":"Hermer LD, Brody H. Defensive Medicine, Cost Containment, and Reform. Journal of General Internal Medicine. 2010; 25(5): 470-473 [CrossRef]","DOI":"10.1007\/s11606-010-1259-3","type":"journal-article"},{"key":"1773759","doi-asserted-by":"crossref","unstructured":"Pour H, Subramani K, Stevens R. An overview of orthodontic malpractice liability based on survey and case assessment review. J Clin Exp Dent. 2022; 14(9): e694 [CrossRef]","DOI":"10.4317\/jced.59785","type":"journal-article"},{"key":"1773760","doi-asserted-by":"crossref","unstructured":"Yuce E, Yurt K. Two decades of dental malpractice litigations in T\u00fcrkiye: a retrospective matched cohort study analyzing legal and clinical outcomes. BMC Oral Health. 2025; 25(1): 487 [CrossRef]","DOI":"10.1186\/s12903-025-05838-1","type":"journal-article"},{"key":"1773761","doi-asserted-by":"crossref","unstructured":"Mizrahi E. Risk management in clinical practice. Part 7. Dento-legal aspects of orthodontic practice. British Dental Journal. 2010; 209(8): 381-390 [CrossRef]","DOI":"10.1038\/sj.bdj.2010.926","type":"journal-article"},{"key":"1773762","doi-asserted-by":"crossref","unstructured":"Hellyer P, Radford DR. Professional risk perception and behavior in dentistry. Br Dent J. 2017; 223: 885-888","DOI":"10.1038\/sj.bdj.2017.996","type":"journal-article"},{"key":"1773763","unstructured":"Jones T, Patel R. Root resorption and orthodontic treatment complications. Am J Orthod Dentofacial Orthop. 2020; 157: 367-375","type":"journal-article"},{"key":"1773764","unstructured":"Liu H, Chen Y. Periodontal effects of orthodontic interventions: a systematic review. 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Di\u015f hekimlerinin defansif t\u0131p uygulamalar\u0131 konusunda tutumlar\u0131n\u0131n de\u011ferlendirilmesi. J Biotechnol Strategic Health Res. 2018; 2: 165-173","type":"journal-article"},{"key":"1773773","doi-asserted-by":"crossref","unstructured":"\u00d6zata M, Terlemez A, \u00d6zer K, Akkoca Y. Defensive Dentistry: The Example of Konya. Turkiye Klinikleri Journal of Health Sciences. 2019; 4(2): 179-188 [CrossRef]","DOI":"10.5336\/healthsci.2018-63278","type":"journal-article"},{"key":"1773774","doi-asserted-by":"crossref","unstructured":"Plebani M. Defensive medicine and diagnostic testing. Diagnosis (Berl). 2014; 1(2): 151-154 [CrossRef]","DOI":"10.1515\/dx-2014-0002","type":"journal-article"},{"key":"1773775","unstructured":"Banaz M, Bal\u00e7\u0131k Y. Hekimlerin defansif t\u0131p tutumlar\u0131n\u0131n incelenmesi. Hacettepe Sa\u011fl\u0131k \u0130daresi Derg. 2022; 25: 501-516","type":"journal-article"},{"key":"1773776","doi-asserted-by":"crossref","unstructured":"Demir AK, Ulusoy H. Perceptions of Patient Safety Culture of Dentistry Students and Dentists in a Faculty of Dentistry. International Journal of Health Management and Tourism. 2022; 12: 85-96 [CrossRef]","DOI":"10.31201\/ijhmt.1199319","type":"journal-article"},{"key":"1773777","doi-asserted-by":"crossref","unstructured":"Hamasaki T, Hagihara A. Dentists' Legal Liability and Duty of Explanation in Dental Malpractice Litigation in Japan. 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