Periodontal care · anaesthesia and X-rays · spotting the signs
Professional indemnity insurance (BAV) for a dental hygiene practice
In a dental hygiene practice a mistake is almost always about the patient's teeth or mucosa. That is injury, and the ordinary advisory variant of a BAV does not cover it.
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Deze pagina in het Nederlands: Beroepsaansprakelijkheidsverzekering voor een mondhygiënepraktijk.
The calculator and the quote form below are in Dutch. Prefer to do this in English? Email info@finassverzekert. nl or call 072 - 509 24 56 and we will take it from there.
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A premium indication, not personal advice. Prefer to talk it through? Call 072 - 509 24 56.
In brief
Claims in this profession follow three lines. The first is undertreatment: periodontitis treated for years as gingivitis, with pockets not measured systematically and bone loss only seen late. The result is tooth loss and an extensive course of remedial treatment. The second is damage during treatment: damage to restorations or enamel, injury to the mucosa, or nerve damage after administering an anaesthetic. The third is a missed sign: a mucosal abnormality not referred to the dentist or a specialist.
That is why the form of policy is decisive here. Your mistake leads to damage to health and not merely to financial detriment; choose professional indemnity insurance in which personal injury arising from the practice of your profession is expressly included. The standard is that of the good care provider in Article 7:453 of the Dutch Civil Code. Dental hygienist is an Article 34 profession under the Wet BIG, with a protected qualification title; complaints follow the route laid down by the Wkkgz (the Dutch healthcare quality, complaints and disputes act), with a complaints officer and a disputes body that can award compensation.
What is distinctive about this practice is the question of competence. Whether you administer anaesthetic and take X-rays independently or on the instructions of a dentist depends on your registration and on the rules in force at the time. Record on the policy schedule under which regime you work and which procedures you carry out. As a practice you are also liable for your staff under Article 6:170 of the Dutch Civil Code. For the self-employed professional working in other people's practices, the considerations are set out under the dental hygienist.
This page deals with one situation. The full overview is on Compare professional indemnity insurance (BAV).
What to look out for
Four subjects that make the difference at a dental hygiene practice once a complaint arrives.
Measure, record and compare
Where undertreatment is alleged, your file is the evidence. Recorded pocket measurements, bleeding indices, X-rays with dates and evaluation of the effect of treatment show that you followed the progression. If those are missing, the discussion is not whether you treated well but whether you monitored the course of the condition, and you lose that discussion without records.
Referring on is part of your care
A lesion that does not heal, a suspicious spot on the mucosa or pain that does not fit your findings belong with the dentist or a specialist. Note the advice, the date and whether the patient acted on it. Failing to refer a sign you ought to have recognised is the most serious claim in this profession.
Team, equipment and infection control
Prevention assistants and staff work under your responsibility; check whether they, together with locums and interns, are treated as insured persons. Record maintenance, sterilisation and equipment checks demonstrably. Where cross-infection or a failure of sterilisation is alleged, your log book is the only defence that counts.
What falls outside the policy
Excluded are, among others: damage caused by products you sell, such as bleaching agents or oral care products, because the product liability in Article 6:185 of the Dutch Civil Code applies to those; guarantees of results about colour or appearance; intent and wilful recklessness (Article 7:952 of the Dutch Civil Code); and the redoing free of charge your own treatment.
What does your premium depend on?
- Annual turnover of the practice: the usual basis for dental care practices
- Number of practitioners: staff, locums and assistants count
- Range of treatments: periodontal aftercare and anaesthesia weigh more heavily than cleaning alone
- X-ray diagnostics in-house: calls for demonstrable radiation protection and training
- Sale of products: determines whether product liability has to be added
- Retroactive and run-off periods: periodontal damage often only becomes visible after years
Insurers weigh these details differently. That is where your saving is.
What is covered
| Situation | AVB | BAV |
|---|---|---|
| After an anaesthetic given by your practitioner a patient is left with permanent numbness in the tongue | No | Provided that |
| A crown breaks off during cleaning and has to be remade | No | Provided that |
| A patient incurs costs at another practice to have your treatment done again | No | Yes |
| A supplier trips over a box in your treatment room | Yes | No |
| Your steriliser leaks and damages the coat of a patient in the waiting room | Yes | No |
| A practitioner administers an anaesthetic without the required qualification and the patient is left with symptoms | No | No |
A procedure not stated in your policy wording does not count, even if you carry it out every day.
Frequently asked questions
This is what people ask us most.
A patient accuses us of noticing his periodontitis too late.
The assessment is then whether you measured, evaluated and referred in line with usual practice. Supply your periodontal chart, X-rays and treatment notes to the insurer and report the complaint as soon as you receive it. The fact that the patient did not cooperate sufficiently or cancelled appointments can be taken into account, but only if you recorded it in the file.
We work together with a dental practice. Who is liable?
That depends on who the patient has a treatment agreement with and who carried out the procedure. If you work on instructions, the question arises whether the instruction was correct and complete and whether you stayed within your competence. Record the division of responsibility in writing, including record-keeping and referrals; otherwise both parties point at each other when a claim arises.
Is a complaint to the disputes body also a claim?
Treat it as one. The Wkkgz disputes body can award compensation, so report the complaint to your insurer as soon as it comes in and consult them before you respond on the substance. Article 7:941 of the Dutch Civil Code requires prompt notification, and admitting liability yourself in the complaints procedure can weaken your position with the insurer.
We also whiten teeth. Does that change the cover?
Report it separately. Cosmetic treatments raise different expectations and lead to disputes about the result more often than about the technique. Insurers assess this element separately from regular dental care. Promise no result in terms of colour, record the information you give about sensitivity and effect, and keep a record of which products you use and from which supplier.
Read more
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